2011-11-15T14:40:22-07:00 2010-12-31 990 2010-01-01 550614866 OHIO VALLEY MEDICAL CENTER INCORPORATED OHIO 3042340123 2000 Eoff Street Wheeling WV 260033823 Lisa Simon 3042348180 2011-11-15 2010 2016-02-24 21:20:13Z Lisa Simon 2000 Eoff Street Wheeling WV 26003 101501529 0 X www.ovmc-online.com X 1890 WV The medical staff and employees of OVMC are committed to providing high-quality, cost-effective care to promote the health and well-being of those living in our community. To achieve this charitable goal, OVMC delivers specialized hospital based care and outpatient services and offers health, wellness, and professional education programs 19 16 0 60 715494 0 49990 422500 100848605 96651523 16399 -19445 5448530 4340611 106363524 101395189 0 0 0 0 47772568 43589164 0 0 0 60434240 61656494 108206808 105245658 -1843284 -3850469 50467850 44328428 46053483 44906501 4414367 -578073 The medical staff and employees of OVMC are committed to providing high-quality, cost-effective care to promote the health and well-being of those living in our community. To achieve this charitable goal, OVMC delivers specialized. hospital-based care and outpatient services and offers health, wellness, and professional education programs. 0 0 91001310 0 101395189 Ohio Valley Medical Center Inc (OVMC) is an acute care facility which provides a teaching program to physician residents/interns and also provides specialty services such as a psychiatric/chemical dependency unit. OVMC provides quality medical healthcare, including acute inpatient care, and outpatient services, to the public regardless of race, creed, sex natural origin, handicap, age or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of OVMC, it is recognized that not all individuals possess the ability to purchase essential medical services. It is the mission of the hospital to service the community with respect to providing healthcare medical services and healthcare education. Therefore, in keeping with the hospital's commitment to service all members of the community: free care and/or subsidized care was provided during the year: care was provided to persons covered by government programs which reimburse the hospital at below cost during the year; and health activities and programs to support the community were conducted during the year. In addition to providing essential healthcare services to the community, other activities conducted during the year included wellness, community education and special programs. 0 0 0 91001310 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 1 1 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 X 19 16 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 1 1 0 0 0 WV X Rick Scherich 3042348433 2000 Eoff St Wheeling WV 260033823 X Kenneth Barber 0 X 0 0 0 James Kepner 0 X 0 0 0 Rajai Khoury MD 0 X 0 0 0 James Squibb Jr 0 X 0 0 0 Charles Swart III 0 X 0 0 0 Howard Shackelford Jr MD 0 X 0 0 0 John Kerr 0 X 0 0 0 Orphy Klempa 0 X 0 0 0 Derrick Latos 0 X 0 0 0 Will Turani 0 X 0 0 0 Kristine Molnar 0 X 0 0 0 Gregory Saracco 0 X 0 0 0 Scott Reed 0 X 0 0 0 John Clarke 0 X 0 0 0 Darrell Cummings 0 X 0 0 0 Jeffrey Knierim 40 X 0 0 0 Lisa Simon 40 X 98659 0 2574 Brian Felici 40 X 270737 0 9009 Shishar Shah MD 40 X 415891 0 15444 Mary Haus MD 40 X 413885 0 6120 Pradip Mehta MD 0 X 379133 0 15444 Santwana Sovani 40 X 375033 0 15444 Romeo Reyes 40 X 370567 0 11760 2323905 0 75795 36 0 1 0 WVU Medical Corporation DBA University PO Box 897 Morgantown WV 26507 Neurosurgeons 719028 Emergency Medicine Physicians 4535 Dressler Rd NW Canton OH 44718 Emergency Room Physicians 677035 Alliance Imaging PO Box 96485 Chicago IL 606936485 MRI & PET 1397964 Sodexho Inc & Affliates PO Box 539622 Atlanta GA 303536922 Food Services & Mgt 1351600 Quest Diagnostics 875 Greentree Road 4 Parkway Center Pittsburgh PA 15220 Lab Services 699761 21 0 0 0 0 422500 0 0 422500 Net Patient Revenue 622000 96616733 96616733 0 0 Non- Patient Revenue 621500 34790 0 34790 0 0 0 0 0 96651523 6017 6017 0 0 0 0 0 0 0 0 0 0 58107 0 45423 0 12684 0 12684 0 12684 0 0 35455 0 60917 0 -25462 -25462 -25462 0 0 0 Cafeteria, Auxiliary & All Other 900099 3659907 0 0 3659907 Health Club Fees 713900 325206 0 325206 0 Other Practitioner Offices 621300 342814 0 342814 0 0 0 0 0 4327927 101395189 96597288 715494 3659907 0 0 0 0 0 0 0 0 80628 0 80628 0 0 0 0 0 36233364 36229998 3366 0 0 0 0 0 4137417 4137417 0 0 3137755 3131503 6252 0 0 0 0 0 155861 14030 141831 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2250952 2250952 0 0 19236 19059 177 0 307138 302394 4744 0 0 0 0 0 0 0 0 0 2381431 2145368 236063 0 88341 87806 535 0 0 0 0 0 0 0 0 0 439625 439625 0 0 0 0 0 0 3041663 3041663 0 0 1186495 183354 1003141 0 Bad Debt 13627180 13627180 0 0 Broad Based Provider Tax 1311241 0 1311241 0 Home Office Allocation 9506760 0 9506760 0 Purchased Services 3624427 3610481 13946 0 All other Supplies 17062684 17062265 419 0 6653460 4718215 1935245 0 105245658 91001310 14244348 0 1650343 -110149 247560 813803 1000 0 14545065 11609523 