ST JOSEPHS HOSPITAL OF BUCKHANNON INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- ST JOSEPHS HOSPITAL OF BUCKHANNON INC (EIN 55-0356996)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-05-05
- IRS object ID
- 201131259349300033
- Schema version
- 2009v1.7
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-05T12:53:48-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 190 CARONDELET AVENUE SUITE 1300 | AddressLine1 |
| City | CLAYTON | City |
| State | MO | State |
| ZIP Code | 63105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550356996 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOSEPH'S HOSPITAL OF BUCKHANNON INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STJO | NameControl |
| Phone | 3044732000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Amalia Drive | AddressLine1 |
| City | Buckhannon | City |
| State | WV | State |
| ZIP Code | 26201 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Sue E Johnson-Phillippe | Name |
| Title | President & CEO | Title |
| Date Signed | 2011-04-27 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3142901024 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | SUE E JOHNSON-PHILLIPPE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 AMALIA DRIVE | AddressLine1 |
| City | BUCKHANNON | City |
| State | WV | State |
| ZIP Code | 26201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 35104513 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c | X | Organization501c |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1989 | YearFormation |
| State Legal Domicile | WV | StateLegalDomicile |
| Activity Or Mission Description | We are inspired by the love of Christ to provide our community with quality health care in ways that respect the God-given dignity of each person and the sacredness of human life. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 464 | TotalNbrEmployees |
| Total Nbr Volunteers | 57 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 335909 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 122144 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 29702642 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 34718185 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 30332 | InvestmentIncomePriorYear |
| Investment Income Current Year | 232591 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1118801 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4397 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 31187684 | TotalRevenuePriorYear |
| Total Revenue Current Year | 35077317 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 18997850 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 20657648 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 16557064 | OtherExpensePriorYear |
| Other Expenses Current Year | 17504454 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 35554914 | TotalExpensesPriorYear |
| Total Expenses Current Year | 38162102 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -4367230 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -3084785 | RevenuesLessExpensesCY |
| Total Assets BOY | 27547421 | TotalAssetsBOY |
| Total Assets EOY | 28221421 | TotalAssetsEOY |
| Total Liabilities BOY | 25111662 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 29753964 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2435759 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -1532543 | NetAssetsOrFundBalancesEOY |
| Mission Description | We are inspired by the love of Christ to provide our community with quality health care in ways that respect the God-given dignity of each person and the sacredness of human life. | MissionDescription |
| Significant New Program Services | true | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 25089734 | Expense |
| Grants | 0 | Grants |
| Revenue | 34718185 | Revenue |
| Description | SEE SCHEDULE O | Description |
| Total Program Service Expense | 25089734 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | 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 |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| 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 |
| Grants To Organizations | false | 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 | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | 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 | true | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 31 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 464 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| 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 |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | 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 | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | 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 |
| States Where Copy Of Return Is Filed | WV | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | RENEE HOFER-STJOSEPH'S HOSP'L | NamePerson |
| Telephone Number | 3044732185 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 AMALIA DRIVE | AddressLine1 |
