JEFFERSON MEMORIAL HOSPITAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- JEFFERSON MEMORIAL HOSPITAL (EIN 55-0359755)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201203209349302860
- Schema version
- 2011v1.2
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-14T12:50:56-00:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550359755 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jefferson Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | JEFF | NameControl |
| Phone | 3042641358 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 Foundation Way Room No 2310 | AddressLine1 |
| City | Martinsburg | City |
| State | WV | State |
| ZIP Code | 25401 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Christopher Knight | Name |
| Title | Vice President of Finance | Title |
| Phone | 3042641358 | Phone |
| Date Signed | 2012-10-23 | DateSigned |
| Authorize Third Party | false | AuthorizeThirdParty |
| 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 | Christopher Knight | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 Foundation Way Suite 2310 | AddressLine1 |
| City | Martinsburg | City |
| State | WV | State |
| ZIP Code | 25401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 50450329 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.wvuh-east.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1912 | YearFormation |
| State Legal Domicile | WV | StateLegalDomicile |
| Activity Or Mission Description | Jefferson Memorial Hospital is a non profit, critical access hospital serving the residents of the Eastern Panhandle of WV, that strives to improve the health status of Eastern Panhandle residents by providing high-quality, health and wellness service regardless of the patients ability to pay. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 463 | TotalNbrEmployees |
| Total Nbr Volunteers | 28 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 1433719 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 137889 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 44332363 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 49594533 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 33039 | InvestmentIncomePriorYear |
| Investment Income Current Year | -4920 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 366605 | OtherRevenuePriorYear |
| Other Revenue Current Year | 500545 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 46165726 | TotalRevenuePriorYear |
| Total Revenue Current Year | 50228047 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 3956 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 4174 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 20645090 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 20577322 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 21504131 | OtherExpensePriorYear |
| Other Expenses Current Year | 23794875 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 42153177 | TotalExpensesPriorYear |
| Total Expenses Current Year | 44376371 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4012549 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5851676 | RevenuesLessExpensesCY |
| Total Assets BOY | 37270656 | TotalAssetsBOY |
| Total Assets EOY | 44304321 | TotalAssetsEOY |
| Total Liabilities BOY | 20336527 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 21737507 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 16934129 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 22566814 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Jefferson Memorial Hospital is a non profit critical access hospital serving the residents in the Eastern Panhandle of WV. It operates a 24/7 emergency room. Jefferson Memorial Hospital is organized to provide quality hospital patient care services to the Eastern Panhandle of WV regardless of the patients ability to pay. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 9968264 | Expense |
| Revenue | 19657393 | Revenue |
| Description | As a not for profit critical access hospital, Jefferson Memorial provides general medical services in the community of Ranson, WV. Such services include family medicine, internal medicine, observation to see if hospital admission is necessary, and outpatient ancillary testing. During 2011, Jefferson Memorial documented 1,285 outpatients in the observation status and 41,998 outpatient ancillary tests were performed. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2007628 | Expense |
| Revenue | 3959039 | Revenue |
| Description | Jefferson Memorial Hospital provides general surgical services to those residents in need located in Ranson, WV. JMH operates as a critical access hospital and operates a 24 hour per day, 7 day per week emergency department which cares for patients regardless of their ability to pay. The hospital also provides a One Day Surgical Unit that provided care to 2,335 patients during 2011. These patients undergo procedures by a variety of surgical subspecialties, including opthalmology, otolarynology, urology, gastroenterology, orthopedics, and gynecology. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1095279 | Expense |
| Revenue | 2159889 | Revenue |
| Description | Jefferson Memorial Hospitals Obstetrics Unit features family centered maternity care services that include birthing rooms, whirlpools, rooming in and sibling visitation. In 2011, Jefferson Memorial Hospital reported 293 births. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 19301873 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 4147 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 23818212 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 32373044 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | true | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 73 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 463 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Christopher Knight | NamePerson |
