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VANDALIA HEALTH INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
VANDALIA HEALTH INC (EIN 55-0664138)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201123189349303537
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-14T13:05:51-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 S Wacker DriveAddressLine1
CityChicagoCity
StateILState
ZIP Code60606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN550664138EIN

Name Name

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

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameLarry C HudsonName
TitleChief Financial OfficerTitle
Phone3043887603Phone
Date Signed2011-11-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameASHLEY SIWULAName
Phone3124861000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1501 Morris StreetAddressLine1
CityCharlestonCity
StateWVState
ZIP Code25301ZIPCode
FieldValueIRS element (for citing)
Gross Receipts619414GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.camc.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1986YearFormation
State Legal DomicileWVStateLegalDomicile
Activity Or Mission DescriptionCAMC Health System, Inc. ("CAMCHSI") is organized and operated solely to provide support to Charleston Area Medical Center, Inc. ("CAMC"), a not-for-profit corporation organized under the laws of the state of West Virginia.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year224010InvestmentIncomePriorYear
Investment Income Current Year202258InvestmentIncomeCurrentYear
Other Revenue Prior Year4851509OtherRevenuePriorYear
Other Revenue Current Year417156OtherRevenueCurrentYear
Total Revenue Prior Year5075519TotalRevenuePriorYear
Total Revenue Current Year619414TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4647003OtherExpensePriorYear
Other Expenses Current Year203868OtherExpensesCurrentYear
Total Expenses Prior Year4647003TotalExpensesPriorYear
Total Expenses Current Year203868TotalExpensesCurrentYear
Revenues Less Expenses Prior Year428516RevenuesLessExpensesPriorYear
Revenues Less Expenses CY415546RevenuesLessExpensesCY
Total Assets BOY300640462TotalAssetsBOY
Total Assets EOY335176632TotalAssetsEOY
Total Liabilities BOY23061217TotalLiabilitiesBOY
Total Liabilities EOY22445745TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY277579245NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY312730887NetAssetsOrFundBalancesEOY
Mission DescriptionCAMCHSI is organized and shall be operated solely to provide support to CAMC, a not-for-profit corporation organized under the laws of the state of West Virginia, through the performance of functions of said Charleston Area Medical Center, Inc or otherwise.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense60120Expense
Revenue417156Revenue
DescriptionCAMCHSI is organized and shall be operated solely for charitable, scientific and educational purposes, and is not organized and shall not be operated for profit; no part of the net earnings of this corporation shall inure to the benefit of any private stockholder or individual, and no substantial part of its activities shall consist of carrying on propaganda, or otherwise attempting to influence legislation, and it shall not participate in, nor intervene in, any political campaign on behalf of any candidate for public office.Description
Total Program Service Expense60120TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Excess Business Holdings0ExcessBusinessHoldings
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWVStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Larry C HudsonBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3043887603TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1501 Morris StreetAddressLine1
CityCharlestonCity
StateWVState
ZIP Code253010000ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerFormerFormer
R Thomas Bowden III DO
Director3.00X000
Mark A Chandler
Director3.00X000
Nelle Ratie Chilton
Director3.00X000
Carol A Egnatoff
Director3.00X000
Wetzel E Harvey
Director3.00X000
John R Hoblitzell
Director3.00X000
Thomas E Potter Esq
Director3.00X000
Linda J Powers
Director3.00X000
Gerald N Smith III
Director3.00X000
Edwin H Welch PhD
Director3.00X000
James P Griffith MD
Director3.00X000
Karen S Price
Director3.00X000
Steven L McCormick MD
Director3.00X000
Asif Rahman MD
Chief of Staff3.00X000
David L Ramsey
President & CEO5.000824125407533X
William R McDavid
Vice Chairperson3.00000X
William A Rice Jr
Chairperson3.00000X
Glenn Crotty Jr MD
COO5.000294849675502X
Larry C Hudson
CFO5.00049624584515X
Marshall A McMullen Jr
Secretary & Gen. Counsel5.000293805121964X
Robert B Danielson
VP Compliance5.00017334757876X
Beth A Samples
VP of HR5.000230849208992X
Lynn Y Brookshire
VP of IT5.000259463128624X
Steven R Matulis MD
Former Director0.00000X
James P Tierney DO
Former Director1.00000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs5226330TotalReportableCompFrmRltdOrgs
Total Other Compensation1085006TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column202258TotalRevenueColumn
Exclusion$202,258ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Affiliate Transfer (NE900099415546415546
Bad Debts90009916101610
FieldValueIRS element (for citing)
Total Other Revenue417156TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column619414TotalRevenueColumn
Related Or Exempt Function Income417156RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$202,258ExclusionAmount

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total88318Total
Management And General88318ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total20939Total
Management And General20939ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total109Total
Management And General109ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total25789Total
Management And General25789ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total60120Total
Program Services60120ProgramServices

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionProperty TaxesDescription
Total8593Total
Management And General8593ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total203868Total
Program Services60120ProgramServices
Management And General143748ManagementAndGeneral
Fundraising0Fundraising

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY179274BOY
EOY189132EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY30111BOY
EOY4321EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY108875BOY
EOY108875EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY295909630BOY
EOY330645726EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4412572BOY
EOY4228578EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY300640462BOY
EOY335176632EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY681BOY
EOY4372EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY23060536BOY
EOY22441373EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY23061217BOY
EOY22445745EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY238657053BOY
EOY264981536EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY18941439BOY
EOY27001452EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY19980753BOY
EOY20747899EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY277579245BOY
EOY312730887EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY300640462BOY
EOY335176632EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses415546ReconcilationRevenueExpenses
Reconcilation Other Changes34736096ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

