CITY HOSPITAL INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- CITY HOSPITAL INC (EIN 55-0383321)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-15
- IRS object ID
- 201213209349302976
- 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 I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-15T10:05:30-00:00 | 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 | 550383321 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | City Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CITY | NameControl |
| Phone | 3042641000 | 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 | VP 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 | 143851426 | 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 | 1940 | YearFormation |
| State Legal Domicile | WV | StateLegalDomicile |
| Activity Or Mission Description | City Hospital is a non profit acute care hospital providing high-quality health wellness services to the residents of the Eastern Panhandle of WV, expanding access to care and participating in the education of healthcare professionals. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1376 | TotalNbrEmployees |
| Total Nbr Volunteers | 91 | TotalNbrVolunteers |
| Total Gross UBI | 752164 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -8507 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 18390 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 159278 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 122008270 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 140692833 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 878976 | InvestmentIncomePriorYear |
| Investment Income Current Year | 681952 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1779750 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1805675 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 124685386 | TotalRevenuePriorYear |
| Total Revenue Current Year | 143339738 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 4335415 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 314403 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 59670788 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 61573352 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 60058968 | OtherExpensePriorYear |
| Other Expenses Current Year | 76084231 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 124065171 | TotalExpensesPriorYear |
| Total Expenses Current Year | 137971986 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 620215 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5367752 | RevenuesLessExpensesCY |
| Total Assets BOY | 94664400 | TotalAssetsBOY |
| Total Assets EOY | 107836793 | TotalAssetsEOY |
| Total Liabilities BOY | 69146750 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 80196400 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 25517650 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 27640393 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | City Hospital is a non-profit acute care hospital located in the Eastern Panhandle of WV. The mission of City Hospital is to provide high quality, cost effective health and wellness services to the community. CHI provides these to patients in need without consideration of their ability to pay. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 45432543 | Expense |
| Revenue | 98445380 | Revenue |
| Description | City Hospital provides general medical services to the residents in the Eastern Panhandle region of WV. Such services include family medicine, internal medicine, observation, a fully accredited cancer center, and outpatient ancillary testing. During 2011, City Hospital documented 136,292 ancillary tests, and 2,347 observation visits. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4476349 | Expense |
| Revenue | 9699563 | Revenue |
| Description | The General Surgery department at City Hospital is staffed by specialists and general surgeons offering the latest in surgical techniques including laproscopic procedures, lithotripsy, and same day/ambulatory surgery. Same day surgery visits for 2011 totaled 7,945. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3850440 | Expense |
| Revenue | 8343315 | Revenue |
| Description | In 2011 at City Hospital, we performed approximately 3,202 GI Endoscopy procedures with associated pre-surgical testing making it one of the top revenue generating services for that fiscal year. We also replaced one equipment tower with all High Definition technology in 2011 and replaced the 3 remaining towers and all GI scopes with High Definition in 2012. High Definition is the latest technology in endoscopy equipment. High resolution and color results in improved visualization. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 51597389 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 314403 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 25714441 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 105356721 | 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 | false | ReportProgRelInvest |
| Report Other Assets | true | 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 | true | 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 | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | 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 | 144 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 1376 | 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 |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| 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 | 3042641358 | 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 (23 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 | |
| Shelia Hamilton | |||||||
| Secretary | 001.00 | X | X | 0 | 0 | 0 | |
| Keith Berkeley DVM | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Fred Butcher PhD | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Betty Gunnoe | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Mitch Jacques MD | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| David Baltierra MD | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| D Scott Roach | |||||||
