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AUXILIARY OF THE CAMDEN CLARK MEMORIAL HOSPITAL OF PARKERSBURG: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
AUXILIARY OF THE CAMDEN CLARK MEMORIAL HOSPITAL OF PARKERSBURG (EIN 55-0386283)
Tax period
2011-04-01 to 2012-03-31
Filed
2012-12-19
IRS object ID
201203549349300645
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-12-19T17:39:37-00:00Timestamp
Tax Period End Date2012-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Altman and Associates PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12803 Dudley AvenueAddressLine1
CityParkersburgCity
StateWVState
ZIP Code26101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN550386283EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Auxiliary of the Camden Clark Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlAUXINameControl
Phone3044242847Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 Garfield AvenueAddressLine1
CityParkersburgCity
StateWVState
ZIP Code26101ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMary DayhoffName
TitlePresidentTitle
Date Signed2012-12-19DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJohn AltmanName
Phone3044282191Phone
Date Prepared2012-12-19DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMary DayhoffNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1800 Garfield AveAddressLine1
CityParkersburgCity
StateWVState
ZIP Code26101ZIPCode
FieldValueIRS element (for citing)
Gross Receipts532122GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2000YearFormation
State Legal DomicileWVStateLegalDomicile
Activity Or Mission DescriptionPROMOTE VOLUNTEER SERVICES PURCHASE HOSPITAL EQUIPMENT.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers500TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year1772ContributionsGrantsPriorYear
Contributions Grants Current Year1528ContributionsGrantsCurrentYear
Program Service Revenue Prior Year526792ProgramServiceRevenuePriorYear
Program Service Revenue CY485527ProgramServiceRevenueCY
Investment Income Prior Year228InvestmentIncomePriorYear
Investment Income Current Year165InvestmentIncomeCurrentYear
Other Revenue Prior Year45286OtherRevenuePriorYear
Other Revenue Current Year44902OtherRevenueCurrentYear
Total Revenue Prior Year574078TotalRevenuePriorYear
Total Revenue Current Year532122TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year100500GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY120500GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year465045OtherExpensePriorYear
Other Expenses Current Year463509OtherExpensesCurrentYear
Total Expenses Prior Year565545TotalExpensesPriorYear
Total Expenses Current Year584009TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8533RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-51887RevenuesLessExpensesCY
Total Assets BOY125636TotalAssetsBOY
Total Assets EOY73749TotalAssetsEOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY125636NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY73749NetAssetsOrFundBalancesEOY
Mission DescriptionPROMOTE VOLUNTEER SERVICES PURCHASE HOSPITAL EQUIPMENT.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense120500Expense
DescriptionGIFT TO HOSPITAL AND GIFT TO HOSPITAL SCHOLARSHIP FUND 62,109 VOLUNTEER HOURS DONATED TO PRODUCE.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense454982Expense
DescriptionREPAIRS TO AUXILIARY EQUIPMENT MISCELLANEOUS EXPENSES.Description
FieldValueIRS element (for citing)
Total Program Service Expense575482TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCCMH AUXILIARYNamePerson
Telephone Number3044243468TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1GARFIELD AVEAddressLine1
CityPARKERSBURGCity
StateWVState
ZIP Code26101ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
MARY DAYHOFF
PRESIDENT001.00X000
TED MAYBERRY
PRESIDENT ELECT001.00X000
RICHARD HAYHURST
VICE PRESIDENT001.00X000
FLORENCE WHITE
REC. SECRETARY001.00X000
EVA FLETCHER
CORR. SECRETARY001.00X000
CHERYLL WILSON
TREASURER GEN FD001.00X000
RUTH GUSTKE
TREAS. GIFT SHOP001.00X000
TERESA COLEMAN
TREAS. CART001.00X000
FieldValueIRS element (for citing)
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Membership Dues1528MembershipDues
Total Contributions1528TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionGift ShopDescription
Total Revenue Column485527TotalRevenueColumn
Related Or Exempt Function Income485527RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue485527TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column165TotalRevenueColumn
Related Or Exempt Function Income165RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Commissions1276912769
Restaurant Club Books96679667
Uniform Sales88328832

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column13634TotalRevenueColumn
Related Or Exempt Function Income13634RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue44902TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column532122TotalRevenueColumn
Related Or Exempt Function Income530594RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total120500Total
Program Services120500ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total3850Total
Management And General3850ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Fees For Services Prof FundraisingFeesForServicesProfFundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1848Total
Program Services1848ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total4023Total
Management And General4023ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total654Total
Management And General654ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
COGS441445441445
Fundraising Expenses77427742
Other Expenses38433843
Licenses104104

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total584009Total
Program Services575482ProgramServices
Management And General8527ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY220BOY
EOY220EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY60987BOY
EOY33621EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY208BOY
EOY207EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY64221BOY
EOY39701EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis14865LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec14865LandBldgEquipmentAccumDeprec

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY125636BOY
EOY73749EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY125636BOY
EOY73749EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY125636BOY
EOY73749EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY125636BOY
EOY73749EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-51887ReconcilationRevenueExpenses
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
Public Support Pertcentage1700.00000PublicSupportPertcentage170
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Included On FSfalseIncludedOnFS

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis14865OtherCostOrOtherBasis
Depreciation14865Depreciation
FieldValueIRS element (for citing)
Total Revenue532122TotalRevenue
Total Expenses584009TotalExpenses
Excess Or Deficit For Year-51887ExcessOrDeficitForYear
Excess Or Deficit Per FS-51887ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt532122TotRevenueEtcAuditedFinclStmt
Revenue Subtotal532122RevenueSubtotal
Total Revenue Per Form990532122TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt584009TotExpensesEtcAuditedFinclStmt
Expenses Subtotal584009ExpensesSubtotal
Total Expenses Per Form990584009TotalExpensesPerForm990

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1CAMDEN CLARK MEMORIAL HOSPITALBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1800 GARFIELD AVEAddressLine1
CityPARKERSBURGCity
StateWVState
ZIP Code26101ZIPCode
FieldValueIRS element (for citing)
Amount Of Cash Grant120500AmountOfCashGrant
Purpose Of GrantGENERAL SUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990 Part VI11BTHE FORM 990 IS PREPARED DURING THE ANNUAL AUDIT OF THE FINANCIAL STATEMENTS UNDER THE DIRECTION OF THE CPA FIRM. THE FORM 990 IS REVIEWED BY THE OFFICERS BEFORE SIGNING.
Form 990 Part VI19NO DOCUMENTS AVAILABLE TO THE PUBLIC
Form 990 Part VI Line 11B THE FORM 990 IS PREPARED DURING THE ANNUAL AUDIT OF THE FINANCIAL STATEMENTS UNDER THE DIRECTION OF THE CPA FIRM. THE FORM 990 IS REVIEWED BY THE OFFICERS BEFORE SIGNING. Form 990 Part VI Line 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC