2011-11-14T13:06:28-06:00 2010-12-31 Deloitte Tax LLP 111 S Wacker Drive Chicago IL 60606 990 2010-01-01 550526150 Charleston Area Medical Center Inc CHAR 3043885432 PO Box 1547 Charleston WV 253261547 Larry Hudson 3043887603 2011-11-11 1 3124861000 2010 2016-03-07 17:11:31Z CAMC Larry Hudson 501 Morris Street Charleston WV 253010000 915126152 0 X www.camc.org X 1971 WV Charleston Area Medical Center, Inc.'s ("CAMC") primary charitable exempt purpose is to provide hospital care, without distinction, for all the inhabitants of the City of Charleston, State of WV and elsewhere, to promote legitimate methods for the prevention of disease and positive promotion of health (both personal and public), and to foster and conduct education in medicine in all its branches and adjunct arts and sciences, such as nursing and technical occupations, which contribute to the diagnosis, treatment and prevention of disease, CAMC owns and operates three hospital as a tertiary-care academic medical center designed to provide care for community residents throughout every stage of life. Our patients depend on us to provide convenient and compassionate care delivered regardless of a patient's ability to pay. 17 12 7418 215 9845033 0 212420 615798 828479763 865558794 2650322 6948634 1899412 1427342 833241917 874550568 8587556 9498371 0 0 345881509 341447981 0 0 0 476562458 501406264 831031523 852352616 2210394 22197952 638554700 664973877 481075864 486933204 157478836 178040673 X Striving to provide the best health care to every patient, every day. 0 0 544702535 211956 835299259 CAMC is West Virginia's largest medical center with over 7,418 employees and 593 medical staff. CAMC is licensed for 838 beds at three campuses and our health care services delivery focuses on providing a full range of inpatient and outpatient services as a tertiary regional referral center, teaching and safety net hospital. As a regional referral center, CAMC has one of only two state Level 1 Trauma Centers, a Level III Neonatal ICU, a Pediatric ICU, a TJC-Certified Primary Stroke Center, and Bariatric Center of Excellence. CAMC is the primary medical safety net provider of women and children's and trauma services in central and southern West Virginia and provides 23% of the charity care in the state. There were inpatient days of 211,395, outpatient visits of 561,811, emergency department visits of 97,376 and deliveries of 3,003 in 2010. We give back to our community because we understand the impact that high quality medical care, charity care, education, corporate contributions and community partnerships have on the lives of real people. 27398746 9139760 CAMC has established medical and allied health education excellence as a core competency. Provision and support for education include training for interns and residents, nurses, anesthetists and other personnel. 85 WVU/WVSOM medical students trained at CAMC hospitals and 156 medical residents were employed by CAMC. CAMC provided faculty support to the University of Charleston helping educate 56 students, assisted 67 employees through student loan forgiveness, and distributed 283 scholarships. 124497964 146655 1187772 CAMC does much more than just provide health care, being involved in nearly every aspect of the lives and well being of the community. CAMC offered 80 programs which served an estimated 108,094 people. CAMC provided acute inpatient and outpatient hospital services including unreimbursed charity care (at cost) of $36,494,503 and bad debts (at cost) of $23,556,528. Creative, state-of-the-art programs and services are provided to our community to serve our community-particularly the needs of the low income, elderly, and other vulnerable persons. Community benefits are programs or activities that provide treatment or promote health and healing as a response to identified community needs and meet at least one of the following community benefit criteria: 1) Improves access to health care services. 