| JMH Med Staff President | 001.00 | X | 0 | 0 | 0 | ||
| Rhonda Monroe | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Dawn Jones MD | |||||||
| CHI Med Staff President | 001.00 | X | 0 | 0 | 0 | ||
| Jeffrey B DeBord DO | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Nicholas Trietsch | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Dr Richard Knapp | |||||||
| Director | 001.00 | X | 0 | 0 | 0 | ||
| Anthony Zelenka | |||||||
| Cheif Administrative Officer | 050.00 | X | 256570 | 0 | 32238 | ||
| Robert Strauch | |||||||
| VP Med Affairs | 040.00 | X | 97185 | 0 | 825 | ||
| Donna Clews | |||||||
| VP of Nursing | 040.00 | X | 148840 | 0 | 7752 | ||
| Linda Campbell Jones | |||||||
| Chief CRNA | 040.00 | 214628 | 0 | 17507 | X | ||
| Jason T White | |||||||
| Assistant Chief CRNA | 040.00 | 202813 | 0 | 32238 | X | ||
| Robert C Johnson Jr | |||||||
| CRNA | 040.00 | 199273 | 0 | 28436 | X | ||
| Mark D Kovacs | |||||||
| CRNA | 040.00 | 198226 | 0 | 33238 | X | ||
| Donna Hupp Baker | |||||||
| CRNA | 040.00 | 192528 | 0 | 10901 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1510063 | TotalReportableCompFromOrg |
| Total Other Compensation | 163135 | TotalOtherCompensation |
| Number Individuals GT100 K | 28 | 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 |
|---|---|---|---|---|---|
| Quest Diagnostics | |||||
| 14225 Newbrook Dr | Chantilly | VA | 20151 | Lab Services | 636750 |
| Handcraft Cleaners and Laundry | |||||
| 1501 Roseneath Rd | Richmond | VA | 23230 | Laundry Services | 565105 |
| C&A Industries Inc | |||||
| 13609 California St | Omaha | NE | 68154 | Contract labor | 634332 |
| Insight Health Services | |||||
| 26250 Enterprise Ct | Lake Forest | CA | 92630 | Mobile MRI and PET services | 628457 |
| Hospitalist Medicine Physicians of Berkeley County PLLC | |||||
| PO Box 645037 | Cincinnato | OH | 45264 | Contracted Hospitalists | 552120 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 28 | NumberOfContractorsGT100K |
| Related Organizations | 152685 | RelatedOrganizations |
| Government Grants | 6593 | GovernmentGrants |
| Noncash Contributions | 2177 | NoncashContributions |
| Total Contributions | 159278 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| Patient Services | 139174941 | 139174941 |
| Wellness Center | 742226 | 742226 |
| Patient Pharmacy | 775666 | 775666 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 140692833 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1193640 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1193640 | RelatedOrExemptFunctionIncome |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 60938 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 60938 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 60938 | TotalRevenueColumn |
| Exclusion | $60,938 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 511688 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -511688 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -511688 | TotalRevenueColumn |
| Exclusion | -$511,688 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|
| Partnership Passthrough Income | 752164 | 752164 | |
| Cafeteria Income | 348926 | $348,926 | |
| Cash Discounts | 327421 | $327,421 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 316226 | TotalRevenueColumn |
| Related Or Exempt Function Income | 316226 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1744737 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 143339738 | TotalRevenueColumn |
| Related Or Exempt Function Income | 142202699 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 752164 | UnrelatedBusinessRevenue |
| Exclusion | $225,597 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 314403 | Total |
| Program Services | 314403 | 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 | 543411 | Total |
| Management And General | 543411 | 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 | 47989739 | Total |
| Program Services | 39809109 | ProgramServices |
| Management And General | 8180630 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1455764 | Total |
| Program Services | 1207605 | ProgramServices |
| Management And General | 248159 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7353313 | Total |
| Program Services | 6133679 | ProgramServices |
| Management And General | 1219634 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4231125 | Total |
| Program Services | 3509861 | ProgramServices |
| Management And General | 721264 | 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 | 125148 | Total |
| Program Services | 293 | ProgramServices |
| Management And General | 124855 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57266 | Total |
| Management And General | 57266 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13274 | Total |
| Management And General | 13274 | 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 | 16142870 | Total |
| Program Services | 11950711 | ProgramServices |
| Management And General | 4192159 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 355458 | Total |
| Program Services | 7608 | ProgramServices |
| Management And General | 347850 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26179498 | Total |
| Program Services | 23850068 | ProgramServices |
| Management And General | 2329430 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 288383 | Total |
| Program Services | 78979 | ProgramServices |
| Management And General | 209404 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2221311 | Total |
| Program Services | 403234 | ProgramServices |
| Management And General | 1818077 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 340065 | Total |
| Program Services | 168790 | ProgramServices |
| Management And General | 171275 | 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 | 2225477 | Total |
| Program Services | 589 | ProgramServices |
| Management And General | 2224888 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6775945 | Total |
