2020-08-17T08:43:15-05:00 2019-09-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 46204 990 2018-10-01 550357057 WHEELING HOSPITAL INC WHEE 3042433681 1 MEDICAL PARK WHEELING WV 260036300 JAMES B MURDY CHIEF FINANCIAL OFFICER 3042433681 2020-08-14 1 JEFFREY D FRANK P00287234 3174648600 73.145.185.187 2020-08-14 13:07:41 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 83E387FBD1AB6D18D445BB5A405FBA040310C20C 2018 2020-11-06 18:47:13Z JOSEPH A WENGER 1 MEDICAL PARK WHEELING WV 260036300 446333175 0 0928 X WWW.WHEELINGHOSPITAL.ORG X 1850 WV TO PROVIDE NEEDED CARE TO THE COMMUNITY REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. 12 10 3300 179 8961525 1243440 428931 803773 349528711 386863083 14295254 622868 19680009 20384305 383932905 408674029 99993 0 0 0 195151368 217312758 0 0 0 184831341 199283156 380082702 416595914 3850203 -7921885 417017935 414256506 106228181 112913784 310789754 301342722 X WHEELING HOSPITAL, INC. IS A CATHOLIC HOSPITAL THAT SERVES AS A HEALTH MINISTRY, PROVIDING COMPASSIONATE CARE TO PEOPLE OF ALL FAITHS IN A LOVING, SPIRITUAL ENVIRONMENT. GOD GIVES US THE RESPONSIBILITY TO CARRY OUT HIS MISSION OF HEALING AND TO PROMOTE THE WELL-BEING OF OUR EMPLOYEES AND OUR COMMUNITY. IN DOING SO, WE, THE WHEELING HOSPITAL, INC. FAMILY, FULFILL OUR MISSION THROUGH OUR:-HEALING-UNDERSTANDING-MINISTRY-ADVANCED TECHNOLOGY-NURTURANCE-TRADITION-ONGOING EDUCATION-UNITY-CARE-HOPE 0 0 363814432 0 372251497 WHEELING HOSPITAL, INC. SERVICED 12,447 INPATIENTS, 702,770 OUTPATIENTS, AND 14,219 HOME HEALTH VISITS DURING FISCAL YEAR 2019. COMMUNITY SERVICES INCLUDED MEDICAL SCREENING, DIABETIC EDUCATION, CANCER SUPPORT, ETC. AND IS PROVIDED FREE OF CHARGE. THIS INCLUDES THE PHYSICIAN PRACTICE DIVISION, THE WHEELING PEDIATRICS DIVISION, AND THE WOMEN'S HEALTH SERVICES DIVISION. SEE SCHEDULE H. 12209745 0 14535191 CONTINUOUS CARE CENTER SERVICED 474 SKILLED AND LONG-TERM PATIENTS FOR A TOTAL OF 48,161 PATIENT DAYS. 376024177 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 1 1 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 1 0 0 1 222 0 1 3300 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 12 10 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 WV X JOSEPH A WENGER 3042433801 1 MEDICAL PARK WHEELING WV 26003 C GARY HILL BOARD MEMBER 1.00 0.00 X 0 0 0 CURTIS R OLIVER BOARD MEMBER 1.00 0.00 X 0 0 0 FRANK L CARENBAUER III DDS BOARD MEMBER 1.00 0.00 X 0 0 0 JAMES E ALTMEYER SR BOARD MEMBER (END 1/19) 1.00 0.00 X 0 0 0 JOHN J BATTAGLINO JR MD BOARD MEMBER 1.00 0.00 X 28325 0 0 KENNETH C NANNERS MD BOARD MEMBER 1.00 0.00 X 74600 0 0 LAWRENCE E BANDI CHAIRMAN/PRESIDENT (AS OF 6/19) 1.00 0.00 X X 0 0 0 MICHAEL A SLIVA BOARD MEMBER 1.00 0.00 X 0 0 0 NICHOLAS A SPARACHANE BOARD MEMBER 1.00 0.00 X 0 0 0 RAYMOND V THALMAN III BOARD MEMBER 1.00 0.00 X 0 0 0 RICHARD M POLINSKY BOARD MEMBER (END 2/19) 1.00 0.00 X 0 0 0 SISTER MARY PALMER CSJ BOARD MEMBER 1.00 0.00 X 0 0 0 THE MOST REV MARK E BRENNAN BOARD MEMBER (AS OF 8/19) 1.00 0.00 X 0 0 0 THOMAS F BURGOYNE BOARD MEMBER 1.00 0.00 X 0 0 0 VERY REV KEVIN M QUIRK JCDJV BOARD MEMBER/PRES. (END 6/19) 1.00 0.00 X X 0 0 0 DOUGLAS HARRISON CHIEF EXECUTIVE OFFICER (AS OF 6/19) 57.00 3.00 X 0 0 0 JAMES B MURDY CHIEF FINANCIAL OFFICER 56.00 4.00 X 333246 0 56592 MICHAEL S MCKEETS CHIEF OPERATING OFFICER (END 12/18) 52.00 8.00 X 209633 0 27364 RONALD L VIOLI CHIEF EXECUTIVE OFFICER (END 5/19) 57.00 3.00 X 0 0 0 ANGELO GEORGES MD CHIEF MEDICAL OFFICER 56.00 4.00 X 532342 0 47819 ANTHONY MARTINELLI SENIOR DIRECTOR 40.00 20.00 X 191576 0 31715 DAVID RAPP CHIEF INFORMATION OFFICER 56.00 4.00 X 318268 0 43617 DENNIS NIESS MD CHIEF MED. INFO. OFFICER 57.00 3.00 X 259681 0 46208 DIANE LIVENGOOD SENIOR DIRECTOR 52.00 8.00 X 167293 0 18445 HEIDI PORTER VP OF QUALITY & REGULATORY AFFAIRS 52.00 8.00 X 177248 0 17620 JOHN DEBLASIS SENIOR ADMIN. & VICE PRESIDENT 30.00 30.00 X 177208 0 25901 KAREEN SIMON VP OF OPERATIONS/COO 56.00 4.00 X 415020 0 14347 KATHY STAHL CHIEF NURSING OFFICER 52.00 8.00 X 157283 0 13621 SHAWN STERN MEDICAL DIRECTOR 52.00 8.00 X 369319 0 47808 VINCENT AZZARELLO SENIOR DIRECTOR 52.00 8.00 X 158062 0 29309 CHANDRA S SWAMY PHYSICIAN 40.00 0.00 X 957266 0 38250 DEVENDER BATRA PHYSICIAN 40.00 0.00 X 1636671 0 26063 GREGORY S MERRICK PHYSICIAN 40.00 0.00 X 1326620 0 14768 HOWARD SHACKELFORD PHYSICIAN 40.00 0.00 X 984263 0 35645 JONDAVID POLLOCK PHYSICIAN 40.00 0.00 X 