0 0 0 0 138182 62434 2657048 2862320 284223 243849 122196378 103892547 20246841 18303831 1825003 334 0 0 2065680 2216372 0 0 6806905 8326111 50467850 44328428 11376163 7879163 13931982 16057493 0 0 6388525 4692845 0 0 0 0 11067150 12968677 0 0 3289663 3308323 46053483 44906501 X -792689 -4067151 298848 341627 4908208 3147451 4414367 -578073 50467850 44328428 X -3850469 -1141971 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 863853 863853 0 80086035 66395982 13690053 0 0 0 0 0 40261816 36708017 3553799 0 984674 788548 196126 18303831 Deferred Pension Costs 7904591 Net Client Accounts Receivable 403705 Debt Issue Costs 17815 8326111 Accrued Building Abatement 1786721 Self Funded Malpractice 1521602 3308323 1 1 1 X 0 0 1 1 0 0 0 0 2384389 222761 2161628 0.0205 0 0 14148628 11785675 2362953 0.0225 0 0 0 0 0 0 0 0 16533017 12008436 4524581 0.0430 0 0 40975 1375 39600 0.0004 0 0 2835796 961170 1874626 0.0178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2876771 962545 1914226 0.0182 0 0 19409788 12970981 6438807 0.0612 0 5021595 0 16502973 16454141 48832 X 1 1 1 1 Ohio Valley Medical Center

2000 Eoff Street Wheeling WV 26003

X X X X Ohio Valley Medical Center 1 0 1 1 100 0 1 X 1 1 X X X 1 X 1 X X X X X 1 0 1 SchH_P01_S00_L03c Schedule H, Part I, Line 3c FPG is used when determining eligibility for free care but not used for providing for discounted care. SchH_P01_S00_L07 Schedule H, Part I, Line 7 Cost to Charge ratio from worksheet 2 was used to determine cost. SchH_P03_S0A_L04 Schedule H, Part III, Section A, Line 4 The organizations financial statements do not include a footnote regarding bad debt expense. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 Cost was determined by Medicare Cost Report. SchH_P03_S0C_L09a Schedule H, Part III, Section C, Line 9a Ohio Valley Medical Center (OVMC) collection on private pay accounts will be performed consistently to ensure optimization of cash flow and for timely identification of bad debt accounts. Patients have the responsibility to provide requested information, pursue all other sources of financial assistance as may be available and to make appropriate payment arrangements. As a service to patients, OVMC will assist by billing insurance companies and other third party payers, and assist in obtaining their payments on behalf of the patients. Patient accounts considered uncollectible are to be written-off to the appropriate bad debt account. RULES (GUIDELINES): - The goal of all contacts with patients is to determine when an outstanding account will be paid. Patients should be asked to commit to a payment date. - Any request for an itemized statement should be fulfilled but at no time should a HCFA 1450 (UB-92) or HCFA 1500 be sent to a patient. - Any request for a discount from the amount billed or financial assistance (charity care) must be referred to the Financial Counselor or Manager of Credit and Collections. - A continuous and reasonable collection effort will be made for all payer types, with the exception of charity care accounts and medically indigent accounts (Medicaid). - All patients should be encouraged to enter into a payment plan arrangement, if they are unable to pay the full amount owed. - If a patient breaches the payment plan arrangement by failure to pay according to terms agreed upon, the account will enter the collection process. - Bad debts are amounts (usually co-insurance and deductibles) owed on the patient accounts for services provided by the hospital that were not anticipated as being uncollectible at the time the services were performed. - Patient accounts considered uncollectible or which are to be written-off to bad debt must meet the following criteria: a. Patient accounts have been returned by the Collection Agency or b. Patient accounts are determined to be charity care or c. Patients are medically indigent (Medicaid) or d. Patient is bankrupt, in which a legal inquiry is required or e. Patient is deceased, in which an estate inquiry is required - When the patient cannot be located (i.e. incorrect address) after all possible steps have been completed (attempts to contact a relative, employer, referring physician, referrals from previous hospital or any other persons or places that may be listed on the admitting forms) the account is sent directly to the Collection Agency. - A Bad Debt log will be updated and accumulated daily as patient accounts are written off. - Payments received on accounts that have been identified as a bad debt and have been written off will be recorded to a Bad Debt Recovery Account. 1. Registration: a. Admitting Office gathers the patient's third party payer (Insurance, Medicare, Medicaid) cards/information and all applicable forms/applications. b. Financial Counselor determines the patient's ability to pay, which includes 1. verifying third payer eligibility; 2. establishing whether all or a portion of the bill will be a Self-Pay account; 3. assisting in the completion of charity care application; 4. establishing a payment plan arrangement when possible; 5. and checking pre-certification requirements. c. On-site WV Department of Health and Human Services employee assists the patient in creating an application for Medicaid and determines Medicaid eligibility. 