| Management And General | 6775945 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1022153 | Total |
| Management And General | 1022153 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Provision for Doubtful Accounts | 14563488 | 14563488 | |
| Association Dues | 138865 | 47716 | 91149 |
| Educational Training | 137194 | 7711 | 129483 |
| Taxes, Licenses, Fees | 4377957 | 3032554 | 1345403 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1119879 | Total |
| Program Services | 270323 | ProgramServices |
| Management And General | 849556 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 137971986 | Total |
| Program Services | 105356721 | ProgramServices |
| Management And General | 32615265 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43010 | BOY |
| EOY | 284197 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18960480 | BOY |
| EOY | 29696025 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12841702 | BOY |
| EOY | 14632710 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1336500 | BOY |
| EOY | 655276 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1777782 | BOY |
| EOY | 1954541 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 359773 | BOY |
| EOY | 354034 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 112412372 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 61157765 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41817952 | BOY |
| EOY | 51254607 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13004060 | BOY |
| EOY | 76010 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 2663680 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4523141 | BOY |
| EOY | 6265713 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 94664400 | BOY |
| EOY | 107836793 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9198849 | BOY |
| EOY | 12206103 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48383698 | BOY |
| EOY | 53299806 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11564203 | BOY |
| EOY | 14690491 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69146750 | BOY |
| EOY | 80196400 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25205594 | BOY |
| EOY | 27326335 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 312056 | BOY |
| EOY | 312058 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 2000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25517650 | BOY |
| EOY | 27640393 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 94664400 | BOY |
| EOY | 107836793 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 5367752 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -3245009 | 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
Total Direct Lobbying TotalDirectLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 13274 | FilingOrganizationsTotals |
Total Lobbying Expenditures TotalLobbyingExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 13274 | FilingOrganizationsTotals |
Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 105356721 | FilingOrganizationsTotals |
Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 105369995 | FilingOrganizationsTotals |
Lobbying Nontaxable LobbyingNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 1000000 | FilingOrganizationsTotals |
Grassroots Nontaxable GrassrootsNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 250000 | FilingOrganizationsTotals |
Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 1000000 | CurrentYearMinus3 |
| Current Year Minus2 | 1000000 | CurrentYearMinus2 |
| Current Year Minus1 | 1000000 | CurrentYearMinus1 |
| Current Year | 1000000 | CurrentYear |
| Total | 4000000 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $6,000,000 | LobbyingCeilingAmount |
Total Lobbying Expenditures2 TotalLobbyingExpenditures2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 12860 | CurrentYearMinus3 |
| Current Year Minus2 | 12507 | CurrentYearMinus2 |
| Current Year Minus1 | 12820 | CurrentYearMinus1 |
| Current Year | 13274 | CurrentYear |
| Total | 51461 | Total |
Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 250000 | CurrentYearMinus3 |
| Current Year Minus2 | 250000 | CurrentYearMinus2 |
| Current Year Minus1 | 250000 | CurrentYearMinus1 |
| Current Year | 250000 | CurrentYear |
| Total | 1000000 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $1,500,000 | GrassrootsCeilingAmount |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | II-A | Identifier |
| Return Reference | 1b | ReturnReference |
| Explanation | The amount listed is made up of the amount of West Virginia Hospital Association and American Hospital Association dues that the associations determined as attributable to lobbying expense. | 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 | 106462 | OtherCostOrOtherBasis |
| Book Value | 106462 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 44197120 | OtherCostOrOtherBasis |
| Depreciation | 14787723 | Depreciation |
| Book Value | 29409397 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 59815587 | OtherCostOrOtherBasis |
| Depreciation | 41647080 | Depreciation |
| Book Value | 18168507 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8293203 | OtherCostOrOtherBasis |
| Depreciation | 4722962 | Depreciation |
| Book Value | 3570241 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 51254607 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Unamortized Borrowing Costs | 420286 |
| Due from Affiliates | 4446235 |
| Estimated Third Party Payor Settlements | 51329 |
| Other Non-current Assets | 1347863 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 6265713 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (7 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Accrued wages, benefits and payroll taxes | $5,283,299 |
| Malpractice Liability | $670,135 |
| Accrued pension benefits | $1,469,225 |
| Accrued bond interest | $42,066 |
| Due to third Party Payors | $1,658,780 |
| Interest Rate Swaps | $2,946,121 |
| Self Insurance Liability | $2,620,865 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 14690491 | TotalOfAmounts |
| Total Revenue | 143339738 | TotalRevenue |
| Total Expenses | 137971986 | TotalExpenses |
| Excess Or Deficit For Year | 5367752 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -1802928 | NetUnrealizedGLOnInvestments |
| Other | -$1,442,081 | OtherAmount |
| Total Adjustments | -3245009 | TotalAdjustments |
| Excess Or Deficit Per FS | 2122743 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 142838878 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -348175 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -348175 | RevenueNotRptdF990 |
| Revenue Subtotal | 143187053 | RevenueSubtotal |
| Other Revenues Not Included | 152685 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 152685 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 143339738 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 139134516 | TotExpensesEtcAuditedFinclStmt |
| Losses Reported | 1462530 | LossesReported |
| Other Expenses Included | -300000 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 1162530 | ExpensesNotRptdF990 |
| Expenses Subtotal | 137971986 | ExpensesSubtotal |
| Total Expenses Per Form990 | 137971986 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| X | 2 | The annual audit and financial statements of City 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 includes 249,806 Change in restricted net assets, 2,177 of comfort items contributed by City Foundation posted to balance sheet, Hospitalists Net AR of 63,736, 1,627,974 of related organization capitalization, and 2,000 capital stock transfered from WVUH-Enterprises that was merged into City Hospital January 31, 2011. |
| XII | 4b | The amount shown consists of 152,685 contributions from City Foundation posted to balance sheet accounts. |
| XIII | 2c | The amount shown on line 2c 1,462,530 unrealized losses on debt instruments included in expense on audited financial statments but not taken as an expense on the Form 990. |
| XIII | 2d | The amount shown on line 2d consists of 300,000 contributions to City Foundation posted to balance sheet accounts. |
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 | 3633885 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3633885 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02940 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22889483 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14352014 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8537469 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06920 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 437640 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 420228 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 17412 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26961008 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14772242 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12188766 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09870 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 248862 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16790 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 232072 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00190 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 345536 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 137887 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 207649 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22725 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 22725 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 617123 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 154677 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 462446 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00380 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 27578131 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14926919 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12651212 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10250 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 11386 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 11386 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 4261 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4261 | NetCommunityBuildingExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 15589 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 15589 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 831 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 831 | NetCommunityBuildingExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 4561 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4561 | NetCommunityBuildingExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 4722 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 4722 | NetCommunityBuildingExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 41350 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 41350 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $6,729,788 | BadDebtExpenseAmount |
| Amount Attributable To | 179739 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 46584639 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 49660257 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3075618 | 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 | City Hospital Inc | BusinessNameLine1 |
Address Address
| 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) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI (34 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part I line 3c | City Hospital Inc. CHI uses 200 Federal Poverty Guideline to determine free care eligibility. However, City Hospital does not offer discounted care to individuals who do not qualify for free care. |
| Part I line 6a | Community benefit amounts for City Hospital, Inc 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 at cost, Unreimbursed Medicaid and other means-tested government programs at cost. To calculate the Medicare allowable cost shown on Part III question 8 we used the allowable cost from the Medicare Cost Report. |