1202477 0 41401 9676401 0 576493 211 0 1 0 R & V ASSOCIATES 310 GRANT STREET STE 1120 PITTSBURGH PA 15219 CONSULTING SERVICES 3519203 MOUNTAIN EMERGENCY PHYSICIANS LLP 4075 COPPER RIDGE DR TRAVERSE CITY MI 49684 PHYSICIAN SERVICES 2806327 QUEST DIAGNOSTICS 2249 COLLECTION CENTER DRIVE CHICAGO IL 60693 LAB TESTING SERVICES 2001807 ERB ELECTRIC COMPANY 500 HALL STREET SUITE 1 BRIDGEPORT OH 43912 ELECTRICIAN SERVICES 1982448 UROLOGY GROUP ASSOCIATES 1524 SUNSET BLVD STEUBENVILLE OH 43952 PHYSICIAN SERVICES 1514715 40 298122 505651 67500 803773 MEDICARE REVENUE 621990 181508582 181508582 NET PATIENT SVC. REV. 622110 163833444 163833444 MEDICAID REVENUE 621990 41422478 41422478 RENTS FROM AFFILIATES 900099 98579 98579 386863083 1808812 -76395 1885207 1355064 289523 1065541 1065541 1065541 35559952 239229 36755252 229873 -1195300 9356 -1185944 -1185944 440432 384498 55934 55934 APOTHECARY INCOME 446110 10087854 5479491 4608363 NON-OPERATING REVENUE 713940 2413024 2126439 286585 MED SVCS/DIAGN LAB 621500 1355595 1355595 5406357 5406357 19262830 408674029 386786688 8961525 12122043 3867457 502375 3365082 166199384 153826029 12373355 7597617 7030306 567311 28230946 24913716 3317230 11417354 10151707 1265647 2434227 2434227 360279 360279 23414 23414 138799 138799 25538386 24257822 1280564 1806967 26659 1780308 18475742 15298614 3177128 558018 558018 4344255 4071062 273193 687825 570924 116901 2194013 1988221 205792 19047416 16352362 2695054 5575059 5061365 513694 MEDICAL SUPPLIES 93661288 93653816 7472 LICENSES & TAXES 9305992 9305992 0 CONSULT/MGMT CONTRACTS 3883080 2201 3880879 UBI TAX 224071 224071 0 11024325 8786935 2237390 416595914 376024177 40571737 0 68223395 54280722 5895151 6063760 40016851 41185651 1152255 4153492 4556635 3581060 4817782 465251387 291655401 177174357 173595986 97712094 100431219 2760412 20261535 25412084 417017935 414256506 48705508 53387109 54615636 56006990 2907037 3519685 106228181 112913784 X 298176223 297488225 12613531 3854497 310789754 301342722 417017935 414256506 X -7921885 2121160 -3646307 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 23414 23414 0 PART II-B, LINE 1: LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT ARE SPECIFICALLY ALLOCABLE TO LOBBYING. WHEELING HOSPITAL, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 6660734 6660734 207297011 102148700 105148311 208497 148063 60434 233317963 182598016 50719947 17767182 6760622 11006560 173595986 MUTUAL FUNDS 26650931 C COMMON STOCK 39096257 C CASH 15646400 C OTHER INVESTMENTS 7400341 C INVESTMENT - WHEELING RENAL CARE, LLC 333255 C INVESTMENT - DISREGARDED ENTITIES 11304035 C 100431219 ESTIMATED AMOUNTS DUE FROM THIRD PARTY PAYORS 4721988 INTERCOMPANY RECEIVABLES 18962553 INTEREST RECEIVABLE 129405 OTHER RECEIVABLES 1598138 25412084 CURRENT PORTION OF INSURANCE RESERVES 739000 ESTIMATED AMOUNTS DUE FROM THIRD PARTY PAYORS 594049 ASSET RETIREMENT OBLIGATION 1469729 DEFERRED COMPENSATION 315699 LONG-TERM PORTION OF ACCRUED PROPERTY TAX 401208 3519685 X PART X, LINE 2: FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF WHEELING HOSPITAL, INC. AND SUBSIDIARIES: WHEELING HOSPITAL, INC. (THE HOSPITAL), BELMONT COMMUNITY HOSPITAL, MEDICAL PARK FOUNDATION (THE FOUNDATION), WHEELING PEDIATRICS, LLC (WP), WOMEN'S HEALTH SPECIALISTS OF WHEELING HOSPITAL, LLC (WHS), HARRISON COMMUNITY HOSPITAL (HCH), AND HARRISON COMMUNITY HOSPITAL FOUNDATION (HCF) ALL QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE US INTERNAL REVENUE CODE. WH HOLDINGS II, LLC (WHH II) IS TREATED AS A DISREGARDED ENTITY OF THE HOSPITAL. MOUNTAINEER FREEDOM LIMITED (MFLTD) IS A FOREIGN ENTITY, INCORPORATED IN THE CAYMAN ISLANDS. THE EFFECT OF INCOME TAXES ON MFLTD IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS IS NOT MATERIAL. THE HOSPITAL DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2019 AND 2018. CENTRAL AMERICA AND THE CARIBBEAN 0 2 PROGRAM SERVICES CAPTIVE INSURANCE ACTIVITY 426277 0 2 0 0 0 2 426277 0 426277 1 0 1 0 0 0 UNIFORM SALE 145381 145381 119130 SHOE SALE 54961 54961 43462 4 240090 240090 12997 208909 440432 440432 12997 371501 384498 55934 1 1 X 1 X 1 X 1 1 0 0 2542839 0 2542839 0.00610 66546053 46916793 19629260 0.04710 69088892 46916793 22172099 0.05320 624740 3471 621269 0.00150 2639937 1519669 1120268 0.00270 3264677 1523140 1741537 0.00420 72353569 48439933 23913636 0.05740 1 19169618 43172 70992679 84607028 -13614349 X 1 1 1 1 