2) Enhances health of the community. 3) Advances medical or health care knowledge. 4) Relieves or reduces the burden of government or other community efforts. 696599245 1 1 0 1 0 0 0 1 1 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 396 0 1 7418 1 1 1 0 0 0 0 0 0 0 0 0 X 17 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WV X Larry Hudson 3043887603 501 Morris Street Charleston WV 253010000 R Thomas Bowden III DO 2.50 X 0 0 0 Mark A Chandler 2.50 X 0 0 0 Nelle Ratrie Chilton 5.00 X 0 0 0 Carol A Egnatoff 2.50 X 0 0 0 James P Griffith MD 2.50 X 0 0 0 Wetzel E Harvey 2.50 X 0 0 0 John R Hoblitzell Esq 2.50 X 0 0 0 Steven McCormick MD 2.50 X 12500 0 0 William R McDavid Esq 5.00 X 0 0 0 Thomas E Potter Esq 5.00 X 0 0 0 Linda J Powers 2.50 X 0 0 0 Karen S Price 2.50 X 0 0 0 Asif Rahman MD 2.50 X 100518 0 0 William A Rice Jr 5.00 X 0 0 0 Gerald N Smith III 2.50 X 0 0 0 Edwin H Welch Ph D 2.50 X 0 0 0 David L Ramsey 50.00 X X 824125 0 407533 Larry C Hudson 50.00 X 496245 0 84515 Glenn Crotty Jr MD 50.00 X 2948496 0 75502 Marshall A McMullen Jr 50.00 X 293805 0 121964 William D Adams 50.00 X 137295 0 22725 Michael D Williams 50.00 X 277831 0 107517 S Andrew Weber 50.00 X 203970 0 103800 Stephen Z Bell 50.00 X 224528 0 198093 Robert D Whitler 50.00 X 195072 0 27515 Beth A Samples 50.00 X 230849 0 208992 Lynn Y Brookshire 50.00 X 259463 0 128624 Elizabeth Spangler MD 50.00 X 340876 0 35470 Ronald E Moore 50.00 X 219990 0 32687 Robert B Danielson 50.00 X 173347 0 57876 Dale R Wood 50.00 X 306816 0 78014 Jeffrey H Goode 50.00 X 188964 0 59011 Clennie Arthur III 45.00 X 211976 0 30574 Mark K Stephens MD 40.00 X 441046 0 29585 Daniel Stickler II MD 40.00 X 450735 0 30727 Kenneth C Wright MD 40.00 X 257152 0 20270 Daniel Foster MD 40.00 X 239731 0 27473 Kathleen Mimnagh MD 40.00 X 209144 0 34036 Patricia Johnston 0.00 X 874380 0 0 10118854 0 1922503 212 1 1 0 West Virginia University Physicians of C 3110 MacCorkle SE Charleston WV 25304 GME/Physician Services 15946204 Siemens Medical Solutions Dept AT 40065 Altanta GA 40065 IT Service & Support 14595800 Wellspring Partners 4795 Paysphere Circle Chicago IL 60674 Consultants 8133275 Neurological Associates 415 Morris Street Suite 400 Charleston WV 25301 Physician Services 2642574 Air Methods Corp PO Box 676592 Dallas TX 752676592 Medical Services 2281049 122 155801 459997 12000 615798 Patient Revenue 621990 828878112 828878112 Lab Services 621500 7864806 3025 6956541 905240 Pharmacy 446110 7557721 7557721 Cafeteria/Vending 721000 5502404 5502404 Rental (Non-res.) 531120 5025876 1376115 27600 3622161 10729875 6229779 1258963 3241133 865558794 3041309 174715 2866594 998364 998364 128 128 43424808 59737 40497199 78385 2927609 -18648 2908961 2908961 Laundry 812300 742869 742869 Medical Center Inn 721110 422496 422496 Management Services 541610 210694 210694 51155 51155 1427214 874550568 836487031 9845033 27602706 9084121 9084121 414250 414250 9537376 135518 9401858 1033363 517352 516011 252410967 218799934 33611033 8459113 7077550 1381563 54567716 45655583 8912133 15439446 15483123 -43677 1758254 1376228 382026 2358986 2358986 391059 391059 111221 111221 706184 706184 60075511 30972310 29103201 1067966 89304 978662 176722170 