POTOMAC VALLEY HOSPITAL INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- POTOMAC VALLEY HOSPITAL INC (EIN 55-0420956)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-13
- IRS object ID
- 201913179349304361
- Schema version
- 2018v3.1
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-13T10:56:09-00:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550420956 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Potomac Valley Hospital of W VA Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | POTO | BusinessNameControlTxt |
| Phone | 3045973500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 Pin Oak Lane | AddressLine1Txt |
| City | Keyser | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 267265908 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Amy Boothe | PersonNm |
| Person Title | VP of Operations | PersonTitleTxt |
| Signature | 2019-04-24 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 157.182.216.2 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-13 | IPDt |
| IP Tm | 16:08:24 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 5D18E0CDD66F5C2C6782695A054BAE6AB9A943F9 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 961A8E11061A341FA9665A68F3B1FFC5AE12E713 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Amy Boothe | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 Pin Oak Lane | AddressLine1Txt |
| City | Keyser | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26726 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $26,545,896 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://wvumedicine.org/potomac-valley-hospital/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2014 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | Potomac Valley strives to improve the total health status of area residents and provide supportive care for the chronically and/or terminally ill patients at home. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 313 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $25,850 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,918 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $23,338,227 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $26,173,990 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,569 | PYInvestmentIncomeAmt |
| CY Investment Income | $561 | CYInvestmentIncomeAmt |
| PY Other Revenue | $318,634 | PYOtherRevenueAmt |
| CY Other Revenue | $359,466 | CYOtherRevenueAmt |
| PY Total Revenue | $23,685,280 | PYTotalRevenueAmt |
| CY Total Revenue | $26,541,935 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $12,837 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $13,820 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,235,069 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,260,884 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,190,265 | PYOtherExpensesAmt |
| CY Other Expenses | $13,235,845 | CYOtherExpensesAmt |
| PY Total Expenses | $24,438,171 | PYTotalExpensesAmt |
| CY Total Expenses | $26,510,549 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$752,891 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $31,386 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $28,206,837 | TotalAssetsBOYAmt |
| Total Assets EOY | $25,130,628 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $26,692,962 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $24,144,591 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,513,875 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $986,037 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Potomac Valley strives to improve the total health status of area residents and provide supportive care for the chronically and/or terminally ill patients at home. PVH recognizes health as a condition to which everyone has a just claim and will make a priority of meeting the changing needs of the community within the limits of available resources. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $11,360,707 | ExpenseAmt |
| Revenue | $14,033,810 | RevenueAmt |
| Desc | Family medicine services are provided in multiple clinic locations, and as rural health clinics, to serve the primary care needs of the population in Mineral county and provide access to care. During 2018, PVH had 342 family medicine patient encounters. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,456,745 | ExpenseAmt |
| Revenue | $4,399,305 | RevenueAmt |
| Desc | PVH Emergency Department is staffed 24 hours everyday with specially trained physicians and nursing staff. The level of care ranges from continuation or initiation of advanced life support, to the assessment and treatment of minor illness, injuries or the acceleration of chronic medical conditions. The Emergency Department is connected by ration to Civil Defense and all area rescue squads and ambulances, thus allowing the staff to be fully prepared for any incoming emergency in advance of the arrival. The Emergency Department handles an average of 12,000 - 14,000 patients per year. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,683,808 | ExpenseAmt |
| Revenue | $3,420,618 | RevenueAmt |