| City | BUCKHANNON | City |
| State | WV | State |
| ZIP Code | 26201 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Robert Skinner | |||||||
| President | 1.0 | X | 0 | 0 | 0 | ||
| Terry Cronin | |||||||
| Vice President | 1.0 | X | 0 | 0 | 0 | ||
| Sister Francesca Lowis | |||||||
| Secretary/Treasurer | 1.0 | X | 0 | 0 | 0 | ||
| Steve Foster | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| Dennis Xander | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| Dr Robert Blake | |||||||
| Chief of Staff | 1.0 | X | 12000 | 0 | 0 | ||
| Sister Roberta Frohnapfel | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| Sister Diane Bushee | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| Sister Celeste Lynch | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| Sister Mary Grace Barile | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| Dr Joseph Reed | |||||||
| Member | 1.0 | X | 0 | 0 | 0 | ||
| Michael Sellards | |||||||
| CEO PHS | 1.0 | X | 0 | 1125855 | 152327 | X | |
| Sue E Johnson-Phillippe | |||||||
| CEO ST. JOSEPH'S HOSPITAL | 40.0 | 0 | 257414 | 0 | X | ||
| James Kim | |||||||
| Orthopedic Surgeon | 40.0 | 313804 | 0 | 0 | X | ||
| John Rollins | |||||||
| OB/GYN | 40.0 | 281092 | 0 | 0 | X | ||
| Harold Hebard III | |||||||
| Internal Medicine Physician | 40.0 | 279679 | 0 | 0 | X | ||
| Dr Susan Long | |||||||
| General Surgeon | 40.0 | 454595 | 0 | 0 | X | ||
| Michael Kirk | |||||||
| FAMILY PRAC PHYS/VP MED AFFAIR | 40.0 | 183246 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1524416 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1383269 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 152327 | TotalOtherCompensation |
| Number Individuals GT100 K | 20 | 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 |
|---|---|---|---|---|---|
| Pallottine Health Services | |||||
| 2900 First Avenue | HUNTINGTON | WV | 25701 | Management Services | 288706 |
| Employee Benefit Service | |||||
| PO Box 890144 | CHARLOTTE | NC | 28289 | Third Party Admin | 439167 |
| ALLIANCE IMAGING | |||||
| PO BOX 96485 | CHICAGO | IL | 60693 | MRI CONTRACT | 274500 |
| WVU MEDICAL CORPORATION | |||||
| PO BOX 740 | MORGANTOWN | WV | 26507 | ER Physician Service | 277396 |
| Weatherby Locums Inc | |||||
| PO Box 972633 | DALLAS | TX | 75397 | ER Physician Service | 569350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Related Organizations | 15904 | RelatedOrganizations |
| Government Grants | 94050 | GovernmentGrants |
| All Other Contributions | 12190 | AllOtherContributions |
| Total Contributions | 122144 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net Patient Service Revenue | 621110 | 34653311 | 34653311 |
| PROGRAM SERVICE RENTAL | 531120 | 64874 | 64874 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 34718185 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 188738 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $188,738 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 183 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $183 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 71049 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 27196 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 43853 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 43853 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $43,853 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 4214 | TotalRevenueColumn |
| Exclusion | $4,214 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4214 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 35077317 | TotalRevenueColumn |
| Related Or Exempt Function Income | 34718185 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $236,988 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 12000 | Total |
| Program Services | 12000 | ProgramServices |
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 | 15941340 | Total |
| Program Services | 15941340 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3642513 | Total |
| Program Services | 3642513 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1061795 | Total |
| Program Services | 1061795 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 216530 | Total |
| Management And General | 216530 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 161032 | Total |
| Management And General | 161032 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25782 | Total |
| Management And General | 25782 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37054 | Total |
| Program Services | 28161 | ProgramServices |
| Management And General | 8893 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3038946 | Total |
| Program Services | 67653 | ProgramServices |
| Management And General | 2971293 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150528 | Total |
| Management And General | 150528 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4501949 | Total |
| Management And General | 4501949 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 240529 | Total |
| Management And General | 240529 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 910791 | Total |