170043227 6678943 7974504 215128 7759376 18175456 12587565 5587891 1588674 1069031 519643 449200 244192 205008 14183329 14183329 22900748 22900748 33969648 16406574 17563074 7260452 5782980 1477472 Prov. For Uncollectible 62241945 62072050 169895 Charity Allowance 52668856 52668856 Provider Tax 16561075 16561075 Preventative Maintenanc 8275200 1217041 7058159 11965826 5225505 6740321 852352616 696599245 155753371 0 31940 33736 80119022 104204140 120123749 108974107 91562 91562 14810830 14125910 4728481 7171928 808883728 537688009 269641038 271195719 20703695 20919842 37104398 41634841 91199985 96622092 638554700 664973877 100449410 105915710 11323036 10396783 304909137 302088734 106196 -50833 18367115 15544643 813105 9470595 45107865 43567572 481075864 486933204 X 132447242 149918809 14402507 17238584 10629087 10883279 157478836 178040673 638554700 664973877 X 22197952 -1636115 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 5608 0 0 1 166642 0 1 1332 173582 0 Explanation of Other Lobbying Activities: Part II-B, Line 1i: Legislative Dinner - $1,332: Occasionally, individuals are asked by legislators for opinions on certain issues and the process of health-related legislation. There are periodic meetings and communications between CAMC representatives and legislative officials concerning health issues, usually in a general manner, rather than for or against any specific bill per se. 0 0 25031594 865051 2980879 710409 45251 28121864 20516626 1047818 3812540 311551 33839 25031594 26766284 906169 -5868928 1268215 18684 20516626 0.39000 0.61000 0 1 1 18216498 18216498 305678303 179721604 125956699 6833676 4183798 2649878 457379132 348511452 108867680 20776119 5271155 15504964 271195719 Malpractice Fund 2747830 C Malpractice Fund 26967111 F Recruitment/Student Loan 6561128 C Workers Comp Self Insured Fund 263197 F RC Byrd Teaching Ctr Fund 7106 F Investments Other 122598 C Affiliate Receivables 4965871 C 41634841 Trustee Funds 6748587 Interest in Net Assets: CAMC Foundation 27870058 Bond Funds 52870342 Bond Collateral 4630000 Deferred Bond Costs 4220252 Investments Other 282853 96622092 190097 Estimated Malpractice Claims 21115000 Estimated Worker's Comp Claims 2275389 Affiliate Payables 5721186 Settlements Due to 3rd Parties 752647 Estimated Retiree Health 4111533 Umbrella Trust & SERP 9401720 43567572 Description of Intended Use of Endowment Funds: Part V, Line 4: To further the mission of the organization. Description of Uncertain Tax Positions Under FIN 48: Part X: CAMC is part of the consolidated audit for 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. A provision of $135,000 has been made in the accompanying consolidated financial statements for the year ended December 31, 2010, for estimated unrelated business income tax. The System does not have any material uncertain tax positions at December 31, 2010. 1 1 X 1 X 1 X 1 1 0 1 1 36494503 36494503 0.04620 134804791 83841000 50963791 0.06450 4578325 1395233 3183092 0.00400 175877619 85236233 90641386 0.11470 2380064 335380 2044684 0.00260 29240453 7088895 22151558 0.02800 135344 135344 0.00020 214905 214905 0.00030 31970766 7424275 24546491 0.03110 207848385 92660508 115187877 0.14580 64728 64728 0.00010 537 537 0.00000 137711 25755 111956 0.00010 202976 25755 177221 0.00020 0 23556528 13285882 253782603 297841167 -44058564 X 1 1 1 General Division Medical Office Building Partnership Medical office space rental 0.79230 0.00000 0.20770 2 Women & Children's Medical Office Building Partnership Medical office space rental 0.88480 0.00000 0.11520 3 1 CAMC Memorial Hospital