| Part I line 7 | Column f - Total community benefit expense for 2011 is 27,578,131 and is 22.35 of total net expenses. To calculate net expense, bad debt of 14,563,488 was deducted from total expenses of 137,971,986 as shown in Part IX line 25 of the core Form 990. |
| Part II | Physical improvements and housing - City Hospital employees spent a weekday volunteering at two local social service agencies on behalf of the United Way of the Eastern Panhandle. City Hospital also provided the kick-off breakfast for all 500 volunteers throughout the Eastern Panhandle. |
| Part II | Economic Development - In 2011,hospital representatives participated as members of the Berkeley County Development Authority and Board Members of the Martinsburg Berkeley County Chamber of Commerce. |
| Part II | Community Support - City Hospital supports and participates in many health related community activities by providing judges for science fairs at the local schools. We have teams that participate in the annual March of Dimes Walk, American Cancer Society Relay for Life in Berkeley County and various other fundraising events for local, health related, non-profit organizations. Many employees serve as volunteer board of directors for 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 - CHI staff participate in the Health Human Services Council as well as Healthier Berkeley County. All of these entities focus on improving community access to health care, human services in general, and determine ways to encourage healthy lifestyles. |
| Part II | Community Health Improvement Advocacy - CHI is a partner in the MAPP project which is a collaborative initiative to assess community social service needs and develop a plan to tackle these issues. In 2011, CHI also began data collection through 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. CHI also has a representative on the Berkeley County Board of Health. |
| Part II | Workforce Development - CHI participates in activities sponsored by the Martinsburg Berkeley County Chambers Workforce Development Committee. CHI is a major sponsor of the Womens Network, an organization, established by the Berkeley County Chamber, which sponsors womens professional activities, social networking and professional development seminars. A representative from CHI also serves on the Blue Ridge Community Technical College Board of Governors. |
| Part II | CHI also has agreements with area community colleges and universities to allow students to complete clinical rotations at the hospital. |
| Part III line 4 | City Hospitals 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. 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. City Hospital grants credit without collateral to its patients, most of whom are local residents and are insured under third-party payor agreements, primarily with Medicare, Medicaid, and various commercial insurance companies. CHI maintains allowances for potential credit losses and such losses have historically been within managements expectations. |
| Part III line 4 | Part III, Line 2 - Bad Debt Expense at cost was calculated by multiplying bad debt expense of 14,563,488 by our cost-to-charge ratio of 46.21 derived from Worksheet 2 in the IRS Schedule H instructions for a total of 6,729,788. Line 3 - Estimated bad debt attributable to patients eligible for charity care was calculated by running a report within our patient revenue software of all bad debt account balances greater than 25,000. The total of that report was 444,407, which was then multiplied by the cost-to-charge ratio of 46.21 for a total of 179,739. |
| Part III line 4 | We feel that, at a minimum, the estimated bad debt attributable to patients eligible for charity care of 179,739 should be considered community benefit due to the fact that a patient with an outstanding balance of 25,000 or greater usually qualifies as catastrophic if the patient completes the application process. In our Charity Care policy, we define catastrophic care as any illness or injury that will likely require continuous or frequent treatment for more than one year. |
| Part III line 8 | Part III Line 6 was calculated using total cost from the Medicare Cost Report less Medicare reimbursement of direct GME. City Hospitals shortfall of 3,075,618 on Medicare program should be considered a community benefit because we are relieving a government burden by providing care in excess of our cost to these patients. |
| Part III line 9b | CHI 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 10 - City Hospital offers discounted care only to individuals who qualify for free care. CHI does offer a prompt pay discount to Self-Pay patients with no third-party coverage that meet certain criteria. |
| Part V | Line 21 - City Hospital charges all patients an amount equal to gross charges regardless of payment method. |
| Part VI Line 2 | City Hospital Inc is a part of WVUH-East, Inc. a healthcare system serving the Eastern Panhandle of WV. The West Virginia University Hospitals, East WVUH-East Marketing Department considers several components in assessing how the organization determines the need of the communities it serves. Through outside consultants to collaborating with various departments, a needs assessment takes into account several factors including physician to population ratios, physician availability in the entire service area, and general health risks for our community. |
| Part VI Line 2 | The Primary Service Area PSA for CHI includes Berkeley and Jefferson Counties in WV with Morgan County, WV being a secondary service area. This data is then analyzed to provide general estimates to guide CHI and WVUH-East to where they could better care for reseidents 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 and the general health risk for our community comes from clinical diagnosis information gathered by the West Virginia Health Care Authority and Thomson Reuters Market Planner Plus. |
| Part VI Line 2 | We also conduct market research to ask consumers how they perceive the health system and where they go for health care services. 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. |