| Telephone Number | 3042641000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 Foundation Way Suite 2310 | AddressLine1 |
| City | Martinsburg | City |
| State | WV | State |
| ZIP Code | 25401 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Richard Pill | |||||||
| Chairman | 001.00 | X | X | 0 | 0 | 0 | |
| Walter Washington | |||||||
| Vice-Chairman | 001.00 | X | X | 0 | 0 | 0 | |
| Robert Baronner Jr | |||||||
| Treasurer | 001.00 | X | X | 0 | 0 | 0 | |
| Sheila Hamilton | |||||||
| Secretary | 001.00 | X | X | 0 | 0 | 0 | |
| Keith B Berkeley DVM | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Dawn Jones MD | |||||||
| Director/ CHI Med Staff President | 001.00 | X | 0 | 0 | 0 | ||
| Dr Richard Knapp | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| D Scott Roach | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Fred Butcher PhD | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| David A Baltierra MD | |||||||
| Director/ JMH Med Staff President | 001.00 | X | 0 | 0 | 0 | ||
| Jeffrey B DeBord DO | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Betty Gunnoe | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Rhonda Monroe | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Nicholas Trietsch | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Mitch Jazques MD | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Christina Coad | |||||||
| CAO | 050.00 | X | 244056 | 0 | 0 | ||
| KC Nau MD | |||||||
| VP Medical Affairs | 050.00 | X | 237152 | 0 | 0 | ||
| Charles Keeling | |||||||
| CRNA | 040.00 | 247878 | 0 | 16412 | X | ||
| Gary Matthews | |||||||
| Pharmacy Director | 040.00 | 135953 | 0 | 27280 | X | ||
| Ray Bernard | |||||||
| CRNA | 040.00 | 191146 | 0 | 19971 | X | ||
| Ryan Nau | |||||||
| CRNA | 040.00 | 198898 | 0 | 17723 | X | ||
| Frew Nagatu | |||||||
| Pharmacist | 043.00 | 134603 | 0 | 25780 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1389686 | TotalReportableCompFromOrg |
| Total Other Compensation | 107166 | TotalOtherCompensation |
| Number Individuals GT100 K | 11 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Alliance Healthcare Services | |||||
| 100 Bayview Cir | Newport Beach | CA | 92660 | Mobile MRI Equipment | 349702 |
| JMH Emergency Physicians | |||||
| 20010 Century Blvd suite 200 | Germantown | MD | 20874 | Medical Staff Coverage | 318195 |
| Quest Diagnostic | |||||
| 14225 Newbrook Dr | Chantily | VA | 20151 | Medical Services | 230528 |
| Ready Tech-Go Inc | |||||
| PO Box 1027 | Fremont | NE | 68026 | Medical Staff Coverage | 134205 |
| Handcraft Cleaners and Laundry | |||||
| 1501 Roseneath Road | Richmond | VA | 23230 | Linen Services | 203200 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Related Organizations | 123386 | RelatedOrganizations |
| Government Grants | 14503 | GovernmentGrants |
| Total Contributions | 137889 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Service Revenue | Description |
| Total Revenue Column | 49594533 | TotalRevenueColumn |
| Related Or Exempt Function Income | 49594533 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 49594533 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 217362 | TotalRevenueColumn |
| Exclusion | $217,362 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 222282 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -222282 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -222282 | TotalRevenueColumn |
| Exclusion | -$222,282 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|
| Cafeteria Income | 133724 | $133,724 |
| Patient Pharmacy Income | 136606 | $136,606 |
| Cash Discounts | 143609 | $143,609 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 86606 | TotalRevenueColumn |
| Exclusion | $86,606 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 500545 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 50228047 | TotalRevenueColumn |
| Related Or Exempt Function Income | 49594533 | RelatedOrExemptFunctionIncome |
| Exclusion | $495,625 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4174 | Total |
| Program Services | 4174 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 481207 | Total |
| Management And General | 481207 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16291582 | Total |
| Program Services | 12914975 | ProgramServices |
| Management And General | 3376607 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 409936 | Total |
| Program Services | 324972 | ProgramServices |
| Management And General | 84964 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1967611 | Total |
| Program Services | 1559802 | ProgramServices |
| Management And General | 407809 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1426986 | Total |
| Program Services | 1131228 | ProgramServices |
| Management And General | 295758 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54861 | Total |
| Program Services | 2063 | ProgramServices |
| Management And General | 52798 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20703 | Total |
| Program Services | 4325 | ProgramServices |
| Management And General | 16378 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7097 | Total |
| Management And General | 7097 | ManagementAndGeneral |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees For Services Prof Fundraising | FeesForServicesProfFundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4972211 | Total |
| Program Services | 3710053 | ProgramServices |
| Management And General | 1262158 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 111967 | Total |
| Program Services | 1643 | ProgramServices |