1. Dual-Eligibility/Crossover Claims are also entered into the system at this time for proper electronic transfer/correspondence from Medicare to Medicaid. d. Manager of Credit & Collections reviews all documentation for accuracy. 2. Charity Care - refer to Policy Number 11.842.55 3. Payment Plan Arrangement: a. Patient must complete a payment plan application (Extended Financial Arrangement Application) b. Approved by the Manager of Credit & Collections based upon the patient's ability to pay as verified by the application. c. Monthly payments must be at least $25.00 per month. d. Patients receive a monthly billing statement reflecting the payment amount per the payment plan arrangement. e. If patient defaults on the arrangement, the outstanding amount is then considered a Self-Pay account. 4. The portion of the bill that has been determined to be the patient's responsibility, such as deductibles, coinsurance, and/or non-covered services, are due and payable when the services are rendered. 5. Patient Accounting Department: a. Accounts are assigned to each Patient Accounting Representative based on payer types (Insurance, Medicare, Medicaid, or Self-Pay accounts). b. Each Representative is responsible for the following: 1. verifying proper and consistent billing; 2. tracking the payment plan arrangements; 3. inquiring on bankruptcy and estate cases; 4. corresponding with third party payers; 5. receiving calls from patients (PHONE CALLS ARE NEVER MADE TO THE PATIENT); 6. and addressing any problems that may arise. c. Representatives document all correspondence and collection processes through notes in the system. 6. Approximately 5 days after discharge/visit, the Patient Accounting Department either bills the patient's third party payer, or processes a statement for Self-Pay accounts to be sent to the patient. 7. Medicare Account: a. Medicare Payment - remaining amount, if determined to be the responsibility of Insurance or Medicaid, is billed to that payer and the specific process at #8 or #9 is followed. If the remaining amount is determined to be the patient's responsibility, then the process at #10 is followed. b. Medicare Denial - determination will be made as to why the amount was denied and either correctly re-bill; bill another payer, if applicable, following the specific process #8 or #9; or bill the patient following the Self-Pay process at #10. 8. Medicaid Account: a. Medicaid Payment - remaining amount is deemed to be charity care as the patient is medically indigent, and the account is written-off as a bad debt. b. Medicaid Denial - determination will be made as to why the amount was denied and either correctly re-bill or bill the patient c. Dually Eligible - proper transfer and billing of Medicare and Medicaid EOB/Remits is verified, and any errors are followed up with the specific payer. Once both EOB/Remits have been received and determined to be accurate, the remaining amount is written off as bad debt. 9. Insurance Account: a. Insurance Payment - remaining amount, if determined to be the responsibility of Insurance or Medicaid, is billed to that payer and the specific process at #8 or #9 is followed. If the remaining amount is determined to be the patient's responsibility, then the process at #10 is followed. b. Insurance Denial - determination will be made as to why the amount was denied and either correctly re-bill; bill another payer, if applicable, following the specific process at #8 or #9; or bill the patient following the Self-Pay process at #10. c. No Response - after approximately 30 days, the system will print a reminder and a follow-up phone call will be made to the payer to assess the situation. Multiple phone calls may be made. If the payer still does not respond the patient receives the following: 1. 20 days after billing - statement is sent to the patient notifying them that their insurance has not responded or paid, and that they should contact their payer. 2. 50 days after billing - statement is sent to the patient notifying them that their insurance has not responded or paid, and that they should contact their payer. 3. 80 days after billing - statement is sent to the patient notifying them that they are responsible for the amount. 4. After the 3rd statement is sent the process at #10 is followed. 5. Medicare and Medicaid patients do not receive these statements. SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b 10. Self Pay Account: a. Billing Statements: 1. 1st bill is sent to the patient approximately 5 days after discharge/visit and states that they have 30 days to pay the outstanding amount. 2. 2nd bill is sent to the patient approximately 35 days after discharge/visit, and states that their account is 30 days old. 3. 