| Management And General | 910791 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58557 | Total |
| Management And General | 58557 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 293418 | Total |
| Management And General | 293418 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1220970 | Total |
| Management And General | 1220970 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 597266 | Total |
| Management And General | 597266 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debts | 3783423 | 3783423 | |
| Provider Tax | 552849 | 552849 | |
| MISCELLANEOUS | 1714830 | 1714830 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38162102 | Total |
| Program Services | 25089734 | ProgramServices |
| Management And General | 13072368 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 801137 | BOY |
| EOY | 520965 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 799086 | BOY |
| EOY | 1086 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4091107 | BOY |
| EOY | 5161072 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58519 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 464630 | BOY |
| EOY | 579220 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 320706 | BOY |
| EOY | 456509 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 37884571 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 22019462 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13481415 | BOY |
| EOY | 15865109 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6641395 | BOY |
| EOY | 4767390 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 769167 | BOY |
| EOY | 87033 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120259 | BOY |
| EOY | 783037 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27547421 | BOY |
| EOY | 28221421 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8919062 | BOY |
| EOY | 10390993 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63435 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 810609 | BOY |
| EOY | 699857 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 699856 | BOY |
| EOY | 670062 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14618700 | BOY |
| EOY | 17993052 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25111662 | BOY |
| EOY | 29753964 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2303819 | BOY |
| EOY | -1593322 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 106940 | BOY |
| EOY | 35779 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25000 | BOY |
| EOY | 25000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2435759 | BOY |
| EOY | -1532543 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27547421 | BOY |
| EOY | 28221421 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 168186 | OtherCostOrOtherBasis |
| Book Value | 168186 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 385317 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 24144654 | OtherCostOrOtherBasis |
| Depreciation | 12587114 | Depreciation |
| Book Value | 11942857 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11348156 | OtherCostOrOtherBasis |
| Depreciation | 8590178 | Depreciation |
| Book Value | 2757978 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1838258 | OtherCostOrOtherBasis |
| Depreciation | 842170 | Depreciation |
| Book Value | 996088 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 15865109 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PENSION PAYABLE | $5,338,717 |
| ACCRUED MALPRACTICE PAYABLE | $363,193 |
| LT DEBT-CURRENT-SWAP 2003 SER. | $720,980 |
| NOTES PAYABLE - PHS | $1,540,000 |
| LEASE PAYABLE | $882,591 |
| BONDS REPORTED ON PARENT RETURN | $9,147,571 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 17993052 | TotalOfAmounts |
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 |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 125. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1226 | PersonsServed |
| Total Community Benefit Expense | 1696009 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1087183 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 608826 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01770 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4744 | PersonsServed |
| Total Community Benefit Expense | 7419299 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7226790 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 192509 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00560 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 376 | PersonsServed |
| Total Community Benefit Expense | 220333 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 197010 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 23323 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6346 | PersonsServed |
| Total Community Benefit Expense | 9335641 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8510983 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 824658 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02400 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6346 | PersonsServed |