WHEELING HOSPITAL INC 1 MEDICAL PARK WHEELING WV 26003 WWW.WHEELINGHOSPITAL.ORG 89 X X X X WHEELING HOSPITAL INC 1 0 0 1 X X X X X X X X X 18 1 1 0 1 X SEE SCHEDULE H, PART V, SECTION C X 1 18 0 1 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X HTTPS://WHEELINGHOSPITAL.ORG/ABOUT/FINANCIALASSISTANCE.ASPX X HTTPS://WHEELINGHOSPITAL.ORG/ABOUT/FINANCIALASSISTANCE.ASPX X HTTPS://WHEELINGHOSPITAL.ORG/ABOUT/FINANCIALASSISTANCE.ASPX X X X X X X 1 X 0 X X X 1 X 0 0 WHEELING HOSPITAL, INC. PART V, SECTION B, LINE 5: INPUT WAS SOLICITED FROM THOSE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY FROM AUGUST AND SEPTEMBER 2019. INDIVIDUAL INTERVIEW DISCUSSIONS INCLUDED THE HEALTH NEEDS OF THE COMMUNITY, BARRIERS TO HEALTH CARE ACCESS, OPPORTUNITIES FOR IMPROVEMENT, PERCEPTION OF WHEELING HOSPITAL, INC., AND FEEDBACK ON PREVIOUS INITIAITIVES.THE FOLLOWING ORGANIZATIONS WERE CONSULTED BY THE HOSPITAL IN CONDUCTING ITS MOST RECENT CHNA:- OHIO COUNTY HEALTH DEPARTMENT- BELMONT BEHAVIORAL HEALTH & REHAB- CONTINUOUS CARE CENTER WHEELING HOSPITAL- WHEELING HEALTH RIGHT- WV DHHR- WHEELING CORPORATE HEALTH - WHEELING HOSPITAL FAMILY MEDICINE WHEELING HOSPITAL, INC. PART V, SECTION B, LINE 6A: THE CHNA FOR WHEELING HOSPITAL, INC. AND BELMONT COMMUNITY HOSPITAL, A RELATED PARTY, WERE CONDUCTED SIMULTANEOUSLY, BUT SEPARATE REPORTS WERE ISSUED FOR EACH HOSPITAL. WHEELING HOSPITAL, INC. PART V, SECTION B, LINE 11: DUE TO THE MOST RECENT CHNA NOT BEING ADOPTED BY THE BOARD UNTIL SEPTEMBER 30 2019, THE HOSPITAL CONTINUED TO ADDRESS THE NEEDS AND ISSUES PRESENTED IN THE PREVIOUS CHNA. THE NEEDS IDENTIFIED IN THE PREVIOUSLY COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT DATED SEPTEMBER 30, 2016 ARE AS FOLLOWS:1. CHRONIC DISEASE MANAGEMENT2. UNHEALTHY LIFESTYLES3. DRUG AND ALCOHOL ABUSEWHEELING HOSPITAL, INC. CURRENTLY HAS VARIOUS COMMUNITY OUTREACH AND EDUCATION PROGRAMS IN PLACE FOR ALL THREE OF THESE NEEDS. AS A RESULT, THE HOSPITAL ADDRESSED ALL THREE OF THESE ISSUES DURING FY19:CHRONIC DISEASE MANAGEMENTWHEELING HOSPITAL, INC. HAS CONTINUED ITS TRADITION OF PROVIDING OUTREACH AND EDUCATION TO THE RESIDENTS OF WHEELING, WV AND SURROUNDING COMMUNITIES REGARDING THE CAUSES OF CHRONIC DISEASE, PREVENTATIVE MEASURE AND TREATMENT. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019, APPROXIMATELY 2,224 AREA RESIDENTS PARTICIPATED IN HEALTH FAIRS CONDUCTED BY WHEELING HOSPITAL, INC. THE HEALTH FAIRS PROVIDED DIABETES SCREENINGS AND EDUCATION, BLOOD PRESSURE MONITORING, CHOLESTEROL SCREENING AS WELL AS EDUCATION ON BREAST HEALTH AND BONE HEALTH. UNHEALTHY LIFESTYLES WHEELING HOSPITAL, INC. PROVIDED OUTREACH AND EDUCATION FOR SMOKING CESSATION, PROPER NUTRITION AND THE IMPORTANCE OF PHYSICAL ACTIVITY TO APPROXIMATELY 787 COMMUNITY MEMBERS DURING THE 9/30/19 FISCAL YEAR. PARTICULAR ATTENTION WAS GIVEN TO HEALTH AND WELLNESS EDUCATION FOR THE OLDER ADULTS IN THE COMMUNITY GIVEN THE AGING OF THE POPULATION IN THE WHEELING HOSPITAL, INC. SERVICE AREA. THE HOSPITAL WILL CONTINUE TO ASSIST WITH HEALTH AND WELLNESS PROGRAMS AND PROVIDE THE NECESSARY RESOURCES FOR THOSE SEEKING HEALTHY LIFESTYLES THROUGH DIET AND EXERCISE. DRUG AND ALCOHOL ABUSEWHEELING HOSPITAL, INC. WILL MAINTAIN ITS COLLABORATION AND REFERRAL NETWORK TO ADDRESS PATIENTS' NEEDS WITH REGARD TO ADDICTION AND ABUSE. THE HOSPITAL WILL PROVIDE OUTREACH AND EDUCATION TO ITS SURROUNDING COMMUNITIES. ADDITIONALLY, WHEELING HOSPITAL, INC. WILL ENGAGE WITH LOCAL LAW ENFORCEMENT AND OTHER COMMUNITY AGENCIES IN INITIATIVES AIMED AT ADDRESSING THE OPIOID EPIDEMIC THAT IS CURRENTLY RAVAGING THE OHIO VALLEY.EFFORTS MADE DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2019 FOR NEEDS IDENTIFIED IN THE PREVIOUS CHNA ARE: 1. PHYSICIAN RECRUITMENT - THE RECRUITMENT CAMPAIGN THAT BEGAN A DECADE AGO IS STILL IN PLACE. AT ANY GIVEN TIME, WHEELING HOSPITAL, INC.'S MANAGEMENT IS IN DISCUSSION OR NEGOTIATION WITH AT LEAST ONE POTENTIAL RECRUIT AND AT TIMES SEVERAL RECRUITS SIMULTANEOUSLY. THIS PROCESS WILL CONTINUE, AND AS GOOD MATCHES ARE FOUND, OFFERS OF EMPLOYMENT WILL BE EXTENDED. IN ADDITION TO RECRUITING PHYSICIANS FROM OUTSIDE OF THE WHEELING, WV AREA, NEW PHYSICIAN PRACTICES HAVE BEEN ESTABLISHED AND STAFFED WITH PHYSICIANS FROM WHEELING HOSPITAL, INC.'S FAMILY PRACTICE MEDICINE INTERN AND RESIDENT PROGRAM. 