| Desc | General surgical services are provided as emergent and scheduled services on both an inpatient and an outpatient basis. PVH had 604 general surgery visits in 2018. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $2,745,371 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $4,354,173 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $21,246,631 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 100 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 313 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Nondeductible Contri Discl | false | NondeductibleContriDisclInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | false | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Amy Boothe | PersonNm |
| Phone | 3045973500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 Pin Oak Lane | AddressLine1Txt |
| City | Keyser | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26726 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Robin Haupt | |||||||
| Director, Secretary | 001.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Jerry Whisner | |||||||
| Director, President | 001.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| James Viglianco MD | |||||||
| Director, Physician | 040.00 | Yes (X) | $415,272 | $0 | $20,140 | ||
| Harshad Bokil MD | |||||||
| Director, Chief of Staff | 001.00 | Yes (X) | $183,955 | $0 | $0 | ||
| Kenneth Mason | |||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | ||
| Lester Clifford | |||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | ||
| Mark Boucot | |||||||
| Director, CEO | 040.00 | Yes (X) | Yes (X) | $320,135 | $0 | $13,880 | |
| Kevin Clark | |||||||
| Director | 001.00 | Yes (X) | $0 | $0 | $0 | ||
| Brandon Combs | |||||||
| Director, Treasurer | 001.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Amy Boothe | |||||||
| VP Operations Finance | 040.00 | Yes (X) | $108,662 | $0 | $20,804 | ||
| Joseph Hahn | |||||||
| Physician | 040.00 | $323,539 | $0 | $20,157 | Yes (X) | ||
| Kellon Smith | |||||||
| Chief CRNA | 040.00 | $218,303 | $0 | $22,707 | Yes (X) | ||
| Ayesha Abid | |||||||
| Physician | 040.00 | $286,111 | $0 | $16,250 | Yes (X) | ||
| Patrick Turner | |||||||
| CRNA | 040.00 | $201,613 | $0 | $16,571 | Yes (X) | ||
| Gregory Casey MD | |||||||
| Physician | 040.00 | $200,436 | $0 | $6,350 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,258,026 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $136,859 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| US Mobile Imaging LLC | |||||
| PO Box 808 | Cumberland | MD | 215010808 | Radiology Services | $373,332 |
| Kenneth Lefler | |||||
| 235 Ridgewood Dr | Fort Ashby | WV | 267199263 | Physician Services | $260,584 |
| Rabie Zalzal | |||||
| 537 S Mineral St | Keyser | WV | 26726 | Physician Services | $230,995 |
| Michael Gould | |||||
| 577 Hillcrest Dr | New Creek | WV | 26743 | Physician Services | $199,699 |
| J&R Landscaping & Tree Experts | |||||
| 375 Timber Ridge Lane | Keyser | WV | 26726 | Excavating and Landscaping Services | $190,524 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,125 | GovernmentGrantsAmt |
| All Other Contributions | $1,793 | AllOtherContributionsAmt |
| Total Contributions | $7,918 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Services | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $26,173,990 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,173,990 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $26,173,990 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $561 | TotalRevenueColumnAmt |
| Exclusion | $561 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $32,540 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $786 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $31,754 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,754 | TotalRevenueColumnAmt |
| Exclusion | $31,754 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $10,781 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $3,175 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,606 | TotalRevenueColumnAmt |
| Exclusion | $7,606 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Physician Billing | 900099 | $224,283 | $224,283 | |
| Cafeteria Income | 900099 | $61,907 | $61,907 | |
| Patient Pharmacy Income | 900099 | $8,559 | $8,559 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,357 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $25,357 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $320,106 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,541,935 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,207,906 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $326,111 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,320 | TotalAmt |
| Program Services | $1,320 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,500 | TotalAmt |
| Program Services | $12,500 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $912,740 | TotalAmt |
| Program Services | $435,412 | ProgramServicesAmt |
| Management And General | $477,328 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,139,027 | TotalAmt |
| Program Services | $9,413,866 | ProgramServicesAmt |
| Management And General | $725,161 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,177 | TotalAmt |
| Program Services | $210,929 | ProgramServicesAmt |
| Management And General | $16,248 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,058,332 | TotalAmt |
| Program Services | $1,013,687 | ProgramServicesAmt |