| Total Community Benefit Expense | 9335641 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8510983 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 824658 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02400 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $1,888,685 | BadDebtExpenseAmount |
| Amount Attributable To | 755474 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5174039 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 11682660 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -6508621 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOSEPH'S HOSPITAL OF BUCKHANNON | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 AMALIA DRIVE | AddressLine1 |
| City | BUCKHANNON | City |
| State | WV | State |
| ZIP Code | 26201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | N/A | IncomeBasedCriteria |
| Annual Community Benefit Expln | N/A | AnnualCommunityBenefitExpln |
| Costing Method Used | St. Joseph's Hospital used cost-to-charge ratio to calculate amounts on Line 7. | CostingMethodUsed |
| Subsidized Health Services Expln | N/A | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | The amount of bad debt deducted before calculating the percent in Column F is $3,783,423. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, line 4 Cost Methodology for determining bad debt expense Patient accounts receivable: Patient accounts receivable are carried at the net realizable value less an estimate for doubtful or uncollectible accounts. The allowance is based upon a review of the outstanding balances, aged by financial class. Management uses collection percentages, based upon historical collection experience, to determine collectability. Management also reviews troubled, aged accounts to determine collection potential. Patients accounts receivable are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received. Interest is not charged on patient accounts receivable. The cost of the bad debt expense was determined using the cost to charge ratio from worksheet 2. . | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, line 8 Cost Methodology for determining Medicare Costs The entire Medicare shortfall should be considered community benefit. Medicare shortfall was determined by netting total Medicare revenues and total Medicare costs for the organization. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, line 9b Collection Policy Prior to an account going to collections, especially if it is a self-pay patient, the organization checks Medicaid and charity eligibility. St Joseph's Hospital requires all self-pay patients to talk to a financial counselor to determine qualification for charity care and Medicaid programs. Self-pay patients are required to show proof that they have been denied by Medicaid. After it is determined that self-pay patients do not qualify for assistance, and if they are still unable to pay their bills, they are set up on a payment plan suited to their income level. Only when a self-pay patient falls behind on his/her payments and it is certain he or she does not qualify for assistance are they sent to a collection agency. | DebtCollectionPolicy |
| Number Of Facility Type Expln | N/A | NumberOfFacilityTypeExpln |
| Needs Assessment | St. Joseph's Hospital will contract with an outside company to perform the community wide needs assessment and is in the process of scheduling this assessment . In addition, an outside company performs post admission surveys for all inpatients. This survey includes questions regarding whether the patients needs were met during the stay , and the hospital reviews this HCAHPS data to determine what services may need to be added based on that data. . | NeedsAssessment |
| Patient Education Assistance | St. Joseph's Hospital's charity care policy is posted in all patient registration areas. Self pay patients in need of services are advised of this policy and referred to financial counseling to apply for charity care as appropriate. Part of the charity care application process involves requiring the patient to apply for Medicaid and provide proof of Medicaid application and denial. Through this process the patient is informed of government programs that may be able to provide assistance to them (Medicaid , SCHIP, etc.), in addition to the Hospital's Charity Care program. | PatientEducationAssistance |
| Community Information | St. Joseph's Hospital is located in a small town in a rural, mountainous region of West Virginia. The hospital serves its home county (with a population of approximately 24,000 residents), as well as parts of five surrounding counties. The population served is an aging population with growing health concerns. In St Joseph's Hospital's home county, 20.5% of the population is below poverty level and only 15% have college degrees. The teen pregnancy rate is 6% for girls aged 15-17 and 15% for those aged 18-19. | CommunityInformation |
| Community Building Activities | None reported - N/A | CommunityBuildingActivities |