3200 MacCorkle Avenue Charleston WV 253010000

X X X X 2 CAMC General Hospital

501 Morris Street Charleston WV 253040000

X X X X 3 CAMC Women and Children's Hospital

800 Pennsylvania Avenue Charleston WV 253025302

X X X X X NA 1 9 SVI Laboratory Services

3004 Chesterfield Charleston WV 253040000

Laboratory Services CAMC Imaging Center

3416 MacCorkle Ave SE Charleston WV 253040000

Outpatient Imaging Center CAMC Urgent Care Center

314 Goff Mountain Road Suite 3 Cross Lanes WV 253130000

Urgent Care Facility CAMC Phys Therapy & Sports Med Center

200 Tracy Way Charleston WV 253111258

Rehabilitation Facility CAMC Wound Healing Center

600 Morris Street Suite 103 Charleston WV 253010000

Wound Healing Center CAMC Ambulatory Infusion Center

3100 MacCorkle Ave Suite 101 Charleston WV 253040000

Ambulatory Infusion Center CAMC Weight Loss Center

3100 MacCorkle Ave Suite 202 Charleston WV 253040000

Weight Loss Center CAMC Imaging Center

60 RHL Boulevard South Charleston WV 253090000

Outpatient Imaging Center CAMC Occupational Lung Center

600 Morris Street Suite 100 Charleston WV 253010000

Occupational Lung Center Part I, Line 7: Utilized Worksheet 2 to determine cost-to-charge ratio. Part II: Community-building activites include programs and services that address root causes of health problems. At CAMC, examples include our participation in the Partners in Health Program that is a network of small and rural hospitals, clinics and health departments who work together to address quality and educational needs for improving care management, assistance with NCQA accreditation for patient centered medical homes and improved quality through addressing sepsis. Access to health care for 5,000 working uninsured individuals in central and southern West Virginia is provided through Partner's Community Access Program. Additionally, CAMC provides students enrolled in post-secondary education with related on-the-job training that is required for their graduation. Health Fairs for the community focusing on adults and children provide screening and health information to identify and address health issues. Part III, Line 4: There is no footnote describing bad debt, however, private pay accounts and amounts for deductibles and co-insurance that are deemed uncollectable that do not appear to meet the charity care guidelines, are written off as bad debt expense and appear as an operating expense in the statement of operations. In determining the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy, one month of actual bad debt write-off's was reviewed. From this one month it was determined the amount of bad debt that was for uninsured patients which turned out to be 60%. Then a sample of 100 of these uninsured patients was taken and ran through a credit worthy calculator that determined 94% of the patients met the income eligibility guidelines under the organization's charity care policy. Part III, Line 8: The organization considers any government reimbursement that is insufficient to cover allocated costs as being a community benefit. The organization chooses to serve the community by participating in the Medicare program and accepting Medicaid reimbursement. Part III, Line 9b: CAMC has a collection policy for patients who qualify for charity care or financial assistance. Patients who receive charity assistance must meet the following requirements: income at 200% or less of Federal poverty income and resource guidelines, insufficient assets to pay for the care, and not eligible for any public programs. For patients without third-party coverage who do not qualify for charity will be given a 20% discount from charges (which is greater than any commercial discount). In additional to charity and uninsured discounts, CAMC provides assistance with payment plans, government programs, and Employee Assistance Program. Part VI, Line 2: CAMC is an active sponsor of the community health survey completed every three years through the Kanawha Coalition for Community Health Improvement. This random telephone survey of Kanawha County residents provides information from our community on community health issues that is used in a county-wide open Community Forum to establish the top three health issues the community will address over the next three-year time frame. The last survey was completed in late 2006 and the Community Forum was held in March 2007 during which obesity, lack of physical activity and tobacco use were identified as the priorities for the next three years. The next