| Management And General | 110324 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6041774 | Total |
| Program Services | 5020149 | ProgramServices |
| Management And General | 1021625 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66273 | Total |
| Program Services | 14198 | ProgramServices |
| Management And General | 52075 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 747061 | Total |
| Program Services | 71865 | ProgramServices |
| Management And General | 675196 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109511 | Total |
| Program Services | 19897 | ProgramServices |
| Management And General | 89614 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 636107 | Total |
| Management And General | 636107 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2594257 | Total |
| Management And General | 2594257 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 156651 | Total |
| Management And General | 156651 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Provision for Doubtful Accounts | 6554781 | 6554781 | |
| Association Dues | 62922 | 18309 | 44613 |
| Educational Training | 42405 | 3237 | 39168 |
| Taxes, Licenses, Fees | 1228580 | 879153 | 349427 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 387714 | Total |
| Program Services | 138220 | ProgramServices |
| Management And General | 249494 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44376371 | Total |
| Program Services | 32373044 | ProgramServices |
| Management And General | 12003327 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1294 | BOY |
| EOY | 56979 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5910745 | BOY |
| EOY | 6844389 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5000790 | BOY |
| EOY | 5816112 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 422733 | BOY |
| EOY | 420000 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 401351 | BOY |
| EOY | 362314 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104513 | BOY |
| EOY | 114159 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 31454357 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 14248772 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17158186 | BOY |
| EOY | 17205585 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6587889 | BOY |
| EOY | 11777349 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1683155 | BOY |
| EOY | 1707434 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37270656 | BOY |
| EOY | 44304321 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6236759 | BOY |
| EOY | 7966946 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12304687 | BOY |
| EOY | 11899811 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 839898 | BOY |
| EOY | 679373 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 955183 | BOY |
| EOY | 1191377 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20336527 | BOY |
| EOY | 21737507 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11871306 | BOY |
| EOY | 17503991 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 137549 | BOY |
| EOY | 137549 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4925274 | BOY |
| EOY | 4925274 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16934129 | BOY |
| EOY | 22566814 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37270656 | BOY |
| EOY | 44304321 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 5851676 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -218991 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| Public Support Pertcentage170 | 0.00000 | PublicSupportPertcentage170 |
| Public Support Percentage509 | 0.00000 | PublicSupportPercentage509 |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Direct Contact Legislators | true | DirectContactLegislators |
| Direct Contact Legislators | $7,097 | DirectContactLegislatorsAmount |
| Total Lobbying Expenditures IIB | 7097 | TotalLobbyingExpendituresIIB |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | II-B | Identifier |
| Return Reference | 1g | ReturnReference |
| Explanation | As a member of the WV Hospital Association and the American Hospital Assoiation, a portion of the dues paid have been identified by the above mentioned organizations as attributable to lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Included On FS | false | IncludedOnFS |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 417155 | OtherCostOrOtherBasis |
| Book Value | 417155 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16263752 | OtherCostOrOtherBasis |
| Depreciation | 5212647 | Depreciation |
| Book Value | 11051105 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 45647 | OtherCostOrOtherBasis |
| Depreciation | 32413 | Depreciation |
| Book Value | 13234 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12325180 | OtherCostOrOtherBasis |
| Depreciation | 7303566 | Depreciation |
| Book Value | 5021614 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2402623 | OtherCostOrOtherBasis |
| Depreciation | 1700146 | Depreciation |
| Book Value | 702477 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 17205585 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (5 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Beneficial Interests in Perpetual Trusts | 4744893 | F |
| Bond Fund | 7887 | F |
| Other Investments | 994584 | F |
| Funded Depreciation | 5299402 | F |
| Self Insurance Fund | 730583 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 11777349 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Capital Leases | $145,979 |
| Self Insurance Liabilities | $629,135 |
| Interest Rate Swaps | $416,263 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1191377 | TotalOfAmounts |
| Total Revenue | 50228047 | TotalRevenue |
| Total Expenses | 44376371 | TotalExpenses |