| Part VI Line 2 | WVUH-East is working with other local organizations in a project known as MAPP Mobilizing for Action through Planning and Partnerships to create and implement a community health improvement plan. |
| Part VI Line 3 | City Hospital employs 4 financial analysts to meet with patients to discuss financial eligibility for our charity care program. City Hospital has the qualification requirements, as well as, applications for charity care available at all registration areas. Patients that do not qualify for state or federally funded programs can apply for the charity care program at City Hospital. |
| Part VI Line 4 | City Hospital is a non-profit acute care hospital located in Berkeley County, WV population 104,169 in the city of Martinsburg, WV. Martinsburg is the largest city in the Eastern Panhandle, and the 8th largest municipality in the state of West Virginia, with a total population of 17,227 residents. The Primary Service Area for City Hospital consists of Berkeley County, WV and Jefferson County, WV, with an extended service area including Morgan County, WV. The 2010 market share for City Hospitals Primary Service Area is 41.61 with 16.8 of those patients covered by Medicaid and 8.6 uninsured. Jefferson Memorial Hospital, a non-profit critical access hospital under common management, is located within the Primary Service Area and War Memorial Hospital, a non-profit critical access hospital, operated by Valley Health System, is located in the extended service area of Morgan County, WV. |
| Part VI Line 4 | Berkeley County has a population of 104,169, with an average household income of 38,763 and an unemployment rate of 8.1. Currently, 11.5 of the people in Berkeley County live below the 2010 Federal Poverty Guideline according to the U.S. Census Bureau 2010 census. Jefferson Countys population is 53,498, with an average household income of 44,347 and an unemployment rate of 5.9. 10.3 of Jefferson County residents live below the 2010 Federal Poverty Guideline. |
| Part VI Line 4 | In WVUH-Easts extended service area, Morgan County has a population of 17,541, with an average household income of 35,016 and an unemployment rate of 9.0. 10.4 of Morgan County residents currently live below 2010 Federal Poverty Guidelines. |
| Part VI Line 5 | The CHI board of directors is a community board, with fourteen of the fifteen members living in or around Martinsburg, WV. The remaining board member lives in Morgantown, WV and has connections with CHI 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 | CHI extends privileges to all qualified medical staff in Berkeley County and surrounding communities to meet its healthcare needs. |
| Part VI Line 5 | CHI allocates available funding to capital purchases and expanding services to improve patient care, support medical education in Berkeley County and surrounding counties in West Virginia and bordering states. |
| Part VI Line 5 | In 2009, CHI began 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, CHI offered Discounted Mammogram Clinics in April and October 2011 cash, no insurance. The clinics were successful in serving over 100 patients at City Hospital. The Rotary Health Fair, held in April, provided a full blood work-up at cost. Nearly 500 individuals took advantage of these screenings. |
| Part VI Line 5 | Our Mini-Medical School Program, which is held 6 times per year in Berkeley 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 75 - 100 in Berkeley County. |
| Part VI Line 6 | CHI is a part of the WV United Health System. CHI 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 service areas. Other hospitals in the System include United Health Center, which is more centrally located in the state, Jefferson Memorial Hospital which is located in the Eastern Panhandle of WV, Camden-Clark Medical Center located in Parkersburg, WV and West Virginia University Hospitals located in Morgantown, WV. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| City Hospital Foundation | |||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 311118075 | 501c3 | 300000 | Support |
| WVUH-East Inc | |||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 202337985 | 501c3 | 12003 | Support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | I | Identifier |
| Return Reference | 2 | ReturnReference |
| Explanation | City Hospital provides physician support to UPC-East Services to help UPC-East Services meet the mission of both City Hopsital and WVUH-East Services. City Hospital also contributed suppport this year to City Hospital Foundation as part of a capital campaign drive that the Foundation is running. During 2011 City Hospital provided support to related parties to help further the exempt purpose of the organization. | Explanation |
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 |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|---|
| Anthony Zelenka | ||||
| 243890 | 11770 | 910 | 32238 | 288808 |
| Donna Clews | ||||
| 148133 | 707 | 7752 | 156592 | |
| Linda Campbell Jones | ||||
| 214330 | 298 | 17507 | 232135 | |
| Jason T White | ||||
| 202751 | 62 | 32238 | 235051 | |
| Robert C Johnson Jr | ||||
| 199225 | 48 | 28436 | 227709 | |
| Mark D Kovacs | ||||
| 198181 | 45 | 33238 | 231464 | |
| Donna Hupp Baker | ||||
| 192270 | 258 | 10901 | 203429 | |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Panhandle Medical Associates | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Jeffrey B DeBord, DO | Relationship |
| Amount Of Transaction | 130400 | AmountOfTransaction |
| Description Of Transaction | Payment for medical services | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | IV | Identifier |
| Return Reference | 1 | ReturnReference |
| Explanation | Jeffrey B DeBord, DO owns greater than 5 of Panhandle Medical Associates. Panhandle Medical Associates provides contracted medical services to City Hospital Inc. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990 Part IV | 24a | Bond issuances allocated to City Hospital, Inc 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 City Hospital, Inc. |