2. ADULT OUTPATIENT BEHAVIORAL HEALTH SERVICES/DIABETIC EDUCATION/WEIGHT LOSS & NUTRITION - THE SEARCH FOR A HEALTH CARE PARTNER TO PROVIDE OUTPATIENT PSYCHIATRIC SERVICES THAT BEGAN IN FY2015 CONTINUED INTO FY2019. WHEELING HOSPITAL, INC. IS ACUTELY AWARE OF THE NEED FOR THESE SERVICES WITHIN OUR SERVICE AREA AND WILL CONTINUE THE NEGOTIATIONS WITH A QUALIFIED PARTNER WHO CAN PROVIDE THESE SERVICES. THE HOWARD LONG WELLNESS CENTER CONTINUES TO PROVIDE A VARIETY OF WEIGHT LOSS, NUTRITION, SMOKING CESSATION AND OTHER HEALTH ENHANCING PROGRAMS IN ADDITION TO THE ONGOING DIABETIC EDUCATION SERVICES.3. AGING POPULATION - WHEELING HOSPITAL, INC. HAS TAKEN ON FEASIBILITY STUDIES IN RELATION TO PROJECTS THAT ADDRESSED THE NEED FOR ADDITIONAL ASSISTED LIVING AND/OR INDEPENDENT LIVING COMMUNITIES FOR THE AREA'S AGING POPULATION. SIGNIFICANT FURTHER REVIEW AND CONSIDERATION IS REQUIRED BEFORE HOSPITAL MANAGEMENT WILL MAKE A DECISION REGARDING MOVING FORWARD WITH SUCH FACILITIES. THIS REMAINS AN AREA OF FOCUS AND INTEREST AND THE HOSPITAL IS COMMITTED TO EXPLORING OPTIONS IN THIS REGARD. THE HOSPITAL CURRENTLY OPERATES VEHICLES TO ASSIST NON-DRIVING ELDERLY PATIENTS WITH TRANSPORT TO AND FROM THE HOSPITAL AND PHYSICIAN OFFICES, AS WELL AS PROVIDING FREE TAXI VOUCHERS TO PATIENTS FOR TRANSPORT HOME AFTER ER OR INPATIENT VISITS. ADDITIONALLY, WHEELING HOSPITAL, INC. HAS CONSTRUCTED A REPLACEMENT FOR THE BISHOP HODGES CONTINUOUS CARE CENTER (SNF/ICF) FACILITY ON ITS CAMPUS WITH A COMPLETION DATE OF JULY 2018. THIS IS A STATE OF THE ART FACILITY WITH PRIVATE ROOMS AND BATHS, LARGE ROOMS AND A DE-INSTITUTIONALIZED THEME OF DECOR. WHEELING HOSPITAL, INC. PART V, SECTION B, LINE 16J: IN ADDITION TO PROVIDING THE FULL FAP UPON REQUEST, A SUMMARY IS POSTED IN THE HOSPITAL FACILITY'S EMERGENCY ROOMS AND WAITING ROOMS. ALSO, SIGNAGE AND LITERATURE HAS BEEN DEPLOYED IN POINTS OF THE FACILITY, AND IN PHYSICIAN OFFICES, TO EDUCATE PATIENTS ABOUT THE FAP PROGRAM. PART V, SECTION B, LINE 7A: THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") OF THE HOSPITAL FACILITY CAN BE FOUND AT THE FOLLOWING WEB ADDRESS:HTTPS://WHEELINGHOSPITAL.ORG/FACILITIES/WHEELINGHOSPITAL/COMMUNITYHEALTHNEEDSASSESSMENT_WH.PDF 1 1 - CONTINUOUS CARE CENTER PO BOX 6313 WHEELING WV 26003 SKILLED NURSING FACILITY PART I, LINE 3C: ELIGIBILITY FOR FINANCIAL ASSISTANCE IS DETERMINED BY REFERENCING THE FINANCIAL ASSISTANCE MATRIX, WHICH IS BASED ON THE FEDERAL POVERTY GUIDELINES FOR THE MOST CURRENT YEAR AVAILABLE AS ISSUED BY THE DEPARTMENTOF HEALTH AND HUMAN SERVICES. APPLICANTS ARE REQUIRED TO PROVIDE PROOF OF INCOME, SUCH AS UNEMPLOYMENT, WORKER'S COMPENSATION, SOCIAL SECURITY, ANDALIMONY/CHILD SUPPORT. THEY ARE ALSO ASKED IF THEY HAVE MEDICAID OR ANY OTHER THIRD PARTY INSURANCE. APPLICANTS CLAIMING THAT THEY HAVE NO INCOME ARE REQUIRED TO PROVIDE A LETTER OF SUPPORT FROM THE INDIVIDUAL PROVIDING THE SUPPORT FOR THE PATIENT. ADDITIONALLY, APPLICANTS MAY PROVIDE LETTERS OF DENIAL FROM INSURANCE PROVIDERS AS SUPPORT. ASSETS ARE ALSO CONSIDERED WHEN DECIDING WHETHER TO GRANT FINANCIAL ASSISTANCE AS THE PATIENT IS REQUIRED TO PROVIDE COPIES OF BANK STATEMENTS, CERTIFICATES OF DEPOSIT, MONEY MARKET ACCOUNT STATEMENTS, ETC. PART I, LINE 7: THE COST OF CHARITY CARE IS COMPUTED BY MULTIPLYING THE AMOUNT OF GROSS PATIENT CHARGES WRITTEN OFF DURING THE FISCAL YEAR IN ACCORDANCE WITH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY BY AN OVERALL COST-TO-CHARGE RATIO THAT IS COMPUTED BASED ON THE METHODOLOGY OF "WORKSHEET 2" OF THE FORM 990, SCHEDULE H INSTRUCTIONS. PART III, LINE 2: BAD DEBT EXPENSE WAS CALCULATED BY TAKING THE BAD DEBT WRITE-OFFS FOR 9/30/19 (BASED ON GROSS CHARGES) FROM THE GENERAL LEDGER. THE TOTAL BAD DEBT WRITE-OFFS WERE THEN MULTIPLIED BY THE OVERALL COST-TO-CHARGE RATIO OF 39.18% CALCULATED ON WORKSHEET 2 OF SCHEDULE H. DISCOUNTS TO PATIENT ACCOUNTS ARE RECORDED AS CONTRACTUAL WRITE-OFF'S AND NOT AS BAD DEBT. THEREFORE, THE CALCULATED BAD DEBT EXPENSE DOES NOT INCLUDE ANY PORTION OF A PATIENT'S CHARGES THAT WERE DISCOUNTED. PART III, LINE 3: ESTIMATE OF FACILITY BAD DEBTS WHICH MAY QUALIFY FOR CHARITY: THIS IS ESTIMATED BY CALCULATING THE CHARITY WRITE-OFFS AS A PERCENTAGE OF TOTAL REVENUE AND APPLYING THIS PERCENTAGE (0.61%) TO THE TOTAL BAD DEBT WRITE-OFFS FOR THE PERIOD. THE RESULTING AMOUNT IS THEN MULTIPLIED BY THE OVERALL COST/CHARGE RATIO COMPUTED ON WORKSHEET 2 OF THE FORM 990 INSTRUCTIONS. PART III, LINE 4: WHEELING HOSPITAL, INC. DOES NOT HAVE