survey process began late 2010 and will be finalized in June 2011 with a Community Forum held during the summer of 2011. CAMC participates on the Coalition's Steering Committee and oversees the Community Work Groups as they address these priority issues. Additionally, since 2006 the Kanawha Coalition for Community Health Improvement has been the coordinating body for addressing youth risks and interventions in our county. Part VI, Line 3: CAMC informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under CAMC's charity care policy during the registration process. Brochures are available at each registration point with contact information and phone numbers for our Financial Counselors. CAMC Financial Counselors are located in each Emergency Department and Admitting area. During registration, if a patient is uninsured, they may be referred to a Financial Counselor who provides education about Charity Care, Medicaid Eligibility and Federal Disability. WV state employees are also on site at each hospital to accept and process Medicaid applications and notify patients if they qualify. Part VI, Line 4: CAMC's community and primary area of focus is defined as our primary and secondary service areas and includes Kanawha, Putnam, Boone, Fayette, Logan, Braxton, Jackson, Lincoln, Raleigh, Clay, Nicholas and Roane Counties. These counties constitute a population of 548,303, with a median age of 41 and household median income of $34,929. We provide, alone and in collaboration, a wide-ranging array of community benefit services designed to improve community health and the health of individuals, and to increase access to health care. This includes providing free and discounted services to people who are uninsured and underinsured. Part VI, Line 6: CAMC has a governing board, community board, board of trustees or board of directors composed of prominent civic leaders, rather than exclusively members who are hospital administrators, physicians or others professionally connected to the hospital. Admission to the hospital's medical staff is open to all qualified physicians in the area, consistent with the size and nature of the facility. The hospital operates a full-time emergency room open to everyone, regardless of ability to pay. The hospital serves a broad cross-section of the community through research or charity care. The hospital applies any surplus funds toward improving facilities, equipment, patient care, medical training, research and education. CAMC's community building activities promote the health of our community through workforce development activities including educational and health care career presentations for youth, under-employed adults and those changing careers and providing work experiences for student enrolled in post-secondary programs with work based experience needed for graduation; and community support through ATV safety education for local businesses. Part VI, Line 7: CAMC Health Education and Research Institute, Inc. ("CHERI"), a sister company to CAMC, is actively engaged in clinical trials and has active research protocols in oncology, cardiology/cardiovascular research, medicine and medicine subspecialties, behavioral health community medicine, pediatrics, nursing research and trauma/pain. The majority of this research is conducted at CAMC hospitals. The CAMC Institute serves as the Education and Research arm of the CAMC Health System. The Charleston Area Medical Center Foundation, Inc.'s ("The Foundation") mission is to support and promote CAMC's delivery of excellent and compassionate health services, and its contribution to the quality of life and economic vitality of the region. Integrated Health Care Providers, Inc., a sister company to CAMC, is called upon to open a practice when determined that an essential physician need or access issues for patients is present. CAMC Teays Valley Hospital, Inc., a sister company to CAMC, is a 68 bed rural hospital in Putnam County, WV and provides acute and emergency services to its community as well as community benefit to the residents in its county. CAMC has a governing board, community board, board of trustees or board of directors composed of prominent civic leaders, rather than exclusively members who are hospital administrators, physicians or others professionally connected to the hospital. Admission to the hospital's medical staff is open to all qualified physicians in the area, consistent with the size and nature of the facility. The hospital operates a full-time emergency room open to