| Form 990 Part VI | 11a | The Form 990 is prepared by the WVUH tax accountant and then reviewed by the WVUH-East Controller. Upon approval, it is then reviewed by the non-profit tax manager of our independent auditing firm. Once all review notes are cleared, it is presented to the WVUH-Easts Vice President of Finance for review. After gaining approval from the VP of Finance, it is then presented to all of the Board Members for a final review. Upon review by the Board of Directors, it is signed and submitted to the IRS. |
| Form 990 Part VI | 12c | All Board Members are required to disclose, annually, any relationship which may lead 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 appropriate. |
| Form 990 Part VI | 15b | The compensation of all executives is determined through the use of an independent salary consulting firm compiling the compensation data of comparable organizations in comparable geographic locations. This data is then used by an independent compensation committee to set the compensation for each executive. The data and supporting documentation are retained and documented. |
| Form 990 Part VI | 19 | All financial and governing documents are retained onsite and are made available to the public upon request. |
| Form 990 Part XI | 5 | The amount on line 5 Other changes in net assets or fund balance includes 1,802,928 of unrealized gains, 249,806 Change in restricted net assets, 2,177 contribution from City Foundation of comfort items for the oncology department posted to net assets on the financial statements and reported as contribution revenue on the Form 990, Hospitalists Net AR of 63,737, 1,627,973 of related organization capitalization, and 2,000 capital stock transfered from WVUH-Enterprises that was merged into City Hospital January 31, 2011. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 51,597,389, Grants and allocations 314,403, Revenue 25,714,441 City Hospital, Inc. CHI is a not-for-profit facility that operates twenty-four hours a day, seven days a week. The hospital provides acute care services, as well as emergency and specialty patient care. CHI serves as part of a regional health system, WVUH-East which serves Berkeley, Jefferson and Morgan Counties. City Hospital serves as a clinical education site for WVU, the WV School of Osteopathic Medicine and other universities and community colleges in the area. The Erma Byrd Health Professions Education Center, which houses WVUs Robert C Byrd Health Sciences Center-Eastern Division, is also located on the City Hospital campus. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 0, Grants and allocations 0, Revenue 0 City Hospital has a Level III Trauma Center and a fully accredited Cancer Program which offers cancer drug trials through its affiliation with the Mary Babb Randolph Cancer Center in Morgantown, WV. CHIs state of the art imaging services include but are not limited to 64 slice CT, PET CT, SPECT CT, MRI, Open Bore MRI, ultrasound, and digital mammography. |
| Form 990 Part III Program Service Accomplishments | Line 4d Other Activities | Program Service Expenses 0, Grants and allocations 0, Revenue 0 A 28 million expansion project launched at City Hospital in 2009 brought a new cardiac catheterization lab to City Hospital in October 2010. Although the lab performed diagnostic catheterizations through December 2010, the lab expanded services in January 2011 to include elective primary coronary intervention PCI and emergent therapeutic cardiac catheterization STEMI. A new 20-bed ICU/CCU opened at the same time which included four cardiac beds to support the cath lab. The third component, a new Emergency Department that can accommodate up to 65,000 patients, opened in 2011 as well. |
| 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 City Hospital, in addition to patient care, include a teaching program and a variety of community outreach involvement programs. In 2006, City Hospital changed surveying vendors to Press Ganey. With over 900 hospitals in their database, allowing for comparison to a much larger base of hospitals than with the prior vendor and creating more opportunities for future improvements. City Hospital also contracted with Custom Learning Systems to create an organizational culture that focuses on customer service. |
| Form 990, Part III, Line 4d Program Service Expenses 51,597,389, Grants and allocations 314,403, Revenue 25,714,441 City Hospital, Inc. CHI is a not-for-profit facility that operates twenty-four hours a day, seven days a week. The hospital provides acute care services, as well as emergency and specialty patient care. CHI serves as part of a regional health system, WVUH-East which serves Berkeley, Jefferson and Morgan Counties. City Hospital serves as a clinical education site for WVU, the WV School of Osteopathic Medicine and other universities and community colleges in the area. The Erma Byrd Health Professions Education Center, which houses WVUs Robert C Byrd Health Sciences Center-Eastern Division, is also located on the City Hospital campus. Form 990, Part III, Line 4d Program Service Expenses 0, Grants and allocations 0, Revenue 0 City Hospital has a Level III Trauma Center and a fully accredited Cancer Program which offers cancer drug trials through its affiliation with the Mary Babb Randolph Cancer Center in Morgantown, WV. CHIs state of the art imaging services include but are not limited to 64 slice CT, PET CT, SPECT CT, MRI, Open Bore MRI, ultrasound, and digital mammography. Form 990, Part III, Line 4d Program Service Expenses 0, Grants and allocations 0, Revenue 0 A 28 million expansion project launched at City Hospital in 2009 brought a new cardiac catheterization lab to City Hospital in October 2010. Although the lab performed diagnostic catheterizations through December 2010, the lab expanded services in January 2011 to include elective primary coronary intervention PCI and emergent therapeutic cardiac catheterization STEMI. A new 20-bed ICU/CCU opened at the same time which included four cardiac beds to support the cath lab. The third component, a new Emergency Department that can accommodate up to 65,000 patients, opened in 2011 as well. Form 990, Part III, Line 4d Program Service Expenses 0, Grants and allocations 0, Revenue 0 Other services provided by City Hospital, in addition to patient care, include a teaching program and a variety of community outreach involvement programs. In 2006, City Hospital changed surveying vendors to Press Ganey. With over 900 hospitals in their database, allowing for comparison to a much larger base of hospitals than with the prior vendor and creating more opportunities for future improvements. City Hospital also contracted with Custom Learning Systems to create an organizational culture that focuses on customer service. Form 990 Part IV Line 24a Bond issuances allocated to City Hospital, Inc 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 City Hospital, Inc. Form 990 Part VI Section B Line 11a The Form 990 is prepared by the WVUH tax accountant and then reviewed by the WVUH-East Controller. Upon approval, it is then reviewed by the non-profit tax manager of our independent auditing firm. Once all review notes are cleared, it is presented to the WVUH-Easts Vice President of Finance for review. After gaining approval from the VP of Finance, it is then presented to all of the Board Members for a final review. Upon review by the Board of Directors, it is signed and submitted to the IRS. Form 990 Part VI Section B Line 12c All Board Members are required to disclose, annually, any relationship which may lead 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 appropriate. Form 990 Part VI Section B Line 15b The compensation of all executives is determined through the use of an independent salary consulting firm compiling the compensation data of comparable organizations in comparable geographic locations. This data is then used by an independent compensation committee to set the compensation for each executive. The data and supporting documentation are retained and documented. Form 990 Part VI Section C Line 19 All financial and governing documents are retained onsite and are made available to the public upon request. Form 990 Part XI Line 5 The amount on line 5 Other changes in net assets or fund balance includes 1,802,928 of unrealized gains, 249,806 Change in restricted net assets, 2,177 contribution from City Foundation of comfort items for the oncology department posted to net assets on the financial statements and reported as contribution revenue on the Form 990, Hospitalists Net AR of 63,737, 1,627,973 of related organization capitalization, and 2,000 capital stock transfered from WVUH-Enterprises that was merged into City Hospital January 31, 2011. |
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 | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| West Virginia United Health System Inc | |||||||||||
| 1000 Technology Drive | Fairmont | WV | 26554 | 550754713 | Healthcare Access | WV | 501C3 | 11 a | N/A | false | |
| West Virginia University Hospitals | |||||||||||
| PO Box 8034 | Morgantown | WV | 26506 | 550643304 | Patient Care | WV | 501C3 | 3 | true | WV United Health System | |
| West Virginia University Hospitals - East Inc | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 202337985 | Patient Access | WV | 501C3 | 11a | true | WVU Hospitals Inc | |
| Jefferson Memorial Hospital Inc | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 550359755 | Patient Care | WV | 501C3 | 3 | true | WVUH-East Inc | |
| City Hospital Foundation | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 311118075 | Hospital Support | WV | 501C3 | 11a | N/A | false | |
| Jefferson Healthcare Foundation Inc | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 550768901 | Hospital Support | WV | 501C3 | 11a | N/A | false | |
| WVUH-East Services Inc | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 311118076 | Patient Care | WV | 501C3 | 3 | true | WVUH-East Inc | |
| United Health Foundation | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550621706 | Hospital Support | WV | 501C3 | 11a | N/A | false | |
| United Hospital Center Inc | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550525724 | Patient Care | WV | 501C3 | 3 | true | WV United Health System | |
| United Physicians Care Inc | |||||||||||
| 686 South Pike Street | Shinnston | WV | 26431 | 550638563 | Patient Care | WV | 501C3 | 3 | N/A | false | |
| United Summit Center Inc | |||||||||||
| 6 Hospital Plaza | Clarksburg | WV | 26301 | 550752788 | Behavioral Health | WV | 501C3 | 3 | N/A | false | |
| West Virginia Health Care Co-Op | |||||||||||
| PO Box 8059 | Morgantown | WV | 26506 | 550650441 | Support | WV | 501C3 | 11a | true | WV United Health System | |
| Camden-Clark Memorial Hospital | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26102 | 311524546 | Patient Care | WV | 501C3 | 3 | true | WV United Health System | |
| Camden-Clark Health Services | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26102 | 550769602 | Healthcare Access | WV | 501C3 | 11a, I | N/A | false | |
| Camden-Clark Foundation | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26102 | 550667789 | Support | WV | 501C3 | 11a | N/A | false | |
| Camden-Clark Physician Corp | |||||||||||
| 604 Ann Street | Parkersburg | WV | 26102 | 264058719 | Patient Care | WV | 501C3 | 11a, I | N/A | false | |
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 | ||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 550653982 | Medical Equip | WV | WVUH-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 | true | 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 | true | 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 | true | 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 | West Virginia University Hospitals-East Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | o | TransactionType |
| Amount Involved | 9547435 | AmountInvolved |
| Method Of Amt Determination | Cost | MethodOfAmtDetermination |