2011-11-14T13:05:51-06:00 2010-12-31 Deloitte Tax LLP 111 S Wacker Drive Chicago IL 60606 990 2010-01-01 550664138 CAMC Health System Inc CAMC 3043885432 PO Box 1547 Charleston WV 253261547 Larry C Hudson 3043887603 2011-11-11 1 ASHLEY SIWULA 3124861000 2010 2016-02-24 21:20:13Z Same Larry C Hudson 501 Morris Street Charleston WV 25301 619414 0 X www.camc.org X 1986 WV CAMC Health System, Inc. ("CAMCHSI") is organized and operated solely to provide support to Charleston Area Medical Center, Inc. ("CAMC"), a not-for-profit corporation organized under the laws of the state of West Virginia. 17 12 0 0 0 0 0 0 0 0 224010 202258 4851509 417156 5075519 619414 0 0 0 0 0 0 0 0 0 4647003 203868 4647003 203868 428516 415546 300640462 335176632 23061217 22445745 277579245 312730887 CAMCHSI 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. 0 0 60120 417156 CAMCHSI 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. 60120 1 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 12 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WV X Larry C Hudson 3043887603 501 Morris Street Charleston WV 253010000 X R Thomas Bowden III DO 3.00 X 0 0 0 Mark A Chandler 3.00 X 0 0 0 Nelle Ratie Chilton 3.00 X 0 0 0 Carol A Egnatoff 3.00 X 0 0 0 Wetzel E Harvey 3.00 X 0 0 0 John R Hoblitzell 3.00 X 0 0 0 Thomas E Potter Esq 3.00 X 0 0 0 Linda J Powers 3.00 X 0 0 0 Gerald N Smith III 3.00 X 0 0 0 Edwin H Welch PhD 3.00 X 0 0 0 James P Griffith MD 3.00 X 0 0 0 Karen S Price 3.00 X 0 0 0 Steven L McCormick MD 3.00 X 0 0 0 Asif Rahman MD 3.00 X 0 0 0 David L Ramsey 5.00 X 0 824125 407533 William R McDavid 3.00 X 0 0 0 William A Rice Jr 3.00 X 0 0 0 Glenn Crotty Jr MD 5.00 X 0 2948496 75502 Larry C Hudson 5.00 X 0 496245 84515 Marshall A McMullen Jr 5.00 X 0 293805 121964 Robert B Danielson 5.00 X 0 173347 57876 Beth A Samples 5.00 X 0 230849 208992 Lynn Y Brookshire 5.00 X 0 259463 128624 Steven R Matulis MD 0.00 X 0 0 0 James P Tierney DO 1.00 X 0 0 0 0 5226330 1085006 0 0 1 0 0 202258 202258 Affiliate Transfer (NE 900099 415546 415546 Bad Debts 900099 1610 1610 417156 619414 417156 0 202258 88318 88318 20939 20939 109 109 25789 25789 60120 60120 Property Taxes 8593 8593 203868 60120 143748 0 179274 189132 30111 4321 108875 108875 295909630 330645726 4412572 4228578 300640462 335176632 681 4372 23060536 22441373 23061217 22445745 X 238657053 264981536 18941439 27001452 19980753 20747899 277579245 312730887 300640462 335176632 X 415546 34736096 X 0 1 1 X 0 X X X 0 0 0 Charleston Area Medical Center Inc 550526150 3 1 1 1 0 1 0 38922192 8827159 47749351 30684686 8237506 38922192 39597745 8913059 30684686 0.57000 0.43000 0 0 0 Affiliates 330645726 C 330645726 Affiliate Payable - CAMC 22441373 22441373 Description of Uncertain Tax Positions Under FIN 48: Part X: CAMCHSI is included in the consolidated audit of CAMC Health System, Inc and Subsidiaries (collectively, the "System"). Language regarding ASC 740 (FIN 48) included in the consolidated footnotes is as follows: "CAMC, the Foundation, the Institute and CAMC Teays, are exempt from income taxes under Section 501 (c)(3) of the Internal Revenue Code (the "Code") and applicable state statutes, but are subject to unrelated business income tax. The System does not have any material uncertain tax positions at December 31, 2010. X X X X X 0 1 0 0 0 0 0 0 0 David L Ramsey 0 581532 0 135748 0 106845 0 388321 0 19212 0 1231658 0 55420 Glenn Crotty Jr MD 0 380146 0 76529 0 2491821 0 52827 0 22675 0 3023998 0 1711036 Larry C Hudson 0 333290 0 71275 0 91680 0 66750 0 17765 0 580760 0 44411 Marshall A McMullen Jr 0 209357 0 29897 0 54551 0 100759 0 21205 0 415769 0 23797 Robert B Danielson 0 146462 0 16885 0 10000 0 41631 0 16245 0 231223 0 0 Beth A Samples 0 181306 0 26953 0 22590 0 178776 0 30216 0 439841 0 8353 Lynn Y Brookshire 0 188152 0 23041 0 48270 0 108572 0 20052 0 388087 0 18354 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 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. Form 990, Part VI, Section A, line 2 David L. Ramsey and Tom Potter have a business relationship with each other. 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 CAMCHSI Board of Directors and Audit Committee. Form 990, Part VI, Section B, line 12c Corporate officers including the President and Secretary develop the agendas for board meetings and identify potential conflict of interest issues relative to action items and assist board chairs with resolution of same. Annual disclosure procedures are implemented and the board chair and Nominating Committee periodically review conflict situations. Form 990, Part VI, Section B, line 15 The CAMCHSI Board of Directors Compensation Committee selects and supervises an independent consultant who advises the Committee on compensation arrangements and transactions between CAMC Health System 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 C, line 19 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 VII Section A: 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 hours Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: 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. 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 Charleston Area Medical Center Foundation Inc PO Box 1547 Charleston WV 253261547 310887133 Fundraising WV Section 501(c)(3) Line 11b, II CAMC Health System Inc 1 CAMC Health Education and Research Institute Inc PO Box 1547 Charleston WV 253261547 550753754 Medical research WV Section 501(c)(3) Line 11b, II CAMC Health System Inc 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 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 Practices & Clinics WV 100 C -66299 1.00000 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 Charleston Area Medical Center Inc B 60120 Contract Charleston Area Medical Center Inc L 88318 Contract Charleston Area Medical Center Inc R 415546 Contract