everyone, regardless of ability to pay. The hospital serves a broad cross-section of the community through research or charity care. The hospital applies any surplus funds toward improving facilities, equipment, patient care, medical training, research and education. Reports Filed With States Part VI, Line 7 WV 1 University of Charleston 2300 MacCorkle Avenue SE Charleston WV 253040000 550357039 501(c)(3) 308583 Nursing and Pharmacy Program Support WV Health Right Inc 1520 Washington Street Charleston WV 253110000 311066881 501(c)(3) 229302 General Program Support Ronald McDonald House Charities of Southern West Virginia Inc 302 30th Street SE Charleston WV 253040000 550631080 501(c)(3) 9009 General Program Support American Heart Association 162 Court Street Charleston WV 253010000 135613797 501(c)(3) 7500 General Program Support Fund for the Arts 803 Quarrier Street 100 Charleston WV 253010000 550614854 501(c)(3) 10500 General Program Support YWCA of Charleston 1114 Quarrier Street Charleston WV 253010000 550357060 501(c)(3) 5000 General Program Support Clay Center for the Arts One Clay Square Charleston WV 253010000 550702471 501(c)(3) 15000 General Program Support Charleston Community and Family Development Center PO Box 20402 Charleston WV 253620000 311604615 501(c)(3) 25000 General Program Support WV Symphony Orchestra PO Box 2292 Charleston WV 253280000 550339426 501(c)(3) 6350 General Program Support West Virginia Kids Count Fund 1031 Quarrier Street Suite 313 Charleston WV 253280000 550692324 501(c)(3) 6000 General Program Support West Virginia Center for Nursing 1018 Kanawha Boulevard East Charleston WV 253010000 203711601 501(c)(3) 5000 General Program Support 12 Nursing Scholarships 72 152500 Allied Health Scholarships 23 48900 Medical Scholarships 18 48600 Employee Dependent Scholarships 25 31250 Employee Scholarships 145 133000 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: CAMC provides nursing, allied health and medical student scholarships funded by the Foundation. An application portfolio is submitted by the candidate and reviewed and scored anonymously by the Foundation's Nursing Allied Health and Medical Student Scholarship committee co-chairs for subsequent scholarship award by the committee. CAMC provides employee and employee dependent scholarships. Candidates submit an application and required materials and a committee reviews applications based on scholarship guidelines and criteria and awards scholarships. Scholarship payments are submitted directly to the college or university on behalf of the recipient. CAMC provides support to the University of Charleston ("UC") nursing program and pharmacy school program. UC is a nonprofit, tax-exempt organization. UC provided CAMC with an acknowledgement letter along with a giving history report. CAMC provides General Medical Education support to West Virginia University ("WVU") for teaching supervision and costs directly related to CAMC's residency training programs. WVU provides a monthly report regarding actual faculty participation and other costs incurred. CAMC provides assistance to various community programs which are reviewed by the Civic Affairs Council for award or at the discretion of the Chief Executive Officer. 0 1 0 0 0 0 0 0 0 David L Ramsey 581532 0 135748 0 106845 0 388321 0 19212 0 1231658 0 55420 0 Larry C Hudson 333290 0 71275 0 91680 0 66750 0 17765 0 580760 0 44411 0 Glenn Crotty Jr MD 380146 0 76529 0 2491821 0 52827 0 22675 0 3023998 0 1711036 0 Marshall A McMullen Jr 209357 0 29897 0 54551 0 100759 0 21205 0 415769 0 23797 0 William D Adams 104918 0 26595 0 5782 0 14050 0 8675 0 160020 0 0 0 Michael D Williams 218897 0 24220 0 34714 0 87986 0 19531 0 385348 0 20523 0 S Andrew Weber 157443 0 24317 0 22210 0 83177 0 20623 0 307770 0 11303 0 Stephen Z Bell 161222 0 25019 0 38287 0 175242 0 22851 0 422621 0 25500 0 Robert D Whitler 149338 0 21667 0 24067 0 7885 0 19630 0 222587 0 0 0 Beth A Samples 181306 0 26953 0 22590 0 178776 0 30216 0 439841 0 8353 0 Lynn Y Brookshire 188152 0 23041 0 48270 0 108572 0 20052 0 388087 0 18354 0 Elizabeth Spangler MD 247176 0 33351 0 60349 0 14700 0 20770 0 376346 0 0 0 Ronald E Moore 169391 0 26266 0 24333 0 22346 0 10341 0 252677 0 10571 0 Robert B Danielson 146462 0 16885 0 10000 0 41631 0 16245 0 231223 0 0 0 Dale R Wood 233276 0 35757 0 37783 0 68671 0 9343 0 384830 0 24857 0 Jeffrey H Goode 144190 0 23030 0 21744 0 38136 0 20875 0 247975 0 10658 0 Clennie Arthur III 174379 0 12138 0 25459 0 10658 0 19916 0 242550 0 0 0 Mark K Stephens MD 437896 0 3000 0 150 0 10909 0 18676 0 470631 0 0 0 Daniel Stickler II MD 445085 0 5500 0 150 0 11651 0 19076 0 481462 0 0 0 Kenneth C Wright MD 248902 0 0 0 8250 0 10847 0 9423 0 277422 0 0 0 Daniel Foster MD 233331 0 6400 0 0 0 11886 0 15587 0 267204 0 0 0 Kathleen Mimnagh MD 197246 0 11898 0 0 0 10400 0 23636 0 243180 0 0 0 Patricia Johnston 11539 0 0 0 862841 0 0 0 0 0 874380 0 0 449979 Part I, Line 4b Supplemental Executive Retirement Plan: Participants-Executive Group Participants paid in 2010 were Glenn Crotty Jr. in the amount of $1,217,085 and Patricia Johnson in the amount of $801,946. Terms & Conditions of SERP Plan: Defined Benefit. 