| Excess Or Deficit For Year | 5851676 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -326087 | NetUnrealizedGLOnInvestments |
| Other | $107,096 | OtherAmount |
| Total Adjustments | -218991 | TotalAdjustments |
| Excess Or Deficit Per FS | 5632685 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 49990972 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -327049 | NetUnrealizedGainsInvestments |
| Other Revenues | 206506 | OtherRevenues |
| Revenue Not Rptd F990 | -120543 | RevenueNotRptdF990 |
| Revenue Subtotal | 50111515 | RevenueSubtotal |
| Other Revenues Not Included | 116532 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 116532 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 50228047 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 44360595 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -15776 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -15776 | ExpensesNotRptdF990 |
| Expenses Subtotal | 44376371 | ExpensesSubtotal |
| Total Expenses Per Form990 | 44376371 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| X | 2 | The annual audit and financial statements of Jefferson Memorial Hospital are prepared on a consolidated basis as a member of the WV United Health System. The System accounts for uncertainty in income taxes using a recognition threshold of more-likely-than not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. There were no tax uncertainties that met the recognition threshold in 2011. |
| XI | 8 | The amount on Line 8 consists of 223,628 related organization capitalization and 116,532 of capital campaign contributions from Jefferson Healthcare Foundation posted to balance sheet accounts. |
| XII | 2d | The amount shown on line 2d consists of 206,506 Loss of change in fair value of derivative financial instruments. |
| XII | 4b | The amount shown on line 4b consists of 116,532 of capital campaign contributions from Jefferson Healthcare Foundation posted to balance sheet accounts. |
| XIII | 2d | The amount shown on line 2d consists of 206,506 Loss of change in fair value of derivative financial instruments and 222,282 Loss on disposal of assets. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2315209 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1042032 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1273177 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03370 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8332722 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6135291 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2197431 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05810 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 170382 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 125208 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 45174 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10818313 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7302531 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3515782 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09300 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 37538 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1320 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 36218 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 610333 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 610333 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01610 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 276 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 276 | NetCommunityBenefitExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 648147 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1320 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 646827 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01710 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11466460 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7303851 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4162609 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11010 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 9247 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 9247 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 9247 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 9247 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $2,166,363 | BadDebtExpenseAmount |
| Amount Attributable To | 109939 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 11528098 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 11672264 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -144166 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | 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 | Jefferson Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 South Preston Street | AddressLine1 |
| City | Ranson | City |
| State | WV | State |
| ZIP Code | 25438 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Teaching Hospital | X | TeachingHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI (36 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part I line 3c | Jefferson Memorial Hospital JMH uses 200 Federal Poverty Guideline to determine free care eligibility. JMH does not offer discounted care to individuals who do not qualify for free care. |
| Part I line 6a | Community Benefit amounts for Jefferson Memorial Hospital are reported on WV United Health Systems website www.wvunitedhealthsystem.org under community responsibility report. |
| Part I line 7 | Worksheet 2 from the IRS Schedule H instructions was used to derive the Cost-to-charge ratio, which was used to calculate Charity Care, Unreimbursed Medicaid and other means-tested government programs at cost. To calculate the Medicare allowable cost shown in Part III question 8 we used the allowable costs from the Medicare Cost report. |