SEPARATE AUDITED FINANCIAL STATEMENTS, BUT THE FOLLOWING FOOTNOTE IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS:THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE PROVISION FOR BAD DEBTS AS A PERCENTAGE OF NET PATIENT REVENUES WAS 4.99% AND 5.75% FOR THE YEARS ENDED SEPTEMBER 30, 2019 AND 2018, RESPECTIVELY.PROVISIONS FOR BAD DEBTS INCLUDE: 2019 2018 GOVERNMENT AND STATE PROVISION $0 $0 COMMERCIAL, OTHER, AND SELF-PAY $21,372,522 $23,067,877 THE BAD DEBT REFLECTED ON THE FINANCIAL STATEMENTS IS THE GROSS AMOUNT OF THE ACCOUNTS DEEMED UNCOLLECTIBLE. THIS WOULD BE FOR ACCOUNTS THAT HAVE HAD NO PAYMENT FOR 60 DAYS AND HAVE HAD A MINIMUM OF FIVE STATEMENTS PRODUCED. THEREFORE, THE BAD DEBT AMOUNTS WOULD BE AFTER ANY DISCOUNTS OR PATIENT PAYMENTS HAVE BEEN APPLIED.THE RATIO FROM WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS WAS USED. THIS RATIO WAS APPLIED TO THE TOTAL BAD DEBT EXPENSE INCLUDED IN NET PATIENT SERVICE REVENUE.THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT COULD REASONABLY BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY WAS CALCULATED BY APPLYING THE PERCENTAGE OF CHARITY CARE TO GROSS PATIENT REVENUE TO THE TOTAL BAD DEBT EXPENSE AT COST. PART III, LINE 8: THE COSTS REFLECTED IN LINE 6 ARE THE ALLOWABLE INPATIENT AND OUTPATIENT COSTS FROM WORKSHEET D-1 AND D, PART V OF THE 9/30/19 CMS COST REPORT. APPROXIMATELY $1.12M OF THE $13.6M SHORTFALL ON LINE 7 IS TREATED AS COMMUNITY BENEFIT. DESPITE THE FACT THAT THE PROGRAM SERVES ALL ELDERLY AND DISABLED BENEFICIARIES AND COULD REPRESENT COMMUNITY BENEFIT, THE MAJORITY OF THE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT. THE $1.12M TREATED AS A COMMUNITY BENEFIT IS THE MEDICARE SHORTFALL RELATING TO THE INTERNS AND RESIDENTS' MEDICAL EDUCATION PROGRAM. THE COMMUNITY BENEFIT FOR THE INTERN AND RESIDENT PROGRAM IS REPORTED ON LINE 7F (HEALTH PROFESSIONS EDUCATION) OF SCHEDULE H. MEDICARE COSTS OF $85M ON PART III, LINE 6, SECTION B, ARE OBTAINED FROM WORKSHEET D-1, D, AND PART V OF THE 9/30/19 MEDICARE COST REPORT. MEDICARE COST IS OBTAINED DIRECTLY FROM THE 9/30/19 WHEELING HOSPITAL, INC. MEDICARE COST REPORT. WORKSHEETS D-1 AND D, PART V OF THE COST REPORT CALCULATE MEDICARE INPATIENT AND OUTPATIENT COST, RESPECTIVELY, BASED ON A FULL-COSTING METHODOLOGY. PART III, LINE 9B: WHEELING HOSPITAL INC.'S COLLECTION POLICY HAS BEEN ESTABLISHED TO DEFRAY THE COSTS OF MEDICALLY NECESSARY SERVICES FOR THOSE PATIENTS WHO MEET CERTAIN GUIDELINES AND HAVE NO OTHER MEDICAL FUNDING SOURCES. INPATIENT, OUTPATIENT, EMERGENCY ROOM SERVICES, PROFESSIONAL SERVICES OF EMPLOYED PHYSICIANS AND PRESCRIPTION DRUGS ON AN ACUTE/EMERGENT BASIS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE/CHARITY CARE. THE FINANCIAL ASSISTANCE/CHARITY CARE APPLICATION MUST BE SIGNED BY THE APPLICANT ATTESTING TO THE TRUTHFULNESS AND ACCURACY OF THE INFORMATION PROVIDED.ELIGIBILITY IS DETERMINED BY REFERENCING THE FINANCIAL ASSISTANCE/CHARITY CARE MATRIX, WHICH IS BASED ON THE FEDERAL POVERTY GUIDELINES FOR THE MOST CURRENT YEAR AVAILABLE. THOSE APPROVED APPLICANTS WHO ARE AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE TO RECEIVE CHARITY CARE, AND THOSE WHO ARE FROM 201% TO 400% OF THOSE LIMITS ARE ELIGIBLE FORDISCOUNTS. PART VI, LINE 2: WHEELING HOSPITAL, INC. IS CONTINUOUSLY EVALUATING AND ASSESSING COMMUNITY NEEDS THAT MAY ARISE OUTSIDE OF THE CHNA. THE IMPLEMENTATION PLAN FOR THE CHNA IS RE-EVALUATED YEARLY TO DETERMINE THE OPTIMAL RESPONSE TO THE UP-TO-DATE NEEDS THAT OCCUR SINCE THE DATE OF THE LAST REPORT AND HOW THE RESOURCES OF THE HOSPITAL CAN BEST BE USED FOR THE GREATER GOOD OF THE SURROUNDING AREA. ADDITIONALLY, EACH DEPARTMENT OF THE HOSPITAL THAT CONDUCTS COMMUNITY ABEYANCE PROGRAMS IS SURVEYED YEARLY IN REGARD TO THE EFFECTIVENESS OF CURRENT PROGRAMS IN PLACE AND THE BEST WAY TO RESPOND TO NEW ISSUES THAT HAVE ARISEN SINCE THE LAST SURVEY. THE RESULTS ARE EVALUATED IN REGARD TO HOW BEST TO DEPLOY HOSPITAL RESOURCES TO MEET THESE OBJECTIVES. PART VI, LINE 3: IF THE PATIENT HAS A SCHEDULED PROCEDURE AND HAS BEEN PRE-REGISTERED AS SELF PAY, THEY ARE DIRECTED TO THE FINANCIAL COUNSELOR, WHERE PAYMENT ARRANGEMENTS AND DISCOUNTS/CHARITY ARE DISCUSSED, IF APPLICABLE. SELF PAYACCOUNTS OVER $500 ARE SCREENED BY MEDASSIST, AN OFFSITE SERVICE FOR GOVERNMENT PROGRAM ELIGIBILITY. ONCE AN ACCOUNT DROPS TO BILLING, THE CREDIT/COLLECTION STAFF GETS THAT ACCOUNT