| Management And General | $44,645 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $923,608 | TotalAmt |
| Program Services | $857,550 | ProgramServicesAmt |
| Management And General | $66,058 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,997 | TotalAmt |
| Management And General | $19,997 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees For Services Prof Fundraising | FeesForServicesProfFundraising |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,219,959 | TotalAmt |
| Program Services | $2,885,637 | ProgramServicesAmt |
| Management And General | $334,322 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,517 | TotalAmt |
| Program Services | $198 | ProgramServicesAmt |
| Management And General | $88,319 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $675,294 | TotalAmt |
| Program Services | $474,469 | ProgramServicesAmt |
| Management And General | $200,825 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,151 | TotalAmt |
| Program Services | $2,151 | ProgramServicesAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $469,366 | TotalAmt |
| Program Services | $302,636 | ProgramServicesAmt |
| Management And General | $166,730 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,938 | TotalAmt |
| Program Services | $142,242 | ProgramServicesAmt |
| Management And General | $25,696 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $512,725 | TotalAmt |
| Program Services | $330,040 | ProgramServicesAmt |
| Management And General | $182,685 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,287,136 | TotalAmt |
| Program Services | $152,896 | ProgramServicesAmt |
| Management And General | $2,134,240 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,277,300 | TotalAmt |
| Program Services | $822,195 | ProgramServicesAmt |
| Management And General | $455,105 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,888 | TotalAmt |
| Program Services | $79,479 | ProgramServicesAmt |
| Management And General | $20,409 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Provision for Doubtful Accounts | $1,338,285 | $1,338,285 | |
| Medical Supplies | $2,099,982 | $2,099,982 | |
| Taxes, Licenses and Fees | $576,865 | $552,464 | $24,401 |
| Recuiting | $355,043 | $102,519 | $252,524 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,399 | TotalAmt |
| Program Services | $16,174 | ProgramServicesAmt |
| Management And General | $29,225 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,510,549 | TotalAmt |
| Program Services | $21,246,631 | ProgramServicesAmt |
| Management And General | $5,263,918 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,036 | BOYAmt |
| EOY | $43,147 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,458,363 | BOYAmt |
| EOY | $578,399 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,000,433 | BOYAmt |
| EOY | $1,143,770 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $127,334 | BOYAmt |
| EOY | $76,538 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $484,460 | BOYAmt |
| EOY | $610,424 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,823 | BOYAmt |
| EOY | $308,090 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $23,074,119 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,582,137 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,225,317 | BOYAmt |
| EOY | $17,491,982 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $897,793 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,878,278 | BOYAmt |
| EOY | $4,878,278 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,206,837 | BOYAmt |
| EOY | $25,130,628 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,031,779 | BOYAmt |
| EOY | $3,938,048 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,023,606 | BOYAmt |
| EOY | $18,500,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,852,736 | BOYAmt |
| EOY | $1,851,944 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $784,841 | BOYAmt |
| EOY | -$145,401 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,692,962 | BOYAmt |
| EOY | $24,144,591 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,852,744 | BOYAmt |
| EOY | $986,037 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,338,869 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,513,875 | BOYAmt |
| EOY | $986,037 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,206,837 | BOYAmt |
| EOY | $25,130,628 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $31,386 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$559,224 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
| Public Support CY170 | 0.00000 | PublicSupportCY170Pct |
| Public Support CY509 | 0.00000 | PublicSupportCY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $5,062 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,062 | TotalLobbyingExpendituresAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | II-B 1i | FormAndLineReferenceDesc |
| Explanation | This amount is calculated based on information provided by the West Virginia Hospital Association and the American Hospital Association. The American Hospital Association estimates that 22.73 of the 2018 dues were allocated to lobbying expense. The West Virginia Hospital Association estimates that during 2018, 16.84 of the dues paid should be allocated to lobbying expense. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,060,000 | OtherCostOrOtherBasisAmt |