3rd bill is sent to the patient approximately 65 days after the discharge/visit, and states that their account is now 60 days old. b. If no payment has been received after approximately 95 days after the discharge/visit, the account is turned over to the Collection Agency. c. If patient is making payments, the billing statements will continue until either 1. amount has been paid in full, or 2. payments cease, at which time the account will be turned over to the Collection Agency. d. When statements and letters are returned due to an incorrect address the Patient Accounting Department will try to locate the 12. Collection Agency: a. Once the accounts are turned over to the Collection Agency, the length of time that they are kept depends on the following: 1. Patient does not make payments - the Collection Agency returns accounts to OVMC after 1 year of inactivity. 2. Patient is making payments - Collection Agency keeps them indefinitely until either the account is paid in full or 1 year from turn-over inactivity, at which time the account is returned to OVMC in an electronic file. b. All accounts sent to the Collection Agency are coded as an "Agency Code" and are tracked. A report of these accounts is periodically reviewed and an inquiry is made for accounts being held for a long period of time. The Collection Agency also has the capability to send reports summarizing the accounts. This report is also reviewed periodically. c. Accounts returned by the Collection Agency should be accompanied by documentation of the collection efforts applied. 13. Once an account is returned from the Collection Agency, it is considered uncollectible and written-off as a bad debt, at which time the collection process ends. 14. Deceased Patient: a. Patient Accounting Department verifies the estate status to determine if there is any possibility of collection of the outstanding amount owed. 1. Estate - collection process continues on the account. 2. No Estate - account is written-off as a bad debt. 15. Bankrupt Patient: a. Patient Accounting Department verifies the bankruptcy status to determine if there is any possibility of collection of the outstanding amount owed. 1. Possibility - collection process continues on account. 2. No Possibility - account is written-off as a bad debt. SchH_P05_S0B_L21 Schedule H, Part V, Section B, Line 21 If the patient requested and if the situation warranted, the patient was given a discount. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 The hospital is under new management and is in the process of creating a new strategic assessment that reviews the healthcare needs of the community it serves. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 See collection/bad debt write off policy. SchH_P06_S00_L04 Schedule H, Part VI, Line 4 See answer to question number two above. X X X X 0 0 0 0 0 0 0 1 0 Shishar Shah MD 399681 0 16210 0 0 0 0 0 15444 0 431335 0 0 0 Mary Haus MD 398885 0 15000 0 0 0 0 0 6120 0 420005 0 0 0 Pradip Mehta MD 370133 0 9000 0 0 0 0 0 15444 0 394577 0 0 0 Santwana Sovani 359743 0 15290 0 0 0 0 0 15444 0 390477 0 0 0 Romeo Reyes 360807 0 9760 0 0 0 0 0 11760 0 382327 0 0 0 Brian Felici 0 270737 0 0 0 0 0 0 0 9009 0 279746 0 0 SchJ_P01_S00_L07 Schedule J, Part I, Line 7 Compensation is reasonable based on comparative data, caps and subject to a formula. Derrick Latos MD Trustee 145890 Physician Services 0 Howard Shackelford Trustee 140072 Physician Services 0 Gregory Saracco Trustee 56200 Physician Services 0 James Squibb Jr Trustee 477547 Advertising 0 F990_P06_S0A_L09 Form 990, Part VI, Section A, Line 9 Brain Felici 86 Oakmont Road Wheeling WV 26003 F990_P06_S0B_L11a Form 990, Part VI, Section B, Line 11a Form 990 and all schedules are reviewed by the CFO prior to final submission. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The executive comitee of the board reviews the conflicts. Trustees with conflicts are not allowed to vote on matters in which their conflict pertains. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 All required documentation is filed with the West Virginia Healthcare Authority and is disclosed on their website. F990_P11_S00_L05 Form 990, Part XI, Line 5 Pension increased by $573,313, Temporary restricted net assets increased by $42,779, Permanent restricted net assets decreased by $1,797,660 and the Auxiliary increased by $39,597. Ohio Valley Health Services & Education Foundation 2000 Eoff Street Wheeling WV 26003 550615693 Supporting Organization WV 501 (c) (3) PF N/A Ohio Valley Health Services & Education Corporation 2000 Eoff Street Wheeling WV 26003 550357044 Supporting Organization WV 501 (c) (3) 13 N/A East Ohio Regional Hospital 90 North Fourth Street Martins Ferry OH 43935 340714457 Hospital OH 501 (c) (3) 3 N/A Family Services of the Upper Ohio Valley 51 11th Street Wheeling WV 26003 550357074 Social Services WV 501 (c) (3) 7 N/A River Health Enterprises Inc 2000 Eoff Street Wheeling WV 26003 550611593 Physician Offices WV N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0