| Other Information | St. Joseph's Hospital further promotes the health of the community by maintaining an open medical staff, using community members on its board of directors, providing support of community health activities (blood screenings , health fair, flu shot clinics, etc). The Hospital has also been actively recruiting both primary care providers and specialists to meet the health care needs of our service area. | OtherInformation |
| Affiliated Health Care System | St. Joseph Hospital of Buckhannon, Inc. is a not-for-profit health care facility wholly sponsored by Pallottine Health Services, Inc. (PHS). Pallottine Health Services is a ministry of the Pallottine Missionary Sisters and includes both St Joseph Hospital of Buckhannon, West Virginia and St Mary's Medical Center of Huntington, West Virginia. Both of these hospitals are committed to the core values of Compassion, Hospitality, Reverence, Interdependence, Stewardship, and Trust. PHS files a Community Benefit report every three years in West Virginia. St. Joseph's Hospital is included in this community benefit report. | AffiliatedHealthCareSystem |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sue E Johnson-Phillippe | |||||||||||||
| 0 | 212098 | 0 | 36566 | 0 | 8750 | 0 | 0 | 0 | 0 | 0 | 257414 | 0 | 0 |
| Michael Sellards | |||||||||||||
| 0 | 484000 | 0 | 213200 | 0 | 428655 | 0 | 133988 | 0 | 18339 | 0 | 1278182 | 0 | 0 |
| James Kim | |||||||||||||
| 313804 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 313804 | 0 | 0 | 0 |
| John Rollins | |||||||||||||
| 281092 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 281092 | 0 | 0 | 0 |
| Harold Hebard III | |||||||||||||
| 279679 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 279679 | 0 | 0 | 0 |
| Dr Susan Long | |||||||||||||
| 347138 | 0 | 107457 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 454595 | 0 | 0 | 0 |
| Michael Kirk | |||||||||||||
| 183246 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 183246 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Compensation of CEO | Identifier |
| Return Reference | Part I, line 3 | ReturnReference |
| Explanation | The organization relies on the related organization (Pallottine Health Services) to determine the compensation package for the CEO. Schedule J-1, Part I Hours Devoted to Related Organizations The following individuals listed on Schedule J-1, Part I, Column A devoted the following hours to all related organizations listed, in addition to their time spent on St. Joseph's Hospital: Michael Sellards - 37 hours (PHS, SMMC and SMF) Sue Johnson-Phillippe - 37 hours (PHS and SJF) Sr. Diane Bushee - 37 hours (PHS, SMMC and SMF) Dr. Susan Long - 2 hours (SJF) Sr. Roberta Fronapfel - 4 hours (PHS and SJF) Sr. Mary Grace Barile - 2 hours (PHS) Sr. Francesca Lowis - 2 hours (PHS) | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule O | Identifier |
| Explanation | Form 990, Part III, Line 2 Description of New Services The hospital began offering Urology services on 5/3/10 and Cardiology services on 6/14/10. FORM 990, PART III, LINE 4A Program Service Activity Description ST. JOSEPH'S HOSPITAL OF BUCKHANNON, INC. PROVIDES IMPARTIAL ACCESS TO TREATMENT OR ACCOMODATIONS FOR CARE THAT IS AVAILABLE OR MEDICALLY INDICATED REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN OR SOURCE OF PAYMENT. IN ORDER TO ENABLE OUR PATIENTS TO LEAD HEALTHY, PRODUCTIVE LIVES, THE HOSPITAL STRIVES TO SUPPLY A COMPREHENSIVE RANGE OF ACUTE INPATIENT, LONG-TERM AND OUTPATIENT CARE, OUTREACH CLINICS, HOME CARE AND EMERGENCY ROOM SERVICES INCLUDING PREVENTION, GUIDANCE, DIAGNOSIS, TREATMENT, RESTORATION, REHABILITATION, AND OTHER EFFORTS AS MAY BE REQUIRED, TO MEET THE HEALTH CARE NEEDS OF THE COMMUNITY AS THE HOSPITAL RESOURCES WILL PERMIT. ALTHOUGH PAYMENT FOR SERVCIES RENDERED IS ESSENTIAL TO THE OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE FINANCIAL MEANS TO PURCHASE ESSENTIAL MEDICAL SERVICES. OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. IN KEEPING WITH THIS COMMITMENT, THE HOSPITAL WILL SERVE ALL MEMBERS OF ITS COMMUNITY REGARDLESS OF MEANS OR SOURCE OF PAYMENT. Form 990, Part IV, Question 24A St. Joseph's Hospital is part of the obligated group for tax-exempt bonds held by Pallottine Health Services. All bonds are reported on Pallottine Health Services Form 990 for the year ended 9/30/10. Form 990, Part VI, Section A, Questions 6, 7a & 7b Organization's Members and Member's Rights Part VI, question 6 - The Organization is a membership (NOT a stock) corporation under West Virginia State law. The Organization's sole corporate member is Pallottine Health Services, a related not-for-profit organization. Part VI, question 7a - In accordance with the terms and requirements of its governing documents (i.e. bylaws), on an annual basis, the Organization's current board members recommend the list of candidates for membership to the governing body for the subsequent term to the St. Joseph's Hospital board of directors. The Pallottine Health Services board of directors approve and elect these candidates to