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VANDALIA HEALTH INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
VANDALIA HEALTH INC (EIN 55-0664138)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201213189349301206
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)
Timestamp2012-11-13T08:28:56-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN550664138EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CAMC Health System IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCAMCNameControl
Phone3043885432Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1547AddressLine1
CityCharlestonCity
StateWVState
ZIP Code253261547ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLarry C HudsonName
TitleChief Financial OfficerTitle
Phone3043887603Phone
Date Signed2012-11-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLaura GillespieName
PTINP00855604PTIN
Phone3124861000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1SameBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonLarry C HudsonNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1501 Morris StreetAddressLine1
CityCharlestonCity
StateWVState
ZIP Code25301ZIPCode
FieldValueIRS element (for citing)
Gross Receipts668951GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.camc.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1986YearFormation
State Legal DomicileWVStateLegalDomicile
Activity Or Mission DescriptionCAMC Health System, Inc. ("CAMCHSI") is organized and operated solely to provide support to Charleston Area Medical Center, Inc. ("CAMC"), a not-for-profit corporation organized under the laws of the state of West Virginia.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers13TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year202258InvestmentIncomePriorYear
Investment Income Current Year194177InvestmentIncomeCurrentYear
Other Revenue Prior Year417156OtherRevenuePriorYear
Other Revenue Current Year474774OtherRevenueCurrentYear
Total Revenue Prior Year619414TotalRevenuePriorYear
Total Revenue Current Year668951TotalRevenueCurrentYear
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 Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year203868OtherExpensePriorYear
Other Expenses Current Year194616OtherExpensesCurrentYear
Total Expenses Prior Year203868TotalExpensesPriorYear
Total Expenses Current Year194616TotalExpensesCurrentYear
Revenues Less Expenses Prior Year415546RevenuesLessExpensesPriorYear
Revenues Less Expenses CY474335RevenuesLessExpensesCY
Total Assets BOY335176632TotalAssetsBOY
Total Assets EOY360657934TotalAssetsEOY
Total Liabilities BOY22445745TotalLiabilitiesBOY
Total Liabilities EOY21786968TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY312730887NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY338870966NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCAMCHSI is organized and shall be operated solely to provide support to Charleston Area Medical Center, Inc. ("CAMC"), a not-for-profit corporation organized under the laws of the state of West Virginia, through the performance of functions of said Charleston Area Medical Center, Inc or otherwise.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense80772Expense
Revenue474774Revenue
DescriptionCAMC Health System, Inc. is organized and shall be operated solely for charitable, scientific and educational purposes, and is not organized and shall not be operated for profit; no part of the net earnings of this corporation shall inure to the benefit of any private stockholder or individual, and no substantial part of its activities shall consist of carrying on propaganda, or otherwise attempting to influence legislation, and it shall not participate in, nor intervene in, any political campaign on behalf of any candidate for public office.Description
Total Program Service Expense80772TotalProgramServiceExpense
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 Endowments1TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets0ReportOtherAssets
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
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
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 With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
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
Excess Business Holdings0ExcessBusinessHoldings
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
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 (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
R Thomas Bowden III DO
Director2.50X000
Charles L Capito Jr
Director2.50X000
Mark A Chandler
Director2.50X000
Nelle Ratie Chilton
Director2.50X000
Carol A Egnatoff
Director2.50X000
James P Griffith MD
Director2.50X000
William R McDavid Esq
Director2.50X000
Thomas E Potter Esq
Director2.50X000
Linda J Powers
Director2.50X000
Karen S Price
Director2.50X000
Edwin H Welch PhD
Director2.50X000
John A Willis MD
Director2.50X0615070
Asif Rahman MD
Chief of Staff2.50X0100000
David L Ramsey
President, CEO & Director5.00X0934889178365X
William A Rice Jr
Chairman of the Board5.00X000X
John R Hoblitzel Esq
Vice Chairman of the Board5.00X000X
Glenn Crotty Jr MD
COO5.00057755979214X
Larry C Hudson
CFO5.00057052389058X
Marshall A McMullen Jr
Secretary & Gen. Counsel5.000323519207019X
Robert B Danielson
VP Compliance5.00018687352425X
Beth A Samples
VP of HR5.000109456648333X
Lynn Y Brookshire
VP of IT5.000286549170306X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4045985TotalReportableCompFrmRltdOrgs
Total Other Compensation824720TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column194177TotalRevenueColumn
Exclusion$194,177ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Affiliate Transfer900099474335474335
Bad Debts900099439439
FieldValueIRS element (for citing)
Total Other Revenue474774TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column668951TotalRevenueColumn
Related Or Exempt Function Income474774RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$194,177ExclusionAmount

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total90613Total
Management And General90613ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total18806Total
Management And General18806ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total79Total
Management And General79ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total4321Total
Management And General4321ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total80772Total
Program Services80772ProgramServices

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionLicense/FeesDescription
Total25Total
Management And General25ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total194616Total
Program Services80772ProgramServices
Management And General113844ManagementAndGeneral
Fundraising0Fundraising