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 5 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. CEO Supplemental Executive Retirement Plan: Participant-CEO Terms and Conditions of CEO SERP Plan: Defined Contribution. Vest at age 65. Benefit at age 65 projected as the difference between 60% of Final 5 Year Average Total compensation and sum of retirement benefits paid from: CAMC Qualified Retirement Plan and 50% of projected age 65 Primary Social Security Benefit. Actual benefits will depend upon simulated investment results based on investment options selected by participant. Eligible to receive SERP benefits upon earliest of: deferred vesting date; death; disability; involuntary termination without cause. Taxes due upon vesting. Subject to the Substantial Risk of Forfeiture. 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. West Virginia Hospital Finance Authority 621256910 956624AQ3 2008-06-19 127355000 See Part V 0 0 0 West Virginia Hospital Finance Authority 621256910 956622ZV9 2009-09-10 177519271 See Part V 0 0 0 West Virginia Hospital Finance Authority 621256910 2010-11-01 8428228 See Part V 0 0 0 385000 129956617 2071347 773024 60055015 33084021 34117691 1 0 0 1 2540000 179163779 15500596 2455533 17301803 148894025 3252056 2009 1 0 0 1 175589 8428228 60028 1 0 1 0 0 0 1 0 1 1 0 0 1 0 1 1 0 0 1 0 1 1 0 1 1 Merrill Lynch Capital Services 29.200000000000 0 0 0 0 1 0 0 0 1 Wachovia 23.000000000000 1 0 1 0 1 0 0 0 1 Part I, Line A (f) Description of purpose: The proceeds for the 2008A Bonds were used to (i) currently refund the Series 1995A Bonds originally issued on 9/26/95, (ii) pay the costs of certain capital expenditures made, or to be made, by CAMC, refinance a bank loan, and (iii) pay the costs of issuing the Series 2008A Bonds, including certain fees of the bank. Part I, Line B (f) Description of purpose: The proceeds for the 2009A Bonds were used to (i) currently refund the outstanding principal amount of the 2002 Series A and B Bonds originally issued on 9/24/02, (ii) pay a portion of a termination payment as a result of termination of hedge agreement in connection with the 2002 Bonds, (iii) fund a debt service reserve fund, and (iv) pay the costs of issuing the 2009 Bonds. Part I, Line C (f) Description of purpose: The proceeds for the 2010A Bonds were used to refund prior bonds issued 12/17/85. Part II Line 3: The total proceeds of issue includes accumulated interest earnings. Working capital expenditures reported in Part II, Line 9, column B consist of an extraordinary working capital expenditure consisting of a swap termination payment. Kathy Crotty Family member of Glenn Crotty Jr., Officer 21742 Employed by organization 0 Rick Crotty Family member of Glenn Crotty Jr., Officer 52282 Employed by organization 0 Barbara Covelli Family member of Glenn Crotty Jr., Officer 67853 Employed by organization 0 Donna Bell Family member of Steve Bell, Officer 157346 Employed by organization 0 Michael Samples Family member of Beth A. Samples, Officer 77156 Employed by organization 0 Glenda Bryant Family member of Ronald Moore, Officer 57655 Employed by organization 0 Terraco Inc Enitity more than 35% ownership by Nelle Chilton, Trustee 220449 Purchase services 0 BBT Entity Board Member, Nelle Chilton, Trustee 2519891 Purchase services 0 Kay Casto Chaney PLLC Partnership more than 5% owned by John R Hoblitzell, Trustee 105235 Purchase services 0 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 A, line 6 CAMC Health System, Inc. ("CAMCHSI") is the organization's sole voting member. Form 990, Part VI, Section A, line 7a CAMCHSI is the organization's sole voting member and has authority to elect all voting trustees of the organization other than ex officio trustees named in the organization's governing documents. The sole voting member has the sole authority to amend the organization's