| Book Value | $1,060,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,357,031 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,902,621 | DepreciationAmt |
| Book Value | $13,454,410 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $373,102 | OtherCostOrOtherBasisAmt |
| Depreciation | $53,863 | DepreciationAmt |
| Book Value | $319,239 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,211,267 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,624,871 | DepreciationAmt |
| Book Value | $2,586,396 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $72,719 | OtherCostOrOtherBasisAmt |
| Depreciation | $782 | DepreciationAmt |
| Book Value | $71,937 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,491,982 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc |
|---|
| Financial derivatives and other financial products |
| Closely-held equity interests |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Goodwill and other intangible | Desc |
| Book Value | $4,878,278 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,878,278 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Federal income taxes | |
| Self Insurance | |
| Debt Issuance Costs | -$145,401 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | -$145,401 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $25,207,611 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$1,338,285 | OtherRevenueAmt |
| Revenue Not Reported | -$1,338,285 | RevenueNotReportedAmt |
| Revenue Subtotal | $26,545,896 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$3,961 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$3,961 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $26,541,935 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $25,173,050 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $786 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $786 | ExpensesNotReportedAmt |
| Expenses Subtotal | $25,172,264 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,338,285 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,338,285 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $26,510,549 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| X 2 | The annual audit and financial statements of Potomac Valley Hospital are prepared on a consolidated basis as a member of the WV United Health System. WVUHS, WVUH, PVH, CCHS, CCMC, CCF, CCPC, University Healthcare, BMC, JMC, UHCF, UHC, USC, UHF, UPC, SJH, SJF, RMH and RMF are tax-exempt organizations and not subject to federal or state income taxes in accordance with Section 501c3 of the Internal Revenue Code. On such basis, they will not incur any liability for income taxes, except for possible unrelated business income. AHS, WVUIS and GHC are organizations subject to federal and/or state income taxes. The System does not have any material uncertain tax positions as of December 31, 2018 and 2017. |
| X 2 | The System accounts for uncertainty in income taxes using a recognition threshold of more-likely-than not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. The Systems policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in operating expenses. |
| XI 2d | The amount shown on line 2d consists of 1,338,285 provision for doubtful accounts reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990. |
| XI 4b | The amount on line 4b consists of 3,175 special events expense that is recorded as an offset to revenue on the Form 990 as well as 786 of rental expenses that is recorded as an offset to revenue on the Form 990. |
| XII 2d | The amount shown on line 2d consists of 786 of rental expenses that is recorded as an offset to revenue on the Form 990. |
| XII 4b | The amount shown on line 4b consists of 1,338,285 provision for doubtful accounts reported as an offset to revenue on the financial statements but is reported as an expense on the Form 990. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf Tournament | Event1Nm |
| Gross Receipts Event1 | $10,781 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $10,781 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $3,175 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $10,781 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $10,781 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $3,175 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $3,175 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $7,606 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $166,536 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,848 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $148,688 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00590 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,238,498 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,238,498 | DirectOffsettingRevenueAmt |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $80,021 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $71,446 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,575 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,485,055 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,327,792 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $157,263 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $73,651 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $73,651 