AND RESEARCH FOR OTHER ACCOUNTS, NOTING INSURANCE OR CHARITY. IF NOTHING PRIOR, THE PATIENT IS CALLED TO DISCUSS PAYMENT/CHARITY, AS APPLICABLE. PART VI, LINE 4: WHEELING HOSPITAL, INC. PREDOMINANTLY SERVICES THE WHEELING METROPOLITAN STATISTICAL AREA. THE PRIMARY SERVICE AREA INCLUDES ONE COUNTY IN THE NORTHERN PANHANDLE OF WEST VIRGINIA (OHIO COUNTY) AND ONE COUNTY IN OHIO (BELMONT COUNTY), WITH A TOTAL POPULATION OF APPROXIMATELY 108,417.THE ESTIMATED RACIAL MAKEUP OF THE MSA AS OF 2018 WAS 93.25% WHITE, 3.95% AFRICAN AMERICAN, 0.65% ASIAN, 0.20% NATIVE AMERICAN, WITH THE REMAINDER FROM OTHER RACES OR A COMBINATION OF TWO OR MORE RACES. THE MEDIAN HOUSEHOLD INCOME FOR 2018 WAS APPROXIMATELY $48,890, WHILE THE MEDIAN HOUSEHOLD INCOME FOR THE UNITED STATES WAS APPROXIMATELY $60,293. THE BELOW POVERTY LEVEL PERCENTAGE FOR 2018 WAS APPROXIMATELY 12.75%, WHILE THE BELOW POVERTY LEVEL PERCENTAGE WAS APPROXIMATELY 11.8% FOR THE UNITED STATES. PART VI, LINE 5: A MAJORITY OF THE HOSPITAL'S BOARD MEMBERS ARE RESIDENTS OF THE PRIMARY SERVICE AREA AND ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE HOSPITAL.IN ADDITION, THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ANY QUALIFIED PHYSICIAN IN THE COMMUNITY. PART VI, LINE 6: WHEELING HOSPITAL, INC. (THE "HOSPITAL OR "WHEELING HOSPITAL") WAS CREATED BY AN ACT OF THE VIRGINIA GENERAL ASSEMBLY IN 1850. CURRENTLY, THE HOSPITAL OPERATES AND EXISTS UNDER THE LAWS OF WEST VIRGINIA AS A NOT-FOR-PROFIT CORPORATION. UNDER ITS CORPORATE CHARTER, THE HOSPITAL IS OPERATED, SUPERVISED, AND CONTROLLED BY THE ROMAN CATHOLIC DIOCESE OF WHEELING/CHARLESTON (THE "DIOCESE"). THE HOSPITAL CONSISTS OF THE WHEELING HOSPITAL DIVISION, A FULL SERVICE REGIONAL TEACHING HOSPITAL OFFERING A WIDE RANGE OF MEDICAL AND SURGICAL SERVICES ON AN INPATIENT AND OUTPATIENT BASIS, AND THE CONTINUOUS CARE CENTER WHEELING HOSPITAL (CCC), HOUSING A 144-BED SKILLED AND INTERMEDIATE CARE CENTER. THE HOSPITAL OWNS AND OPERATES THE PHYSICIAN PRACTICE DIVISION AS A DEPARTMENT OF THE HOSPITAL. THIS DIVISION CONSISTS OF A GROUP OF PRIMARY CARE AND MULTISPECIALTY PHYSICIANS PRACTICING AT THE HOSPITAL.THE HOSPITAL IS THE SOLE MEMBER OF BELMONT COMMUNITY HOSPITAL ("BELMONT HOSPITAL") LOCATED IN BELLAIRE, OHIO. BELMONT HOSPITAL CEASED HOSPITAL OPERATIONS IN APRIL 2019. THE HOSPITAL WHOLLY OWNS A CAPTIVE INSURANCE COMPANY, MOUNTAINEER FREEDOM, LTD. (MFLTD). THE HOSPITAL IS THE SOLE MEMBER OF THE MEDICAL PARK FOUNDATION (THE "FOUNDATION"), WHICH RAISES CONTRIBUTIONS SOLELY FOR THE USE OF THE HOSPITAL-CONTROLLED ENTITIES. THE PURPOSE OF THE FOUNDATION IS TO CULTIVATE PHILANTHROPIC SUPPORT FOR PATIENT CARE SERVICES, IMPROVE HOSPITAL FACILITIES, SUPPORT THE UNCOMPENSATED CARE PROGRAM, AND SUPPORT COMMUNITY OUTREACH PROGRAMS.THE HOSPITAL IS THE SOLE MEMBER OF WHEELING PEDIATRICS, LLC (WP) AND WOMEN'S HEALTH SERVICES (WHS). HOWEVER, THERE ARE NO ASSETS NOR ACTIVITIES FOR EITHER OF THESE LEGAL ENTITIES AS OF AND FOR THE YEARS ENDED SEPTEMBER 30, 2019 AND 2018. IN 2017, THE HOSPITAL BECAME THE SOLE MEMBER OF HARRISON COMMUNITY HOSPITAL (HCH), LOCATED IN CADIZ, OHIO, AND HARRISON COMMUNITY HOSPITAL FOUNDATION (HCF), WHICH RAISES CONTRIBUTIONS FOR THE USE OF HCH.IN 2019, THE HOSPITAL BECAME THE SOLE MEMBER OF WHEELING HOSPITAL AMBULATORY SURGERY CENTER LLC ("WH ASC") LOCATED IN BRIDGEPORT, OHIO. THE HOSPITAL ALSO ENTERED INTO AN AGREEMENT WITH WEST VIRGINIA UNIVERSITY TO PROVIDE KEY MANAGEMENT SERVICES IN 2019. THE HOSPITAL OWNS TWO HOLDING COMPANIES, WH HOLDINGS I, LLC (WHH I) AND WH HOLDINGS II, INC. (WHH II). WHH I IS A TAXABLE LIMITED LIABILITY COMPANY. WHH II IS A NONPROFIT CORPORATION. THESE HOLDING COMPANIES MAY BE USED FOR ANY FUTURE ENDEAVORS THAT MIGHT BE UNDERTAKEN AND CAPITALIZED BY THE HOSPITAL OUTSIDE OF THE COVENANTS AND AGREEMENTS GOVERNING THE US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) - INSURED MORTGAGE. AS OF AND FOR THE YEARS ENDED SEPTEMBER 30, 2019 AND 2018, THERE WERE NO ASSETS NOR ACTIVITIES FOR WHH I. X X X 0 0 0 1 0 0 0 0 0 JAMES B MURDY CHIEF FINANCIAL OFFICER 258246 0 75000 0 0 0 21554 0 35038 0 389838 0 0 0 MICHAEL S MCKEETS CHIEF OPERATING OFFICER (END 12/18) 184633 0 25000 0 0 0 16510 0 10854 0 236997 0 0 0 ANGELO GEORGES MD CHIEF MEDICAL OFFICER 507342 0 25000 0 0 0 12466 0 35353 0 580161 0 0 0 ANTHONY MARTINELLI SENIOR DIRECTOR 161576 0 30000 0 0 0 9203 0 22512 0 223291 0 0 0 DAVID RAPP CHIEF