| Part I line 7 | Column f - Total community benefit expense for 2011 is 11,466,460 and is 25.84 of total net expenses. To calculate net expense, bad debt of 6,554,781 was deducted from total expenses of 44,376,371 as shown in Part IX line 25 of the core Form 990. |
| Part II | Physical improvements and housing - Jefferson Memorial Hospital employees spent a weekday volunteering at two local social service agencies on behalf of the United Way of the Eastern Panhandle. |
| Part II | Community Support - We sponsor and have a team participate in the annual March of Dimes Walk Jefferson County, American Cancer Society Relay for Life in Jefferson County and various other fundraising events for local, health related, non-profit organizations. Many WVUH-East employees serve as volunteer board directors on community non-profit organizations such as Hospice of the Panhandle, Boys Girls Club of the Eastern Panhandle, Eastern Panhandle Free Clinic and the United Way of the Eastern Panhandle. |
| Part II | Coalition building - JMH staff participate in the Health Human Services Council as well as Community Health Initiative -Healthier Jefferson County. These activities focus on improving community access to health care, human services in general, and determine ways to encourage healthy lifestyles. JMH also sponsored health and wellness events with the local schools and Jefferson County Parks Recreation. |
| Part II | Community health improvement advocacy - WVUH-East is also a partner in the MAPP project which is a collaborative initiative to assess community social services needs and develop a plan to tackle these issues. In 2011, Jefferson Memorial Hospital also began data collection thru a survey, focus groups and face-to-face interviews as part of a community health needs assessment to develop a plan to address health needs in the community. |
| Part II | Workforce Development - WVUH-East is a major sponsor of the Womens Network, which is a new organization established by the Berkeley and Jefferson County Chambers. This group sponsors womens professional activities, social networking and professional development seminars. Jefferson Memorial Hospital also has agreements with area community colleges and universities to allow students to complete clinical rotations at the hospital. |
| Part III line 4 | Jefferson Memorial Hospitals financial statements are prepared on a consolidated bases as a member of WV United Health System. The footnote for Accounts Receivable - Patients states Accounts receivable are reported at net realizable value. Accounts are written off when they are determined to be uncollectible based upon managements assessment of individual accounts. |
| Part III line 4 | The allowance for doubtful accounts is estimated based upon a periodic review of the accounts receivable aging, payor classifications, and application of historical write-off percentages. |
| Part III line 4 | JMH grants credit without collateral to its patients, most of whom are local residents and are insured under third-party agreements, primarily with Medicare, Medicaid, and various commercial insurance companies. JMH maintians allowances for potential credit losses and such losses have historically been within managements expectations. |
| Part III line 4 | Bad Debt Expense at Cost on Line 2 was calculated by multiplying bad debt expense of 6,554,781 by our cost-to-charge ratio of 60.10 for a total of 3,939,423 less DSH allocations to self-pay patient accounts of 1,773,060 for a total of 2,166,363. |
| Part III line 4 | Estimated bad debt attributable to patients eligible for charity care on Line 3 was calculated by pulling all outstanding patient balances of 15,000 or greater from our patient accounting system. That report totaled 182,926 which was then multiplied by the cost-to-charge ratio of 60.10 for a total of 109,939. |
| Part III line 4 | We feel that, at a minimum, the estimated bad debt attributable to patients eligible for charity care of 109,939 should be considered community benefit due to the fact that patients requiring such extensive care more than likely have suffered a catastrophic illness or injury and would have qualified for charity care if paperwork was completed. |
| Part III line 8 | The amount reported in Part III Line 6 11,672,264 was calculated using the total Medicare allowable cost from the Medicare cost report. |
| Part III line 8 | Jefferson Memorial Hospitals 144,166 shortfall of Medicare program reimbursement should be considered a community benefit because we are relieving a government burden by providing care in excess of our costs to these patients. |
| Part III line 9b | Yes, JMH does have a debt collection policy. The policy does not yet address collection practices to be followed for patients who are known to qualify for charity care or financial assistance. |
| Part V | Line 21 - JMH charges all patients with or without insurance gross charges for services rendered. |
| Part VI Line 2 | Jefferson Memorial Hospital is a critical care hospital within the health care system of West Virginia University Hospitals, East WVUH-East. The WVUH-East Marketing Department considers several components in assessing how the organization determines the needs of the communities it serves. Through outside consultants to collaborating with various departments, a needs assessment takes into account several factors including physicians to population ratios, physician availability in the entire |
| Part VI Line 2 | service area, and the general health risks for our community. The Primary Service Area PSA for WVUH-East includes Berkeley and Jefferson Counties in West Virginia, with Morgan County, WV being a secondary service area. This data is then analyzed to provide general estimates to where WVUH-East could better care for the residents of West Virginias Eastern Panhandle. |