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,090 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $43,090 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,833 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,833 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $125,574 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $125,574 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,610,629 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,327,792 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $282,837 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01120 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,204 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,204 | NetCommunityBenefitExpnsAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,204 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,204 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $726,952 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $70,931 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,689,263 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,992,954 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,303,691 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Potomac Valley Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 Pin Oak Lane | AddressLine1Txt |
| City | Keyser | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26726 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | https//wvumedicine.org/potomac-valley-hospital/ | WebsiteAddressTxt |
| State License | 02 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Facility Reporting Group | a | FacilityReportingGroupCd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | a | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https//wvumedicine.org/potomac-valley-hospital/wp-content/uploads/sites/2/2019/02/2018-CHNA.pdf | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https//wvumedicine.org/potomac-valley-hospital/wp-content/uploads/sites/2/2019/02/2018-CHNA.pdf | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 0000000200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https//wvumedicine.org/bill-pay/financial-assistance/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https//wvumedicine.org/bill-pay/financial-assistance/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https//wvumedicine.org/bill-pay/financial-assistance/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | Yes (true) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Group Potomac Valley Hospital Line Part V, Section B, Line 5 | As a part of the West Virginia United Health System WVUHS, PVH contracted with the WVU School of Public Health WVU SPH to assist in the CHNA process and report. The CHNA process utilized two primary sources of data, which included a public input survey and a community meeting. The public input survey was developed by the WVU SPH with the leadership team following an iterative process to gain stakeholder input. Members of the leadership team were selected because of their familiarity with Mineral County, Potomac Valley Hospital, and health services and needs in the area. These individuals included Andrew Root - Administrator, Mineral County Health Department Christian Brooks - Directors of Public Relations, Potomac Valley Hospital Michael Gould, DO - Emergency Physician, Potomac Valley Hospital Amy Boothe - VP of Operations, Potomac Valley Hospital Paula Eisenhour - Administrative Associate, Potomac Valley Hospital Mark Boucot - CEO, PVH and Garrett Regional Medical Center Daniel Staggers - Board of Directors, Potomac Valley Hospital Brenna Earnest, RN - Diabetes Prevention/Education - Potomac Valley Hospital Connie Moore - Director of Care Management, Potomac Valley Hospital Curtis Crawford - Volunteer Clergy, Potomac Valley Hospital Teresa White - Director of Nursing, Potomac Valley Hospital. The public interest survey topics included questions about specific health issues, thoughts on overall health of the community, quality of life, access to healthcare and medical needs including specialist care, risky behaviors, and demographic information including geographic location and income. This survey was intended to solicit the communitys perception of their health needs and was collected both online and through hard copies from residents who are 18 or older. |
| Group Potomac Valley Hospital Line Part V, Section B, Line 11 | The leadership team met in September 2018 to review the data collected through the survey and community event and identify priority areas for developing implementation strategies. The WVU SPH reviewed survey data, including responses to the three most important health problems or issues in the three counties Mineral County, WV Allegany County, MD Garrett County, MD it defined as the community served. Mineral Countys top three health concerns were 1 Drug Abuse 2 Obesity and 3 Cancer. Allegany Countys top concerns were 1 Drug Abuse 2 Cancer 3 Low Income while Garrett County reported top concerns in 1 Obesity 2 Drug Abuse and 3 Mental Health Problems respectively. In conclusion, the 2018 CHNA identified two main health priorities and significant needs obesity and diabetes that will guide PVH and the leadership team in the implementation planning process. According to the CHNA, implementation activities will aim to address these issues using existing resources and partnerships with other community organizations where possible and building upon past success, including past efforts to address health needs identified in the last CHNA report. |
