2011-05-05T12:53:48-05:00 2010-09-30 ERNST & YOUNG US LLP 190 CARONDELET AVENUE SUITE 1300 CLAYTON MO 63105 990 2009-10-01 550356996 ST JOSEPH'S HOSPITAL OF BUCKHANNON INC STJO 3044732000 1 Amalia Drive Buckhannon WV 26201 Sue E Johnson-Phillippe 2011-04-27 3142901024 2009 2016-02-24 21:20:13Z SUE E JOHNSON-PHILLIPPE 1 AMALIA DRIVE BUCKHANNON WV 26201 35104513 false 0928 X N/A X 1989 WV 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. 12 10 464 57 0 335909 122144 29702642 34718185 30332 232591 1118801 4397 31187684 35077317 0 0 0 0 18997850 20657648 0 0 0 16557064 17504454 35554914 38162102 -4367230 -3084785 27547421 28221421 25111662 29753964 2435759 -1532543 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. true false 25089734 0 34718185 SEE SCHEDULE O 25089734 true true false false false false false false false true false true false false false false false false false false true false false true false false false false false false false false false false false false false true true false false true 31 0 464 true true true false false false false false false false false 12 10 false false false false true true true true true false false true true true true true true true true false WV X RENEE HOFER-STJOSEPH'S HOSP'L 3044732185 1 AMALIA DRIVE BUCKHANNON WV 26201 Robert Skinner 1.0 X 0 0 0 Terry Cronin 1.0 X 0 0 0 Sister Francesca Lowis 1.0 X 0 0 0 Steve Foster 1.0 X 0 0 0 Dennis Xander 1.0 X 0 0 0 Dr Robert Blake 1.0 X 12000 0 0 Sister Roberta Frohnapfel 1.0 X 0 0 0 Sister Diane Bushee 1.0 X 0 0 0 Sister Celeste Lynch 1.0 X 0 0 0 Sister Mary Grace Barile 1.0 X 0 0 0 Dr Joseph Reed 1.0 X 0 0 0 Michael Sellards 1.0 X X 0 1125855 152327 Sue E Johnson-Phillippe 40.0 X 0 257414 0 James Kim 40.0 X 313804 0 0 John Rollins 40.0 X 281092 0 0 Harold Hebard III 40.0 X 279679 0 0 Dr Susan Long 40.0 X 454595 0 0 Michael Kirk 40.0 X 183246 0 0 1524416 1383269 152327 20 false true false 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 8 15904 94050 12190 122144 Net Patient Service Revenue 621110 34653311 34653311 PROGRAM SERVICE RENTAL 531120 64874 64874 34718185 188738 0 188738 0 0 183 0 183 71049 27196 43853 43853 0 43853 0 0 0 0 0 0 OTHER REVENUE 621110 4214 4214 4214 35077317 34718185 0 236988 0 0 0 0 12000 12000 0 15941340 15941340 0 3642513 3642513 1061795 1061795 216530 216530 161032 161032 25782 25782 0 0 37054 28161 8893 3038946 67653 2971293 150528 150528 4501949 4501949 240529 240529 0 910791 910791 0 0 58557 58557 293418 293418 0 1220970 1220970 597266 597266 Bad Debts 3783423 3783423 Provider Tax 552849 552849 MISCELLANEOUS 1714830 1714830 38162102 25089734 13072368 0 801137 520965 799086 1086 4091107 5161072 58519 0 464630 579220 320706 456509 37884571 22019462 13481415 15865109 6641395 4767390 769167 87033 120259 783037 27547421 28221421 8919062 10390993 63435 0 810609 699857 699856 670062 14618700 17993052 25111662 29753964 X 2303819 -1593322 106940 35779 25000 25000 2435759 -1532543 27547421 28221421 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 168186 168186 385317 24144654 12587114 11942857 11348156 8590178 2757978 1838258 842170 996088 15865109 0 PENSION PAYABLE 5338717 ACCRUED MALPRACTICE PAYABLE 363193 LT DEBT-CURRENT-SWAP 2003 SER. 720980 NOTES PAYABLE - PHS 1540000 LEASE PAYABLE 882591 BONDS REPORTED ON PARENT RETURN 9147571 17993052 true true X true X 125. true X true true false true true 1226 1696009 1087183 608826 0.01770 4744 7419299 7226790 192509 0.00560 376 220333 197010 23323 0.00070 6346 9335641 8510983 824658 0.02400 6346 9335641 8510983 824658 0.02400 true 1888685 755474 5174039 11682660 -6508621 X true true ST JOSEPH'S HOSPITAL OF BUCKHANNON

1 AMALIA DRIVE BUCKHANNON WV 26201

X X X N/A N/A St. Joseph's Hospital used cost-to-charge ratio to calculate amounts on Line 7. N/A The amount of bad debt deducted before calculating the percent in Column F is $3,783,423. 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. . 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. 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. N/A 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. . 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. 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. None reported - N/A 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. 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. false false false false false false false false false 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 Compensation of CEO Part I, line 3 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) Schedule O 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. 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 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 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 false false false false true false false false false false false false false false false false false false