| Part VI Line 2 | Sources utilized to help gather this information come from a variety of areas. Physician distribution and population data come from the American Medical Association and the U.S. Census Bureau, the general health risk for our community come from clinical diagnosis information gathered by the West Virginia Health Care Authority and Thomson Rueters Market Planner Plus. We also conduct market research to ask consumers how the perceive the health system and where they go for health care services. |
| Part VI Line 2 | Once all the data is gathered to determine where residents of West Virginia are going for care and what types of services they are receiving, a needs assessment can then begin based on physician distribution and population estimates. WVUH-East is working with other local organizations in a project known as MAPP Mobilizing for Action through Planning and Partnership to create and implement a community health improvement plan. |
| Part VI Line 3 | JMH employs 2 financial analysts to meet with patients to discuss financial eligibility for our charity care program. JMH has applications for charity and the qualification requirements for receiving charity available at all registration areas for both facilities. Patients who do not qualify for state or federal funded programs can apply for the charity care program at WVUH-East. |
| Part VI Line 4 | Jefferson Memorial Hospital is a non-profit critical access hospital located in Jefferson County, WV population 53,498 in the city of Ranson with a total population of 3,000 residents. Jefferson Memorial Hospital along with City Hospital located in Martinsburg makes up West Virginia University Hospitals - East WVUH-East which is a part of West Virginia United Health Systems. |
| Part VI Line 4 | WVUH-East provides the majority of inpatient services for the population in our PSA. The PSA for WVUH-East includes Berkeley and Jefferson Counties in WV. The 2010 market share for Jefferson Memorials Primary Service Area is 10.67 with 19.3 of those patients covered by Medicaid and 10.9 of the patients are uninsured. City Hospital, Inc. a non-profit acute care hospital under common management, is within the PSA and War Memorial Hospital, a non-profit critical access hospital, |
| Part VI Line 4 | operated by Valley Health System, is in the secondary service area. |
| Part VI Line 4 | Jefferson County, WV population is 53,498, with an average household income of 44,374 and an unemployment rate of 5.9. Currently, 10.3 of Jefferson county residents live below the poverty line according to the US Census Bureau 2010 census. Berkeley County has a population of 104,169, an average household income of 38,763 and an unemployment rate of 8.1. |
| Part VI Line 4 | 11.5 of Berkeley County residents in 2010 lived below the poverty line. In the extended service area, Morgan County has a population of 17,541, with an average household income of 35,016 and unemployment of 9.0. 10.4 of Morgan County residents currently live below the poverty line. |
| Part VI Line 5 | The JMH board of directors is a community board, with fourteen of the fifteen members living in or around Jefferson County. The remaining board member lives in Morgantown, WV and has connections with JMH through the WV United Health System. Having members living outside our PSA allows us to be more aware of the healthcare needs in other areas of West Virginia. None of the board members are neither employees nor contractors of the organization, nor family members thereof. |
| Part VI Line 5 | JMH extends privileges to all qualified medical staff in Jefferson County and surrounding communities to meet its healthcare needs. |
| Part VI Line 5 | JMH allocates available funding to capital purchases and expanded services to improve patient care, support medical education in Jefferson County and surrounding counties in West Virginia and bordering states. |
| Part VI Line 5 | In 2009, WVUH-East started offering discounted screening in response to a struggling economy. Recognizing that individuals were putting off scheduling routine, preventive testing such as mammograms and blood work, WVUH-East offered Discounted Mammogram Clinics in April and October 2011 cash, no insurance. The clinics were successful in serving over 50 patients at Jefferson Memorial Hospital. |
| Part VI Line 5 | Our Mini-Medical School Program, which is held twice a year in Jefferson County, is a community health education program featuring local physicians and topics that address health needs in our communities. The program is jointly sponsored by WVUH-East and the WVU Robert C. Byrd Health Sciences Center Eastern Division. It is offered free to the community with an average attendance of 20 - 30 in Jefferson County. |
| Part VI Line 6 | JMH is a part of the WV United Health System. JMH plays a significant role in improving the general health care of the community. The strategic plan of the System states intent to build a regional health care delivery system in its services area, defined above, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves. |
| Part VI Line 6 | System management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems services areas. Other hospitals in the System include United Health Center, which is more centrally located in the state, City Hospital, Inc. which is located in the Eastern Panhandle of West Virginia, West Virginia University Hospital located in Morgantown, WV, and Camden-Clark Medical Center in Parkersburg, WV. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg |
|---|---|---|---|---|
| Christina Coad | ||||
| 231934 | 10807 | 1314 | 244055 | |
| KC Nau MD | ||||