| Group Potomac Valley Hospital Line Part V, Section B, Line 22d | No adjustments are made to charges based on Financial Assistance eligibility. |
| Group Potomac Valley Hospital Line Part V, Section B, Line 24 | During 2018, PVH did charge Financial Assistance eligible patients amounts equal to gross charges for services provided but the charges were reduced appropriately for those receiving financial assistance. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Riverside Clinic | ||||
| 122 Ashfield St | Piedmont | WV | 26750 | Rural Health Clinic |
| Elk Garden Clinic | ||||
| 48 Oak St | Elk Garden | WV | 26717 | Rural Health Clinic |
Supplemental Information Detail SupplementalInformationDetail (24 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I Line 3c | Potomac Valley Hospital PVH uses 200 Federal Poverty Guideline to determine free care eligibility. PVH offers a Prompt - Pay Discount Program - patients who have no third party coverage uninsured or uninsurable may be eligible for a 20 self-pay discount while patients who have a guarantor balance may be eligible for a 20 discount. To be eligible for either discount the patient/guarantor must meet certain requirements. |
| Part I Line 6a | Potomac Valley Hospital community benefit numbers are reported in total with the other hospitals within West Virginia United Health System. The 2018 amounts can be found at the following web address http//wvumedicine.org/about/community-benefit/. |
| Part I Line 7 | Column f - Total community benefit expense for 2018 is 5,610,629 and is 21.16 of total net expenses. To calculate net expense, bad debt of 1,338,285 was deducted from total expenses of 26,510,549 as shown in Part IX line 25 of the core Form 990. |
| Part I Line 7 | Worksheet 2 from the IRS Schedule H instructions was used to derive the Cost-to-charge ratio, which was used to calculate Charity Care, Unreimbursed Medicaid and other means-tested government programs at cost. To calculate the Medicare allowable cost shown in Part III question 8, we used the allowable costs from the Medicare Cost report. |
| Part II | For 2018, PVH employees spent work time volunteering for the Mineral County United Way Day of Caring. |
| Part III Line 2 | Bad Debt Expense at Cost on Line 2 was calculated by multiplying bad debt expense of 1,338,285 by our cost-to-charge ratio of 60.84 for a total of 814,213 less DSH allocations to self-pay patient accounts of 87,260 for a total of 726,953. |
| Part III Line 3 | Estimated bad debt attributable to patients eligible for charity care on Line 3 was calculated by pulling all outstanding patient balances of 5,000 or greater from our patient accounting system. That report totaled 116,587, which was then multiplied by the cost-to-charge ratio of 60.84 for a total of 70,932. |
| Part III Line 3 | We feel that at a minimum, the estimated bad debt attributable to patients eligible for charity care of 70,932 should be considered community benefit due to the fact that anyone with outstanding balances of 5,000 or greater in our demographic usually qualifies as catastrophic if the patient completes the application process. In our Charity Care Policy, we define catastrophic care as any illness or injury that will likely require continuous or frequent treatment for more than one year and would have qualified for charity care if paperwork was completed. |
| Part III Line 4 | Potomac Valleys financial statements are prepared on a consolidated basis as a member of the WV United Health System WVUHS. The footnote for Accounts Receivable is as follows Patient accounts receivable are reported at net realizable value. For receivables associatted with services provided to patients who have third-party coverage, the System estimates net realizable value based on the estimated contractual reimbursement percentage, which in turn is based on current contract provisions and historical paid claims by payor. For self-pay accounts, including uninsured and patient responsibility accounts, the net realizable value is determined using historical collection experience, adjusted for estimated conversions of patient responsibility portions, expected recoveries and changes in trends to estimate implicit price concessions in 2018 or the provision for bad debts in 2017. Management continually reviews the estimated net realizable value of accounts receivable by monitoring cash collections, economic conditions and trends, changes in payor mix, changes in federal or state healthcare coverage and other matters. The System grants credit without collateral to its patients, most of whom are local residents and are insured under third-party payor agreements, primarily with Medicare, Medicaid, and various commercial insurance companies. The System records accounts receivable net of estimated price concessions in 2018 and allowances for bad debts in 2017 and such amounts have historically been within managements expectations. The mix of accounts receivable at December 31, 2018 and 2017, from patients and third-party payors is as follows. For 2018, Medicare 29, Medicaid 18, Blue Cross 24, Commercial/Managed Care/Other 26, Patients 3, Total 100. For 2017, Medicare 29, Medicaid 14, Blue Cross 21, Commercial/Managed Care/Other 32, Patients 4, Total 100. |