INFORMATION OFFICER 258268 0 60000 0 0 0 15707 0 27910 0 361885 0 0 0 DENNIS NIESS MD CHIEF MED. INFO. OFFICER 239681 0 20000 0 0 0 17651 0 28557 0 305889 0 0 0 DIANE LIVENGOOD SENIOR DIRECTOR 152293 0 15000 0 0 0 7928 0 10517 0 185738 0 0 0 HEIDI PORTER VP OF QUALITY & REGULATORY AFFAIRS 127248 0 50000 0 0 0 6965 0 10655 0 194868 0 0 0 JOHN DEBLASIS SENIOR ADMIN. & VICE PRESIDENT 162208 0 15000 0 0 0 12408 0 13493 0 203109 0 0 0 KAREEN SIMON VP OF OPERATIONS/COO 365020 0 50000 0 0 0 12925 0 1422 0 429367 0 0 0 KATHY STAHL CHIEF NURSING OFFICER 147283 0 10000 0 0 0 11620 0 2001 0 170904 0 0 0 SHAWN STERN MEDICAL DIRECTOR 344319 0 25000 0 0 0 12375 0 35433 0 417127 0 0 0 VINCENT AZZARELLO SENIOR DIRECTOR 151062 0 7000 0 0 0 6879 0 22430 0 187371 0 0 0 CHANDRA S SWAMY PHYSICIAN 523777 0 433489 0 0 0 15216 0 23034 0 995516 0 0 0 DEVENDER BATRA PHYSICIAN 1636671 0 0 0 0 0 11550 0 14513 0 1662734 0 0 0 GREGORY S MERRICK PHYSICIAN 1308620 0 18000 0 0 0 13200 0 1568 0 1341388 0 0 0 HOWARD SHACKELFORD PHYSICIAN 938752 0 45511 0 0 0 8525 0 27120 0 1019908 0 0 0 JONDAVID POLLOCK PHYSICIAN 1202477 0 0 0 0 0 13200 0 28201 0 1243878 0 0 0 PART I, LINE 5A: DR. SWAMY'S AND DR. SHACKLEFORD'S INCENTIVES ARE BASED ON A PERCENTAGE OF NET REVENUE. OVERALL PHYSICIAN COMPENSATION WAS DETERMINED TO BE REASONABLE. VALORIE SATKOSKE DAUGHTER OF RONALD L. VIOLI - CHIEF EXECUTIVE OFFICER THRU MAY 2019. 210859 PAYMENTS - EMPLOYEE COMPENSATION 0 R & V ASSOCIATES CHIEF EXECUTIVE OFFICER (THRU JUNE 2019) IS PRINCIPAL OF R & V ASSOCIATES. 4093997 PAYMENTS - INCLUDING OTHER CONSULTING SERVICES AND EXPENSES FOR REIMBURSEMENT. 0 PART IV, LINE 3: EXPLANATION OF RELATIONSHIP/TRANSACTIONS WITH R & V ASSOCIATES:R & V ASSOCIATES IS AN INDEPENDENT BUSINESS CONSULTING FIRM THAT PROVIDES SERVICES TO WHEELING HOSPITAL, INC. (THE "HOSPITAL"). MR. VIOLI, INDEPENDENT CONSULTANT, IS A PRINCIPAL AND ONE OF THE MANAGING DIRECTORS OF THE CONSULTING FIRM. MR. VIOLI RECEIVES ALL COMPENSATION DIRECTLY FROM R & V ASSOCIATES FOR HIS SERVICES AT THE HOSPITAL, AND NOT FROM THE HOSPITAL. ALTHOUGH MR. VIOLI CURRENTLY SERVED AS CHIEF EXECUTIVE OFFICER OF THE HOSPITAL THRU MAY 2019, HE DOES SO THROUGH HIS AFFILIATION WITH R & V ASSOICATES AND NOT THROUGH DIRECT EMPLOYMENT WITH THE HOSPITAL. THE COMPENSATION PAID TO R & V ASSOCIATES BY THE HOSPITAL IS ESTABLISHED BY AN INDEPENDENT AD HOC COMMITTEE OF THE BOARD OF DIRECTORS OF THE HOSPITAL. IT IS THE PRACTICE OF THE AD HOC COMMITTEE TO CONDUCT ITS DELIBERATIONS IN FULL COMPLIANCE WITH THE ESTABLISHED PROCEDURES UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND WITH THE SETTLED PURPOSE OF ESTABLISHING A REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION PAID TO R & V ASSOCIATES. ADDITIONALLY, THE AD HOC COMMITTEE HAS SOLE AUTHORITY OVER THE RETENTION AND DISCHARGE OF R & V ASSOCIATES, AND MR. VIOLI, AS CHIEF EXECUTIVE OFFICER, HAS NO AUTHORITY OVER SUCH RETENTION OR ANY OTHER ASPECT OF THAT ENGAGEMENT. THE PAYMENTS TO R & V ASSOCIATES INLCUDE COMPENSATION PAYMENTS FOR MR. VIOLI, EXPENSE REIMBURSEMENTS, AND OTHER PAYMENTS FOR CONSULTING SERVICES. X 1 67500 OTHER 0 0 1 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. FORM 990, PART VI, SECTION A, LINE 2 THE VERY REVEREND MONSIGNOR KEVIN M. QUIRK WAS THE ASSISTANT TO MARK E. BRENNAN, BISHOP OF THE DIOCESE OF WHEELING-CHARLESTON. THE VERY REVEREND MONSIGNOR KEVIN M. QUIRK RESIGNED JUNE 10, 2019. FORM 990, PART VI, SECTION A, LINE 3 RONALD L. VIOLI, CHIEF EXECUTIVE OFFICER OF WHEELING HOSPITAL, INC. IS NOT AN EMPLOYEE OF WHEELING HOSPITAL, INC. RONALD L. VIOLI, INDEPENDENT CONSULTANT, IS 50% PARTNER IN R & V ASSOCIATES, A CONSULTING FIRM WHICH WHEELING HOSPITAL, INC. CONTRACTS WITH FOR CONSULTING AND MANAGEMENT SERVICES. FORM 990, PART VI, SECTION A, LINE 6 WHEELING HOSPITAL, INC. HAS A SINGLE MEMBER, MARK E. BRENNAN, BISHOP OF THE DIOCESE OF WHEELING-CHARLESTON. FORM 990, PART VI, SECTION A, LINE 7A WHEELING HOSPITAL, INC. HAS A SINGLE MEMBER, MARK E. BRENNAN, BISHOP OF THE DIOCESE OF WHEELING-CHARLESTON, WHO HAS THE ABILITY TO ELECT MEMBERS OF THE GOVERNING BODY OF WHEELING HOSPITAL, INC. FORM 990, PART VI, SECTION B, LINE 11B FOLLOWING COMPLETION OF FORM 990 BY THE WHEELING HOSPITAL, INC. TAX PREPARER, FORM 990 IS REVIEWED BY INTERNAL PERSONNEL AND THE EXECUTIVE TEAM PRIOR TO FILING. THE DRAFT RETURN IS SENT TO THE AD HOC COMMITTEE OF THE BOARD VIA COURIER, FEDEX OR