| 200429 | 34401 | 2322 | 237152 | |
| Charles Keeling | ||||
| 247620 | 258 | 264290 | 16412 | |
| Gary Matthews | ||||
| 135683 | 270 | 163233 | 27280 | |
| Ray Bernard | ||||
| 190948 | 198 | 211117 | 19971 | |
| Ryan Nau | ||||
| 198855 | 43 | 216621 | 17723 | |
| Frew Nagatu | ||||
| 134465 | 138 | 160383 | 25780 | |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990 Part IV | 24a | Bond issuances allocated to Jefferson Memorial Hospital are being reported on Schedule K of West Virginia University Hospitals, Inc EIN 55-0643304. West Virginia University Hospitals, Inc is a 501c3 and is the parent hospital of Jefferson Memorial Hospital. |
| Form 990 Part VI | 11b | The Form 990 is prepared by the WVUH accounting department and then reviewed by the WVUH-East controller. Upon approval, it is then reviewed by the WVUH-East Vice President of Finance. After approval by the VP of Finance, it is presented to all Board Members for final review and approval. After it is approved by the Board of Directors, it is signed and submitted to the IRS. |
| Form 990 Part VI | 12c | Each board member is required to disclose, annually, any relationships which may give rise to a potential conflict of interest. These responses are processed and maintained by the WVUH-East Compliance Committee. All board members are to be willing to identify conflicts of interest and abstain from voting when apropriate. |
| Form 990 Part VI | 15b | Executive compensation is based upon the work of an independent salary consulting firm, which compiles data from comparable facilities in comparable geographic regions. The information is then used by the board of directors and compensation committee to set salaries. This work is documented and retained. |
| Form 990 Part VI | 19 | All financial and governing documents are maintained on site and made available to the public upon written request. |
| Form 990 Part VI | 1ab | One board member is considered not independent due to being an independent contractor affiliated with the hospitals of WVUH-East, Inc. |
| Form 990 Part XI | 5 | Other changes in net assets consists of 326,087 of net unrealized loss, 223,628 related organization capitalization and capital campaign contributions of 116,532 posted to Jefferson Memorial balance sheet. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 19,301,873, Grants and allocations 4,147, Revenue 23,818,212 Jefferson Memorial Hospital JMH is a not-for-profit critical access hospital that operates twenty-four 24 hours a day, seven 7 days a week. The hospital offers acute care services, as well as emergency services. It serves as part of a regional health system, West Virginia University Hospitals-East, Inc. WVUH-East which serves Berkeley, Jefferson and Morgan Counties. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 0, Grants and allocations 0, Revenue 0 The WVUH-East Board of Directors serves as the official Board for JMH. This Board includes representatives from the medical community, business and industry, labor, and advocates for the poor in Berkeley and Jefferson Counties. WVUs Vice President of Health Services in Morgantown and the Dean of the WVU School of Medicine-Eastern Division also serve as Board Directors. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 0, Grants and allocations 0, Revenue 0 Other services provided by Jefferson Memorial Hospital, in addition to patient care, include a teaching program and a variety of community outreach involvement programs. In 2011, JMH continued to use surveying vendor Press Ganey. With over 900 hospitals in their database, this vendor offers comparison of JMH survey results to a much larger base of hospitals, creating more opportunities for future improvements. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 0, Grants and allocations 0, Revenue 0 In 2011, JMH completed renovations of the third floor and planned for a remodel of the surgery department. A spiritual care program was also established and volunteer chaplains were recruited to staff the service. Perhaps the biggest event for JMH in 2011 was the announcement of the purchase of 50 acres of land in Jefferson County that will be developed into a new medical campus. |
| Form 990, Part III, Line 4d Program Service Expenses 19,301,873, Grants and allocations 4,147, Revenue 23,818,212 Jefferson Memorial Hospital JMH is a not-for-profit critical access hospital that operates twenty-four 24 hours a day, seven 7 days a week. The hospital offers acute care services, as well as emergency services. It serves as part of a regional health system, West Virginia University Hospitals-East, Inc. WVUH-East which serves Berkeley, Jefferson and Morgan Counties. Form 990, Part III, Line 4d Program Service Expenses 0, Grants and allocations 0, Revenue 0 The WVUH-East Board of Directors serves as the official Board for JMH. This Board includes representatives from the medical community, business and industry, labor, and advocates for the poor in Berkeley and Jefferson Counties. WVUs Vice President of Health Services in Morgantown and the Dean of the WVU School of Medicine-Eastern Division also serve as Board Directors. Form 990, Part III, Line 4d Program Service Expenses 0, Grants and allocations 0, Revenue 0 Other services provided by Jefferson Memorial Hospital, in addition to patient care, include a teaching program and a variety of community outreach involvement programs. In 2011, JMH continued to use surveying vendor Press Ganey. With over 900 hospitals in their database, this vendor offers comparison of JMH survey results to a much larger base of hospitals, creating more opportunities for future improvements. Form 990, Part III, Line 4d Program Service Expenses 0, Grants and allocations 0, Revenue 0 In 2011, JMH completed renovations of