| Part III Line 4 | For receivables associated with self-pay patients, which includes both patients without insurance and insured patients with deductible and copayment balances, the System records a significant provision for bad debt in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the billed rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. |
| Part III Line 8 | The amount reported in Part III Line 6 12,992,954 was calculated using the total Medicare allowable cost from the Medicare cost report. |
| Part III Line 8 | Potomac Valley is reimbursed 100 by Medicare reimbursement includes DSH and IME for services provided to Medicare patients. |
| Part III Line 9b | PVH does have a debt collection policy. When a patient has been approved for financial assistance under our charity care policy, they will not be sent to bad debt. Additionally, if a patient is being evaluated for charity care, the patient will not be sent to a bad debt agency pending charity guarantor status until the pending status has been finalized approved/denied. All other patients with outstanding balances will be processed through billing and collections pursuant to our Financial Policy. |
| Part VI Line 2 | The CHNA included review of publicly available secondary data related to counties within PVHs service area, including census data and County Health Ranking Data. Using these reports, the CHNA leadership team started the initial discussion around critical health needs. According to the CHNA, primary data collection was comprised of a survey of community members perceptions of health issues and a community event focused on reviewing survey data, discussing community assets that impact population health in PVHs service area, and working as a group to outline possible strategies for each area of concern. |
| Part VI Line 2 | PVH leadership continually monitors issues in their primary service area that impact patient care. PVH works with West Virginia University Hospitals and University Health Associates to expand the services available to PVH patients. |
| Part VI Line 2 | As a member of the West Virginia United Health System WVUHS, PVH will be utilizing the West Virginia University School of Public Health to assist with the CHNA process and reports. |
| Part VI Line 2 | Potomac Valley Hospital PVH completed their first Community Health Needs Assessment process in December 2015. The CHNA was issued and approved by the Board of Directors in January 2016. A new CHNA was completed in 2018 and plans to build on the community health priorities, goals and strategies outlined in the prior CHNA report as well as offering new insight and plans to address emerging health priorities. |
| Part VI Line 3 | The Director of Patient Financial Services at PVH along with 2 collections representatives are available to meet with patients to discuss financial eligibility for our charity care program. PVH has applications for charity care and the qualification requirements for receiving charity available to patients. |
| Part VI Line 4 | PVH is a non-profit critical access hospital located in Mineral County, WV population 26,940 in the city of Keyser with a total population of 4,985 residents according to 2018 estimates. According to the 2018 CHNA, the leadership team defined the community served as a tri-county area comprised of Mineral County in West Virginia, as well as neighboring Allegany and Garrett counties in Maryland. |
| Part VI Line 5 | The PVH board of directors is a community board, with all nine members living in or around Mineral County. |
| Part VI Line 5 | PVH extends privileges to all qualified medical staff in Mineral County and surrounding communities to meet its healthcare needs. PVH allocates available funding to capital purchases, expanded services to improve patient care, and support medical education in Mineral County and surrounding counties in West Virginia and bordering states. |
| Part VI Line 6 | PVH is a part of the WV United Health System. PVH plays a significant role in improving the general health care of the community. The strategic plan of the System states intent to build a regional health care delivery system in its service area, defined above, while offering a variety of options for providers who want to participate. The System maintains a demonstrated committment to assist rural communites in preserving and improving the health care available to the patients it serves. The WV United Health Systems management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. |
| Part VI Line 6 | Other hospitals in the System include United Hospital Center, which is more centrally located in the state, City Hospital, Inc. dba Berkeley Medical Center and Jefferson Memorial Hospital dba Jefferson Medical Center both located in the Eastern Panhandle of West Virginia, West Virginia University Hospital located in Morgantown, WV, Camden-Clark Medical Center in Parkersburg, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Hospital in Glen Dale, WV. |