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

Supported Org Information SupportedOrgInformation

Name Name

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

Schedule D IRS990ScheduleD

Current Year CurrentYear

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

Current Year Minus1 Year CurrentYearMinus1Year

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

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance39597745BeginningOfYearBalance
Investment Earnings Or Losses8913059InvestmentEarningsOrLosses
End Of Year Balance30684686EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.57000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.43000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionAffiliatesDescription
Book Value330645726BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related330645726TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionAffiliate Payable - CAMCDescription
Amount$22,441,373Amount
FieldValueIRS element (for citing)
Total Of Amounts22441373TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X:ReturnReference
ExplanationCAMCHSI is included in the consolidated audit of CAMC Health System, Inc and Subsidiaries (collectively, the "System"). Language regarding ASC 740 (FIN 48) included in the consolidated footnotes is as follows: "CAMC, the Foundation, the Institute and CAMC Teays, are exempt from income taxes under Section 501 (c)(3) of the Internal Revenue Code (the "Code") and applicable state statutes, but are subject to unrelated business income tax. The System does not have any material uncertain tax positions at December 31, 2010.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
David L Ramsey
058153201357480106845038832101921201231658055420
Glenn Crotty Jr MD
0380146076529024918210528270226750302399801711036
Larry C Hudson
03332900712750916800667500177650580760044411
Marshall A McMullen Jr
020935702989705455101007590212050415769023797
Robert B Danielson
0146462016885010000041631016245023122300
Beth A Samples
01813060269530225900178776030216043984108353
Lynn Y Brookshire
018815202304104827001085720200520388087018354

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Supplemental InformationPart IIIPart 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 InformationPart IIIPart I, Line 4b: Supplemental Executive Retirement Plan: Participant paid in 2010 was Glenn Crotty 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: CAMC 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 five 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.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 2David L. Ramsey and Tom Potter have a business relationship with each other.
Form 990, Part VI, Section B, line 11The 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 CAMCHSI Board of Directors and Audit Committee.
Corporate officers including the President and Secretary develop the agendas for board meetings and identify potential conflict of interest issues relative to action items and assist board chairs with resolution of same. Annual disclosure procedures are implemented and the board chair and Nominating Committee periodically review conflict situations.Form 990, Part VI, Section B, line 12c
The CAMCHSI Board of Directors Compensation Committee selects and supervises an independent consultant who advises the Committee on compensation arrangements and transactions between CAMC Health System companies and executives (including the CEO). The Committee uses the data to determine the total compensation of the CEO and the executive officers. This data is reviewed every two years or when a new person comes into an executive role.Form 990, Part VI, Section B, line 15
CAMC Health System, Inc. is part of a consolidated financial audit for CAMC Health System, Inc. and Subsidiaries. Consolidated audited financial statements are available online at CAMC.org. They are also filed with the WV Health Care Authority where they are available on-line and in person. There is no formal method of making the Bylaws and Conflict of Interest policy publicly available, but they are available upon request. The Articles of Incorporation are publicly available at the WV Secretary of State's Office.Form 990, Part VI, Section C, line 19
Some members of the Board were compensated by related organizations for other duties as follows: CAMC - David L. Ramsey 50 hours, Glenn Crotty Jr. 50 hours, Larry C. Hudson 50 hours, Beth A. Samples 50 hours, Lynn Y. Brookshire 50 hours, Marshall A. McMullen Jr. 50 hours, Robert B. Danielson 50 hoursForm 990, Part VII Section A:
Changes in Net Assets or Fund Balances:Change in Temporary Restricted Contributions of subsidiaries 8,060,013. Change in Permanent Restricted Contributions of subsidiaries 767,146. Change in beneficial interest in affiliates 25,908,937. Total to Form 990, Part XI, Line 5: 34,736,096.Form 990, Part XI, line 5:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Charleston Area Medical Center Inc
PO Box 1547CharlestonWV253261547550526150HospitalWVSection 501(c)(3)Line 3CAMC Health System Inc1
Charleston Area Medical Center Foundation Inc
PO Box 1547CharlestonWV253261547310887133FundraisingWVSection 501(c)(3)Line 11b, IICAMC Health System Inc1
CAMC Health Education and Research Institute Inc
PO Box 1547CharlestonWV253261547550753754Medical researchWVSection 501(c)(3)Line 11b, IICAMC Health System Inc1
CAMC Teays Valley Hospital Inc
PO Box 1547CharlestonWV253261547550752636HospitalWVSection 501(c)(3)Line 3CAMC Health System Inc1

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAPredominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Women and Children's Medical Office Building Partnership
PO Box 1547CharlestonWV253261547550669065Medical office BuildingWVN/AN/A00
General Division Medical Office Building Partnership
PO Box 1547CharlestonWV253261547550623949Medical office BuildingWVN/AN/A00

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Integrated Health Care Providers IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 1547AddressLine1
CityCharlestonCity
StateWVState
ZIP Code253261547ZIPCode
FieldValueIRS element (for citing)
EIN550751010EIN
Primary ActivityPhysician Practices & ClinicsPrimaryActivity
Legal Domicile StateWVLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1100BusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Share Of Total Income-66299ShareOfTotalIncome
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Charleston Area Medical Center Inc
B60120Contract
Charleston Area Medical Center Inc
L88318Contract
Charleston Area Medical Center Inc
R415546Contract