the third floor and planned for a remodel of the surgery department. A spiritual care program was also established and volunteer chaplains were recruited to staff the service. Perhaps the biggest event for JMH in 2011 was the announcement of the purchase of 50 acres of land in Jefferson County that will be developed into a new medical campus. Form 990 Part IV Line 24a Bond issuances allocated to Jefferson Memorial Hospital are being reported on Schedule K of West Virginia University Hospitals, Inc EIN 55-0643304. West Virginia University Hospitals, Inc is a 501c3 and is the parent hospital of Jefferson Memorial Hospital. Form 990 Part VI Section B Line 11b The Form 990 is prepared by the WVUH accounting department and then reviewed by the WVUH-East controller. Upon approval, it is then reviewed by the WVUH-East Vice President of Finance. After approval by the VP of Finance, it is presented to all Board Members for final review and approval. After it is approved by the Board of Directors, it is signed and submitted to the IRS. Form 990 Part VI Section B Line 12c Each board member is required to disclose, annually, any relationships which may give rise to a potential conflict of interest. These responses are processed and maintained by the WVUH-East Compliance Committee. All board members are to be willing to identify conflicts of interest and abstain from voting when apropriate. Form 990 Part VI Section B Line 15b Executive compensation is based upon the work of an independent salary consulting firm, which compiles data from comparable facilities in comparable geographic regions. The information is then used by the board of directors and compensation committee to set salaries. This work is documented and retained. Form 990 Part VI Section C Line 19 All financial and governing documents are maintained on site and made available to the public upon written request. Form 990 Part VI Section A Line 1ab One board member is considered not independent due to being an independent contractor affiliated with the hospitals of WVUH-East, Inc. Form 990 Part XI Line 5 Other changes in net assets consists of 326,087 of net unrealized loss, 223,628 related organization capitalization and capital campaign contributions of 116,532 posted to Jefferson Memorial balance sheet. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (16 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WVU Hospitals - East Inc | |||||||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 202337985 | Health System | WV | 501C3 | 11a | WVU Hospitals Inc | true | |
| WVU Hospitals Inc | |||||||||||
| PO Box 8034 | Morgantown | WV | 26506 | 550643304 | Patient Care | WV | 501C3 | 3 | WV United Health System | true | |
| WV United Health System Inc | |||||||||||
| 1000 Technology Drive | Fairmont | WV | 26554 | 550754713 | Health System | WV | 501C3 | 11a | false | N/A | |
| City Hospital Inc | |||||||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 550383321 | Patient Care | WV | 501C3 | 3 | WVU Hospitals - East Inc | true | |
| City Hospital Foundation | |||||||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 311118075 | Hospital Support | WV | 501C3 | 11a | false | N/A | |
| Jefferson Healthcare Foundation Inc | |||||||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 550768901 | Hospital Support | WV | 501C3 | 11a | false | N/A | |
| WVUH - East Services Corp | |||||||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 311118076 | Patient Care | WV | 501C3 | 3 | WVU Hospitals - East Inc | true | |
| United Summit Center | |||||||||||
| 6 Hospital Plaza | Clarksburg | WV | 26301 | 550752788 | Behavioral Health | WV | 501C3 | 3 | false | N/A | |
| United Hospital Center Inc | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550525724 | Patient Care | WV | 501C3 | 3 | WV United Health System | true | |
| United Physicians Care Inc | |||||||||||
| 686 South Pike Street | Shinnston | WV | 26431 | 550638563 | Patient Care | WV | 501C3 | 3 | false | N/A | |
| United Health Foundation | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550621706 | Hospital Support | WV | 501C3 | 11a | false | N/A | |
| WVU Healthcare Co-Op | |||||||||||
| PO Box 8059 | Morgantown | WV | 26506 | 550650441 | Support | WV | 501C3 | 11a | WV United Health System | true | |
| Camden-Clark Health Services | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26102 | 550769602 | Healthcare Access | WV | 501C3 | 11a, I | false | N/A | |
| Camden-Clark Foundation | |||||||||||
| 604 Ann Street | Parkersburg | WV | 26102 | 550667789 | Support | WV | 501C3 | 11a, I | false | N/A | |
| Camden-Clark Memorial Hospital | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26102 | 311524546 | Patient Care | WV | 501C3 | 3 | WV United Health System | true | |
| Camden-Clark Physician Corp | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26102 | 264058719 | Patient Care | WV | 501C3 | 11a, I | false | N/A | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|
| Allied Health Services Inc | ||||||||||
| PO Box 782 | Morgantown | WV | 26507 | 550652017 | Medical Lab | WV | WV United Health System | C Corp | -301353 | 1.00000 |
| West Virginia United Insurance Services Inc | ||||||||||
| 1000 Technology Drive Suite 2320 | Fairmont | WV | 26554 | 550756055 | Provider Network | WV | WV United Health System | C Corp | -5878 | 1.00000 |
| WVUH - East Enterprises Inc | ||||||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 550653982 | Medical Equip | WV | WVU Hospitals - East Inc | C Corp | 70009 | 1.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WVUH-East Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | o | TransactionType |
| Amount Involved | 3142268 | AmountInvolved |
| Method Of Amt Determination | Cost | MethodOfAmtDetermination |