2012-11-13T08:28:56-06:00 2011-12-31 861065772 Deloitte Tax LLP 111 S Wacker Drive Chicago IL 60606 990 2011-01-01 550664138 CAMC Health System Inc CAMC 3043885432 PO Box 1547 Charleston WV 253261547 Larry C Hudson 3043887603 2012-11-12 1 Laura Gillespie P00855604 3124861000 2011 2016-02-24 21:20:13Z Same Larry C Hudson 501 Morris Street Charleston WV 25301 668951 0 X www.camc.org X 1986 WV CAMC 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. 14 9 0 13 0 0 0 0 0 0 202258 194177 417156 474774 619414 668951 0 0 0 0 0 0 0 0 0 203868 194616 203868 194616 415546 474335 335176632 360657934 22445745 21786968 312730887 338870966 X CAMCHSI 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. 0 0 80772 474774 CAMC 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. 80772 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 14 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WV X Larry C Hudson 3043887603 501 Morris Street Charleston WV 25301 X R Thomas Bowden III DO 2.50 X 0 0 0 Charles L Capito Jr 2.50 X 0 0 0 Mark A Chandler 2.50 X 0 0 0 Nelle Ratie Chilton 2.50 X 0 0 0 Carol A Egnatoff 2.50 X 0 0 0 James P Griffith MD 2.50 X 0 0 0 William R McDavid Esq 2.50 X 0 0 0 Thomas E Potter Esq 2.50 X 0 0 0 Linda J Powers 2.50 X 0 0 0 Karen S Price 2.50 X 0 0 0 Edwin H Welch PhD 2.50 X 0 0 0 John A Willis MD 2.50 X 0 61507 0 Asif Rahman MD 2.50 X 0 10000 0 David L Ramsey 5.00 X X 0 934889 178365 William A Rice Jr 5.00 X X 0 0 0 John R Hoblitzel Esq 5.00 X X 0 0 0 Glenn Crotty Jr MD 5.00 X 0 577559 79214 Larry C Hudson 5.00 X 0 570523 89058 Marshall A McMullen Jr 5.00 X 0 323519 207019 Robert B Danielson 5.00 X 0 186873 52425 Beth A Samples 5.00 X 0 1094566 48333 Lynn Y Brookshire 5.00 X 0 286549 170306 0 4045985 824720 0 0 1 0 0 194177 194177 Affiliate Transfer 900099 474335 474335 Bad Debts 900099 439 439 474774 668951 474774 0 194177 90613 90613 18806 18806 79 79 4321 4321 80772 80772 License/Fees 25 25 194616 80772 113844 0 189132 201458 4321 108875 108875 330645726 356311470 4228578 4036131 335176632 360657934 4372 6590 22441373 21780378 22445745 21786968 X 264981536 284691980 27001452 33186530 20747899 20992456 312730887 338870966 335176632 360657934 X 474335 25665744 X 0 1 1 X 0 X X X 0 0 0 Charleston Area Medical Center Inc 550526150 3 1 1 1 0 1 0 47749351 6429635 54178986 38922192 8827159 47749351 30684686 8237506 38922192 30684686 30684686 0.38750 0.61250 0 0 0 Affiliates 356311470 C 356311470 Affiliate Payable - CAMC 21780378 21780378 Description of Uncertain Tax Positions Under FIN 48: Part X: CAMCHSI 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." X X X X X 0 1 0 0 0 0 0 0 0 David L Ramsey 0 592116 0 235000 0 107773 0 155318 0 23047 0 1113254 0 57392 Glenn Crotty Jr MD 0 387962 0 129183 0 60414 0 54032 0 25182 0 656773 0 37564 Larry C Hudson 0 339999 0 125135 0 105389 0 68312 0 20746 0 659581 0 51021 Marshall A McMullen Jr 0 214979 0 49413 0 59127 0 184956 0 22063 0 530538 0 29050 Robert B Danielson 0 149257 0 27616 0 10000 0 33699 0 18726 0 239298 0 0 Beth A Samples 0 184907 0 41792 0 867867 0 30170 0 18163 0 1142899 0 598275 Lynn Y Brookshire 0 193082 0 43860 0 49607 0 148436 0 21870 0 456855 0 20075 Part I, Line 3 Part 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 4b Supplemental 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. Form 990, Part VI, Section B, line 11 CAMC 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 12c Corporate 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 15 The 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 19 CAMC 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. Avg hours devoted to related org(s) when related comp is reported: 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. Changes in Net Assets or Fund Balances: 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. Charleston Area Medical Center Inc PO Box 1547 Charleston WV 253261547 550526150 Hospital WV 501(c)(3) Line 3 CAMC Health System Inc 1 Charleston Area Medical Center Foundation Inc PO Box 1547 Charleston WV 253261547 310887133 Fundraising WV 501(c)(3) Line 11, Type II CAMC Health System Inc 1 CAMC Health Education and Research Institute Inc PO Box 1547 Charleston WV 253261547 550753754 Medical Educational Research WV 501(c)(3) Line 11, Type II CAMC Health System Inc 1 CAMC Teays Valley Hospital Inc PO Box 1547 Charleston WV 253261547 550752636 Hospital WV 501(c)(3) Line 3 CAMC Health System Inc 1 Women and Children's Medical Office Building Partnership PO Box 1547 Charleston WV 253261547 550669065 Medical Office Building WV N/A General Division Medical Office Building Partnership PO Box 1547 Charleston WV 253261547 550623949 Medical Office Building WV N/A Integrated Health Care Providers Inc PO Box 1547 Charleston WV 253261547 550751010 Speciality Physician Practices WV CAMC Health System Inc C 1.00000 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 Charleston Area Medical Center Inc B 80772 FMV Charleston Area Medical Center Inc L 90613 FMV Charleston Area Medical Center Inc R 474335 FMV