UPS, PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS AND OFFICERS RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY ANNUALLY. RECIPIENTS ARE ANNUALLY ASKED TO ACKNOWLEDGE THEY HAVE READ THE POLICY, INDENTIFY ANY AREAS OF CONFLICT AND RETURN THE SIGNED DISCLOSURE FORM TO WHEELING HOSPITAL, INC. RESPONSES ARE REVIEWED AND IDENTIFIED. CONFLICTS ARE REFERRED TO THE BOARD OF DIRECTORS FOR DISCUSSION AND APPROVAL. KEY EMPLOYEES AND OTHER EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AT HIRING AND WHEN A CHANGE OCCURS THAT MAY BE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 RONALD L. VIOLI, CHIEF EXECUTIVE OFFICE OF WHEELING HOSPITAL, INC., IS NOT AN EMPLOYEE OF WHEELING HOSPITAL, INC. RONALD L. VIOLI, INDEPENDENT CONSULTANT, RECEIVES HIS COMPENSATION FROM R & V ASSOCIATES, WHICH RECEIVES PAYMENT FROM WHEELING HOSPITAL, INC. FOR CONSULTING AND MANAGEMENT SERVICES IT PROVIDES, INCLUDING FOR RONALD L. VIOLI'S SERVICES AS CHIEF EXECUTIVE OFFICER WHICH ENDED IN MAY 2019. WHEELING HOSPITAL, INC. HAS DETERMINED, BY MEANS OF COMMITTEE REVIEW, THAT THE PAYMENTS TO R & V ASSOCIATES ARE REASONABLE AND AT FAIR MARKET VALUE. THEREFORE, ALL COMPENSATION PAYMENTS TO RONALD L. VIOLI ARE REASONABLE. OTHER OFFICERS AND KEY EMPLOYEES' COMPENSATION IS REVIEWED BY THE WHEELING HOSPITAL AD HOC COMMITTEE. THE COMMITTEE REVIEWS NATIONAL, REGIONAL, AND LOCAL COMPENSATION SURVEYS. ADDITIONALLY, YEARS OF SERVICE ARE ALSO TAKEN INTO ACCOUNT. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. WHEELING HOSPITAL, INC. ALSO FILES THE FINANCIAL STATEMENTS WITH WVHCA ANNUALLY. FORM 990, PART XI, LINE 9: NET RESTRICTED GRANT ACTIVITY -36,294. UNREALIZED GAIN RESTRICTED INVESTMENTS 83,438. RESTRICTED ACTIVITY VARIANCE 4,568. FORGIVENESS OF DEBT -3,698,019. PART XII, LINE 3A: WHEELING HOSPITAL, INC. ENTERED INTO A HUD/FHA SECTION 242 MORTGAGE INSURANCE AGREEMENT AND WAS REQUIRED BY THIS ARRANGEMENT TO UNDERGO AN A-133 AUDIT. WHEELING PEDIATRICS LLC 222 N 5TH STREET MARTINS FERRY OH 43935 261482791 PHYSICIAN OFFICES OH 0 0 WHEELING HOSPITAL INC WOMEN'S HEALTH SPECIALISTS OF WHEELING HOSPITAL LLC 1 MEDICAL PARK WHEELING WV 26003 262809731 PHYSICIAN OFFICES WV 0 0 WHEELING HOSPITAL INC WH HOLDINGS II LLC 1 MEDICAL PARK WHEELING WV 26003 273193246 PURCHASE REAL ESTATE WV -1895217 34651766 WHEELING HOSPITAL INC WH HOLDINGS I LLC 1 MEDICAL PARK WHEELING WV 26003 273193207 PURCHASE REAL ESTATE WV 0 0 WHEELING HOSPITAL INC BELMONT COMMUNITY HOSPITAL 4697 HARRISON STREET BELLAIRE OH 43906 340714643 HOSPITAL OH 501(C)(3) 3 WHEELING HOSPITAL INC 1 MEDICAL PARK FOUNDATION 1 MEDICAL PARK WHEELING WV 26003 550744690 CHURCH WV 501(C)(3) 1 WHEELING HOSPITAL INC 1 SELF INSURANCE TRUST AGREEMENT OF WHEELING HOSPITAL INC 1 MEDICAL PARK WHEELING WV 26003 550676674 INSURANCE WV 501(C)(3) 12A, I WHEELING HOSPITAL INC 1 HARRISON COMMUNITY HOSPITAL 951 EAST MARKET STREET CADIZ OH 43907 341571750 HOSPITAL OH 501(C)(3) 3 WHEELING HOSPITAL INC 1 HARRISON COMMUNITY HOSPITAL FOUNDATION 951 EAST MARKET STREET CADIZ OH 43907 341571749 SUPPORT OF HOSPITAL OH 501(C)(3) 12B, II WHEELING HOSPITAL INC 1 WHEELING HOSPITAL AMBULATORY SURGERY CENTER LLC 68 STATE ROUTE 7 BRIDGEPORT OH 43912 832914078 SURGERY CENTER OH 501(C)(3) 3 WHEELING HOSPITAL INC 1 MOUNTAINEER FREEDOM LIMITED 94 SOLARIS AVENUE 2ND FLOOR CAMAN GRAND CAYMAN KY CJ 981217988 CAPTIVE INSURANCE CJ WHEELING HOSPITAL INC C 2606454 27599884 1.00000 1 MOUNTAINEER FREEDOM PHYSICIAN & HOSPITAL ASSOCIATION INC 1 MEDICAL PARK WHEELING WV 26003 300386759 PHYSICIAN HOSPITAL WV WHEELING HOSPITAL INC C 1.00000 1 1 0 0 1 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 BELMONT COMMUNITY HOSPITAL Q 152266 ACTUAL AMOUNT PAID BELMONT COMMUNITY HOSPITAL L 168768 ACTUAL AMOUNT PAID BELMONT COMMUNITY HOSPITAL O 108223 ACTUAL AMOUNT PAID BELMONT COMMUNITY HOSPITAL J 62064 ACTUAL AMOUNT PAID BELMONT COMMUNITY HOSPITAL D 3698019 ACTUAL AMOUNT PAID BELMONT COMMUNITY HOSPITAL S 141796 ACTUAL AMOUNT PAID HARRISON COMMUNITY HOSPITAL L 55107 ACTUAL AMOUNT PAID HARRISON COMMUNITY HOSPITAL Q 2609722 ACTUAL AMOUNT PAID HARRISON COMMUNITY HOSPITAL O 856277 ACTUAL AMOUNT PAID MOUNTAINEER FREEDOM LIMITED R 4935007 ACTUAL AMOUNT PAID WHEELING HOSPITAL AMBULATORY SURGERY CENTER LLC R 1250000 ACTUAL AMOUNT PAID WHEELING HOSPITAL AMBULATORY SURGERY CENTER LLC P 3852541 ACTUAL AMOUNT PAID WHEELING HOSPITAL AMBULATORY SURGERY CENTER LLC O 541737 ACTUAL AMOUNT PAID