serve as the organizations board of directors. Part VI, question 7b - Pallottine Health Services, as the sole corporate member, also has the right to approve or ratify significant decisions of the Organization's governing body including the amendment of bylaws and charters, removal of members of the governing body, and the decision to dissolve the organization. Form 990, Part VI, Section B, Question 11A Review Process for Form 990 THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S MANAGEMENT (A TEAM COMPRISED OF REPRESENTATIVES OF THE FINANCE, HUMAN RESOURCES, AND LEGAL DEPARTMENTS) IN CONSULTATION WITH AN INDEPENDENT ACCOUNTING FIRM (ERNST & YOUNG LLP). THE FINANCIAL REVIEW IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS FOR THE RELEVANT TIME PERIOD. BEFORE THE FORM 990 IS FILED WITH THE IRS THE FINANCE COMMITTEE OF THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE RORM 990. A FULL COPY OF THE FORM 990 WAS MADE AVAILABLE TO THE ENTIRE BOARD IN LATE APRIL, 2011. Form 990, Part VI, Section B, Question 12c Description of Process to Monitor Transactions for Conflicts of Interest UPON EMPLOYMENT AND ANNUALLY THEREAFTER EACH KEY EMPLOYEE AND OFFICER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, PROVIDING SUFFICIENT INFORMATION ABOUT HIS/HER PERSONAL INTERESTS AND RELATIONSHIPS SO THE ORGANIZATION CAN (1) DETERMINE WHETHER ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST MAY EXIST, AND (2) MONITOR WORK OR SERVICE ASSIGNMENTS TO AVOID PLACING THE KEY EMPLOYEE, OFFICER OR DIRECTOR IN A POSITION WHERE THERE MAY BE AN APPEARANCE, POTENTIAL OR ACTUAL, OF A CONFLICT OF INTEREST OR A QUESTION OF OBJECTIVITY. The completed conflicts of interest AND DISCLOSURE FORMS for directors are returned to the ORGANIZATION. THESE MEMBERS ARE MONITORED AND NOT ASSIGNED ANY PROJECTS THAT WOULD CREATE ANY POTENTIAL CONFLICT OF INTEREST. THE DETERMINATION OF CONFLICT OF INTEREST WOULD BE MADE AT THE PHS BOARD LEVEL. ANY BOARD MEMBER WITH A POTENTIAL CONFLICT RECUSES HIMSELF OR HERSELF FROM ALL DISCUSSIONS REGARDING THE CONFLICT. Form 990, Part VI, Questions 15a and 15b Compensation Review Process Pallottine Health Services ("PHS"), the organization's single member, regularly provides documentation to PHS's compensation committee with respect to the compensation of the organization's officers and key employees for review and approval. Such information includes comparable data from similar size tax-exempt organizations in the Huntington, West Virginia community as well as compensation for these positions (as disclosed on Form 990) with other organizations in the health care industry that are of similar size, demographics, and geography. Review and approval of the compensation arrangement by the officers/executive committee is documented. Form 990, Part VI, Section C, Question 19 Access to Organizational Documents The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request at its office at 1 Amalia Drive, Buckhannon, WV 26201. A nominal fee is charged if copies are requested. | Explanation |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| Pallottine Health Services(PHS) | |||||||||
| 2900 First Avenue | Huntington | WV | 25702 | 550688201 | Parent-mgmt o | WV | 501(c)(3) | 11a | NA |
| Pallottine Missionary Sisters (PMS) | |||||||||
| 1 Amalia Drive | Buckhannon | WV | 26201 | 431783315 | Church | MO | 501(c)(3) | 1 | NA |
| St Mary's Medical Center (SMMC) | |||||||||
| 2900 First Avenue | Huntington | WV | 25702 | 550357050 | Hospital | WV | 501(c)(3) | 3 | NA |
| St Mary's Medical Center Foundation | |||||||||
| 2900 First Avenue | Huntington | WV | 25702 | 141887211 | Foundation | WV | 501(c)(3) | 11b | NA |
| St Joseph's Foundation of Buckhannon | |||||||||
| 1 Amalia Drive | Buckhannon | WV | 26201 | 550727650 | Foundation | WV | 501(c)(3) | 11c | NA |
Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)
| Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Code VCodeVAmount |
|---|---|---|---|---|---|---|
| St Mary's Occup Health Med Services | ||||||
| Medical Services | WV | na | n/a | 0 | 0 | $0 |
| Tri-State Cyber Knife | ||||||
| Medical Services | WV | na | n/a | 0 | 0 | $0 |
| Tri-State MRI | ||||||
| Medical Services | WV | na | n/a | 0 | 0 | $0 |
| Claire-Frances Health Services | ||||||
| Medical Services | WV | na | n/a | 0 | 0 | $0 |
| Huntington Area MRI | ||||||
| Medical Services | WV | na | n/a | 0 | 0 | $0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 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 | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| UPSHUR MEDICAL MNGMNT SERVICES (UMMS) | |||||||||||
| ONE AMALIA DRIVE | BUCKHANNON | WV | 26201 | 550727649 | INACTIVE | WV | SJH | C-CORP | 0 | 0 | 1.00000 |
| VANGUARD FINANCIAL SERVICES | |||||||||||
| 450496141 | COLLECTION AGENCY | WV | NA | C-CORP | 0 | 0 | 0.00000 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | 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 | false | 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 | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |