2011-11-14T13:05:23-06:00 2010-12-31 Deloitte Tax LLP 111 SWacker Drive Chicago IL 606064301 990 2010-01-01 550753754 CAMC Health Education and Research Institute Inc CAMC 3043889900 PO Box 1547 Charleston WV 253261547 Sharon A Hall 3043889900 2011-11-11 1 ASHLEY SIWULA 3124861000 2010 2016-03-07 17:11:31Z CAMC Institute Sharon A Hall 3200 MacCorkle SE Charleston WV 25304 11074598 0 X www.camcinstitute.org X 1996 WV CAMC Health Education and Research Institute, Inc. ("CHERI")'s primary exempt purpose is to provide education opportunities and perform research which benefits both the community and Charleston Area Medical Center ("CAMC"), a not-for-profit corporation organized under the laws of the State of West Virginia. The organization administers a graduate medical education program. Its education focus and research opportunities center around anesthesia and trauma, as well as other health related programs. 11 2 139 0 0 0 1952584 1261454 3692183 4423059 0 0 4758889 5390085 10403656 11074598 0 0 0 0 6569712 6738776 0 0 0 4186057 4691969 10755769 11430745 -352113 -356147 5392609 6217506 2232333 3164298 3160276 3053208 See response, Schedule O. 0 0 3519058 2435640 The organization serves as administrator of Charleston Area Medical Center, Inc. ("CAMC") graduate medical education and nurse anesthesia programs, and conducts a variety of professional education and training programs for CAMC healthcare professionals as well as healthcare professionals throughout the state of West Virginia. 4239406 1457844 Provision of services pertaining to various research activities including centers for clinical trials and cancer research, health services and outcomes research, trauma research and other health related research centers of excellence. 1274551 529575 Provision of various health programs designed to improve health education and awareness in the state and local communities. 9033015 1 1 0 0 0 0 0 0 0 1 1 0 0 1 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 1 135 0 1 139 1 0 0 0 0 0 0 0 0 0 0 0 X 11 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WV X Larry C Hudson 3043887603 501 Morris Street Charleston WV 253010000 William H Carter MD 1.00 X 0 0 0 Glenn Crotty Jr MD 1.00 X 0 2948496 75502 Clark Hansbarger MD 1.00 X 0 0 0 Steven Jubelirer MD 1.00 X 0 318232 30865 Ronald E Moore 1.00 X 0 219990 32687 E Gail Pitchford 1.00 X 0 204516 47514 David L Ramsey 1.00 X 0 824125 407533 Beth A Samples 1.00 X 0 230849 208992 Edwin Welch PhD 1.00 X 0 0 0 Robert D Whitler 1.00 X X 0 195072 27515 Sharon A Hall 40.00 X X 232297 0 51236 Angela F Hill 1.00 X 0 157164 26305 Gregory E Souther 40.00 X 62291 0 11454 Nancy L Tierney 40.00 X 170858 0 29706 Priscilla P Walkup 40.00 X 152725 0 26738 William A White Jr 40.00 X 152522 4760 30820 Cassandra L Taylor 40.00 X 144364 0 17967 Kathryn F Newcome 40.00 X 138574 6663 29732 1053631 5109867 1054566 6 0 1 0 Marshall University One John Marshall Drive Huntington WV 25755 School of Nurse Anesthesia faculty 507085 WVU Medical Corporation 3110 MacCorkle Ave Charleston WV 25304 Physician Services 218499 Thoracic and Cardiovascular Associates 2335 Chesterfield Ave Charleston WV 25304 Physician Services 127794 3 1261454 1261454 Education Services Sol 611710 2435641 2435641 Research Revenue 621990 1457844 1457844 Non Clinical Services 621990 529574 529574 4423059 Related Organizations 900099 5390085 5390085 5390085 11074598 9813144 0 0 392152 392152 4880115 4799781 80334 163066 147928 15138 947987 106719 841268 355456 329088 26368 336492 336492 486391 -13609 500000 6949 6949 3043 3043 638185 629873 8312 52087 52087 195867 191325 4542 81330 66830 14500 431022 327280 103742 158266 150025 8241 1582761 1580583 2178 350335 324110 26225 25448 1324 24124 Miscellaneous 131299 128305 2994 Medical supplies 116150 116150 Dietary 73436 72645 791 Repairs and maintenance 22908 22571 337 11430745 9033015 2397730 0 359737 238412 1157 5561 4818 5129223 4094406 1019715 1034817 4007182 4938716 5392609 6217506 1290758 2230851 941575 933447 2232333 3164298 X -943415 -1299562 2402123 2646819 1701569 1705951 3160277 3053208 5392609 6217506 X -356147 249078 X 0 1 0 X 1 1 X X X 0 0 0 Charleston Area Medical Center 550526150 3 1 1 1 4958945 1 4958945 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3554856 11882 340282 191625 1819 3713576 2904182 10174 479445 -154052 -7013 3554856 3710567 17354 -1046394 -216001 -6654 2904182 0.51000 0.49000 0 1 1 202880 154517 48363 4926343 3939889 986454 1034817 Interest in net asset : CAMC Foundation 3350992 Affiliate Receivables 1587724 4938716 Affiliate payable 361513 Accrued payroll and related payroll expenses 571934 933447 Part IV, Line 2b: 3,350,992 Description of Intended Use of Endowment Funds: Part V, Line 4: To provide education opportunities and perform medical research, which benefits both the community and CAMC. Description of Uncertain Tax Positions Under FIN 48: Part X: CHERI is part of the consolidated audit for 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. The System does not have any material uncertain tax positions at December 31, 2010. 0 1 0 0 0 0 0 0 0 Glenn Crotty Jr MD 0 380146 0 76529 0 2491821 0 52826 0 22676 0 3023998 0 1711036 Steven Jubelirer MD 0 317932 0 0 0 300 0 14700 0 16165 0 349097 0 0 Ronald E Moore 0 169391 0 26266 0 24333 0 22346 0 10341 0 252677 0 10571 E Gail Pitchford 0 149715 0 23565 0 31236 0 38139 0 9375 0 252030 0 15085 David L Ramsey 0 581533 0 135748 0 106844 0 388322 0 19211 0 1231658 0 55420 Beth A Samples 0 181306 0 26953 0 22590 0 178776 0 30216 0 439841 0 8353 Robert D Whitler 0 149338 0 21667 0 24067 0 7886 0 19629 0 222587 0 0 Sharon A Hall 154625 0 26670 0 51002 0 35650 0 15586 0 283533 0 20377 0 Angela F Hill 0 147954 0 9210 0 0 0 6268 0 20037 0 183469 0 0 Nancy L Tierney 156239 0 6124 0 8495 0 10370 0 19336 0 200564 0 0 0 Priscilla P Walkup 145763 0 0 0 6962 0 9192 0 17546 0 179463 0 0 0 William A White Jr 146360 4760 0 0 6162 0 9484 0 21336 0 183342 4760 0 0 Cassandra L Taylor 144364 0 0 0 0 0 8952 0 9015 0 162331 0 0 0 Kathryn F Newcome 138574 6663 0 0 0 0 9641 0 20091 0 168306 6663 0 0 Supplemental Information Part III Part I, Line 3: The 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 the CEO and the executive officers. The data is reviewed every two years or when a new person comes into an executive role. Supplemental Information Part III Part I, Line 4b: Supplemental Executive Retirement Plan: Participant paid in 2010 was Glenn Crotty Jr. in the amount of $1,217,085. Terms & conditions of SERP Plan: 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: CHERI 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. Taxes due upon distribution. Subject to the Substantial Risk of Forfeiture. Form 990, Part VI, Section A, line 6 CAMC Health System, Inc. ("CAMCHSI")is the organization's sole voting member. Form 990, Part VI, Section A, line 7a CAMCHSI is the organization's sole voting member and has authority to elect all voting directors of the organization other than ex officio directors named in the organization's governing documents. The sole voting member has the sole authority to amend the organization's governing documents. Form 990, Part VI, Section A, line 7b CAMCHSI is the organization's sole voting member and has reserved powers under the organization's governing documents, which provide that decisions of the organization's governing body such as election of officers, approval of annual budgets, and borrowings are subject to approval by the sole voting member. The sole voting member also has all approval powers provided to members of West Virginia nonprofit corporations under state law. Form 990, Part VI, Section B, line 11 The organization compiles necessary information for Form 990 with various officers and directors 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 CAMC Health System, Inc. Board of Directors Audit Committee and the CAMC Health System, Inc. Board of Directors. 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 the board chair 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 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 companies (including CAMC Health Education and Research Institute, Inc.) and executives (including the CEO).The Committee uses the data to determine the total compensation of the CEO, as well as the executive officers of other System companies. This data is reviewed every two years or when a new person comes into an executive role. Form 990, Part VI, Section C, line 19 CHERI is part of a consolidated financial audit for CAMC Health System, Inc. and Subsidiaries. Consolidated audited financial statements are available on-line 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. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: CHERI interest in the net assests of the Foundation Description of reasonable effort made to obtain comp from related org: Form 990, Part VII: Some members of the board were compensated by related organizations for other duties as follows: CAMC - David L. Ramsey 48 hours, Glenn Crotty Jr. 45 hours, Ronald E. Moore 45 hours, Beth A. Samples 45hours, Robert D. Whitler 45 hours, Angela F. Hill 45 hours, Steven Jubilerir 45 hours, E. Gail Pitchford 45 hours, William White 1 hour, Kathryn Newcome 2 hours. Changes in Net Assets: Form 990, Part XI, Line 5: CHERI interest in the net assets of the Foundation : 249,078 Charleston Area Medical Center Inc PO Box 1547 Charleston WV 253261547 550526150 Hospital WV Section 501(c)(3) Line 3 CAMC Health System Inc 1 CAMC Health System Inc PO Box 1547 Charleston WV 253261547 550664138 Parent Company WV Section 501(c)(3) Line 11c, III-FI N/A 1 CAMC Teays Valley Hospital Inc PO Box 1547 Charleston WV 253261547 550752636 Hospital WV Section 501(c)(3) Line 3 CAMC Health System Inc 1 Charleston Area Medical Center Foundation Inc PO Box 1547 Charleston WV 253261547 310887133 Foundation WV Section 501(c)(3) Line 11b, II 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 N/A 0 0 General Division Medical Office Building Partnership PO Box 1547 Charleston WV 253261547 550623949 Medical Office Building WV N/A N/A 0 0 Integrated Health Care Providers Inc PO Box 1547 Charleston WV 253261547 550751010 Physician Offices WV N/A C 0 0 1 0 0 0 0 0 0 1 0 1 0 0 1 1 0 0 Charleston Area Medical Center Inc C 4958945 Contract CAMC Foundation Inc C 431140 Contract Charleston Area Medical Center Inc J 252419 Contract Charleston Area Medical Center Inc L 336492 Contract Charleston Area Medical Center Inc O 3167255 FMV CAMC Teays Valley Hospital Inc P 115506 FMV Charleston Area Medical Center Inc P 615082 FMV