governing documents. Form 990, Part VI, Section A, line 7b CAMCHSI is the organization's sole voting member and has reserved powers under the organization's governing documents, which provide that decisions of the organization's governing body such as election of officers, approval of annual budgets and borrowings are subject to approval by the sole voting member. The sole voting member also has all approval powers provided to members of West Virginia nonprofit corporations under state law. Form 990, Part VI, Section B, line 11 The organization compiles necessary information for Form 990 with various officers and trustees 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 CAMC Board of Trustees 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 the board chairs with resolutions 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 advices the Committee on compensation arrangements and transactions between CAMC Health System companies (including CAMC) 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 is part of a consolidated financial audit for CAMC Health System, Inc. and Subsidiaries. Consolidated audited financial statements are available on-line 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. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 2,304,788. Prior period adjustments: 17,556. Affiliate transfers -5,133,047. Distribution to non-controlling interest 327,175. Effect of adoption of FAS 158 1,238,405. Change in retirement obligation -380,498. Assets released from restrictions for capital expenditures -10,494. Total to Form 990, Part XI, Line 5: -1,636,115. Charleston Area Medical Center Foundation Inc PO BOX 1547 Charleston WV 253261547 310887133 Foundation WV 501(c)(3) Line 11b, II CAMC Health SystemInc 1 CAMC Health System Inc PO BOX 1547 Charleston WV 253261547 550664138 Parent Company WV 501(c)(3) Line 11c, III-FI N/A 1 CAMC Health Education and Research Institute Inc PO BOX 1547 Charleston WV 253261547 550753754 Medical Research WV 501(c)(3) Line 11b, II CAMC Health SystemInc 1 CAMC Teays Valley Hospital Inc PO BOX 1547 Charleston WV 253261547 550752636 Hospital WV 501(c)(3) Line 3 CAMC Health SystemInc 1 Women & Children's Medical Office Building Partnership PO Box 1547 Charleston WV 253261547 550669065 Medical office building WV CAMC Related 397223 0 1 0.88480 General Division Medical Office Building Partnership PO Box 1547 Charleston WV 253261547 550623949 Medical office building WV CAMC Related 286872 0 1 0.79230 Integrated Health Care Providers Inc PO Box 1547 Charleston WV 253261547 550751010 Physicians Offices WV N/A C 1 1 1 1 0 0 0 0 1 1 1 0 0 0 1 1 1 0 General Division Medical Office Building Partnership A 36667 Contract Women and Children's Medical Office Building Partnership A 9167 Contract CAMC Health Education and Research Institute Inc B 4958945 Contract Integrated Health Care Providers Inc B 18686148 Contract CAMC Health System Inc C 60120 Contract Charleston Area Medical Center Foundation Inc C 534033 Contract General Division Medical Office Building Partnership D 12000 Contract CAMC Health Education and Research Institute Inc I 252419 Contract Integrated Health Care Providers Inc I 634501 Contract Charleston Area Medical Center Foundation Inc J 1014717 Contract Women and Children's Medical Office Building Partnership J 1024982 Contract General Division Medical Office Building Partnership J 728785 Contract Integrated Health Care Providers Inc J 150731 Contract CAMC Health System Inc K 88318 Contract CAMC Teays Valley Hospital Inc K 1639982 Contract Charleston Area Medical Center Foundation Inc K 208898 Contract CAMC Health Education and Research Institute Inc K 336492 Contract Women and Children's Medical Office Building Partnership K 165469 Contract General Division Medical Office Building Partnership K 127391 Contract Integrated Health Care Providers Inc K 2582971 Contract CAMC Teays Valley Hospital Inc O 7391728 FMV Charleston Area Medical Center Foundation Inc O 20608 FMV CAMC Health Education and Research Institute Inc O 615082 FMV Integrated Health Care Providers Inc O 352642 FMV CAMC Teays Valley Hospital Inc P 3512739 FMV Charleston Area Medical Center Foundation Inc P 169608 FMV CAMC Health Education and Research Institute Inc P 3167255 FMV Women and Children's Medical Office Building Partnership P 68363 FMV Integrated Health Care Providers Inc P 37393117 FMV CAMC Teays Valley Hospital Inc Q 945034 FMV CAMC Health System Inc Q 415546 Contract Integrated Health Care Providers Inc Q 4391631 Contract