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY189132BOY
EOY201458EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4321BOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY108875BOY
EOY108875EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY330645726BOY
EOY356311470EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4228578BOY
EOY4036131EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY335176632BOY
EOY360657934EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4372BOY
EOY6590EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY22441373BOY
EOY21780378EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY22445745BOY
EOY21786968EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY264981536BOY
EOY284691980EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY27001452BOY
EOY33186530EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY20747899BOY
EOY20992456EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY312730887BOY
EOY338870966EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY335176632BOY
EOY360657934EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses474335ReconcilationRevenueExpenses
Reconcilation Other Changes25665744ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1Charleston Area Medical Center IncBusinessNameLine1
FieldValueIRS element (for citing)
EIN550526150EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance47749351BeginningOfYearBalance
Investment Earnings Or Losses6429635InvestmentEarningsOrLosses
End Of Year Balance54178986EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance38922192BeginningOfYearBalance
Investment Earnings Or Losses8827159InvestmentEarningsOrLosses
End Of Year Balance47749351EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance30684686BeginningOfYearBalance
Investment Earnings Or Losses8237506InvestmentEarningsOrLosses
End Of Year Balance38922192EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Contributions30684686Contributions
End Of Year Balance30684686EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.38750PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.61250TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionAffiliatesDescription
Book Value356311470BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related356311470TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionAffiliate Payable - CAMCDescription
Amount$21,780,378Amount
FieldValueIRS element (for citing)
Total Of Amounts21780378TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X:ReturnReference
ExplanationCAMCHSI is included in the consolidated audit 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. A System does not have any material uncertain tax positions at December 31, 2011."Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
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 Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base 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
059211602350000107773015531802304701113254057392
Glenn Crotty Jr MD
038796201291830604140540320251820656773037564
Larry C Hudson
0339999012513501053890683120207460659581051021
Marshall A McMullen Jr
021497904941305912701849560220630530538029050
Robert B Danielson
0149257027616010000033699018726023929800
Beth A Samples
01849070417920867867030170018163011428990598275
Lynn Y Brookshire
019308204386004960701484360218700456855020075

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 3Part I, Line 3: The CAMC Health System, Inc. ("CAMCHSI") 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 CAMCHSI's CEO and the other executives. 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. Participant Beth Samples in 2011 was paid in the amount of $846,435 in SERP benefits. 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 Health System, 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 Health System, 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.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section B, line 11CAMC Health System, Inc. ("CAMCHSI") compiles necessary information for Form 990 through the efforts of various officers and trustees of the organization. The return is then prepared and reviewed by an external consultant firm. This firm then reviews the completed Form 990 with the CAMCHSI Board of Trustees and its Audit Committee.
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 board chairs with resolution of same. Annual disclosure procedures are implemented and the board chair and 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. subsidiaries (including CAMCHSI) and executives (including CAMCHSI's CEO). The Committee uses the data to determine the total compensation of CAMCHSI's CEO and other executive officers. This data is reviewed every two years or when a new person comes into a executive role.
Form 990, Part VI, Section C, line 19CAMC Health System, Inc. is part of a consolidated financial audit for CAMC Health System, Inc. and Subsidiaries, (collectively). Consolidated audited financial statements are available online 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.
Form 990, Part VII:Some were compensated by related organizations for other duties as follows: CAMC - David L. Ramsey 50 hours, Glenn Crotty Hr. 50 hours, Larry C. Hudson 50 hours, Beth A. Samples 50 hours, Lynn Y. Brookshire 50 hours, Marshall A. McMullen Jr. 50 hours, Robert N. Danielson 50 hours.Avg hours devoted to related org(s) when related comp is reported:
Form 990, Part XI, line 5:Change in Temporary & Permanent Restricted Contributions of Subsidiaries 6,429,635. Change in Beneficial Interest in Affiliates 19,236,109. Total to Form 990, Part XI, Line 5: 25,665,744.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Charleston Area Medical Center Inc
PO Box 1547CharlestonWV253261547550526150HospitalWV501(c)(3)Line 3CAMC Health System Inc1
Charleston Area Medical Center Foundation Inc
PO Box 1547CharlestonWV253261547310887133FundraisingWV501(c)(3)Line 11, Type IICAMC Health System Inc1
CAMC Health Education and Research Institute Inc
PO Box 1547CharlestonWV253261547550753754Medical Educational ResearchWV501(c)(3)Line 11, Type IICAMC Health System Inc1
CAMC Teays Valley Hospital Inc
PO Box 1547CharlestonWV253261547550752636HospitalWV501(c)(3)Line 3CAMC Health System Inc1

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
Women and Children's Medical Office Building Partnership
PO Box 1547CharlestonWV253261547550669065Medical Office BuildingWVN/A
General Division Medical 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 ActivitySpeciality Physician PracticesPrimaryActivity
Legal Domicile StateWVLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CAMC Health System IncBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
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 Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Charleston Area Medical Center Inc
B80772FMV
Charleston Area Medical Center Inc
L90613FMV
Charleston Area Medical Center Inc
R474335FMV