| Part VI Line 6 | The System includes the physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp that operate in conjunction with the System hospitals. United Summit Center is a behavioral health center located in Clarksburg, WV. The System also has Foundations that do various fundraising activities for the hospitals University Healthcare Foundation in Martinsburg, WV, United Health Foundation in Clarksburg, Camden-Clark Foundation in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation, in Glen Dale, WV. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Scholarships for students pursuing medical careers | GrantTypeTxt |
| Recipient | 4 | RecipientCnt |
| Cash Grant | $12,500 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part III Line 1-3 | FormAndLineReferenceDesc |
| Explanation | PVH awarded scholarships to local high school students that will be pursuing education in a medical field. Recipients are chosen based on an essay submission and need. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|
| James Viglianco MD | |||||
| Director, Physician | $390,473 | $21,236 | $3,563 | $20,140 | $435,412 |
| Harshad Bokil MD | |||||
| Director, Chief of Staff | $183,955 | $183,955 | |||
| Joseph Hahn | |||||
| Physician | $289,546 | $5,339 | $28,654 | $20,157 | $343,696 |
| Kellon Smith | |||||
| Chief CRNA | $218,090 | $213 | $22,707 | $241,010 | |
| Ayesha Abid | |||||
| Physician | $275,523 | $10,385 | $203 | $16,250 | $302,361 |
| Patrick Turner | |||||
| CRNA | $201,446 | $167 | $16,571 | $218,184 | |
| Mark Boucot | |||||
| Director, CEO | $261,147 | $50,000 | $8,988 | $13,880 | $334,015 |
| Gregory Casey MD | |||||
| Physician | $159,065 | $40,000 | $1,371 | $6,350 | $206,786 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4d | Program Service Expenses 2,745,371, Grants and allocations 0, Revenue 4,354,173 PVH is a Critical Access Hospital with licensure for 25 beds. PVH provides both inpatient and outpatient services, including cardiac rehabiliation, care management, diabetes education/prevention, hospital, laboratory, orthopaedics, physical therapy, radiology, respiratory therapy, same day surgery, and skilled swing beds. |
| Form 990, Part XI, Line 9 | Other changes in net assets includes 636,840 of related organization capitalization, 12,100 contributed to Summersville Regional Medical Center, 86,455 malpractice insurance adjustment, 3,175 special events expense and 86 of error suspense account balance adjustment. The malpractice adjustment was a related party transfer of medical malpractice liability from the local hospital PVH to the System as part of moving to a self-insured captive insurance plan across the System with these hospitals only paying a premium for coverage under the plan and the medical malpractice liability residing at the System level under the captive insurance entity, Augusta LLC. |
| Form 990, Part VI, Section B, Line 12c | Each board member is required to disclose, annually, any relationship which may give rise to a potential conflict of interest. These responses are processed and maintained by the Director of Health Information Management. All board members are to be willing to identify conflicts of interest and abstain from voting when appropriate. |
| Form 990, Part VI, Section B, Line 15b | The compensation of the CEO is determined by the West Virginia United Health System Compensation Committee based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This information is provided to the compensation committee which is made up of independent board members who are then responsible for setting the compensation packages offered to each executive, ensuring that the compenstion package does not exceed fair market value based on the data from the consultant group. The minutes of the compensation committee are contemporaneously documented and retained. Full compensation surveys are completed annually. |
| Form 990, Part VI, Section C, Line 19 | All financial and governing documents, including the conflict of interest policy are maintained onsite and made available to the public upon written request. |
| Form 990, Part IX, Line 11g | This total consists of Consulting Professional fees of 105,605 of which 95,717 is considered program service expense and 9,888 management and general expense Contracted Labor expense of 1,181,900 of which 972,896 is program service expense and 209,004 is considered management and general expense PVH Contracted Physician expense of 1,686,088 of which 1,653,548 is considered program service expense and 32,540 is considered management and general expense Consulting Professional Fees- Medical Staff of 72,089 of which is all considered management and general expense Collection Agency fees of 47,163 of which all is considered program service expense and Consulting Professional Fees - Medical Staff Director of 127,114 of which 116,314 is considered program service expense and 10,800 is considered management and general expense. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| West Virginia United Health System | |||||||||||
| 3040 University Avenue | Morgantown | WV | 26505 | 550754713 | Healthcare access | WV | 501c3 | 12a, I | N/A | false | |
| West Virginia University Hospitals East Inc | |||||||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 202337985 | Healthcare access | WV | 501c3 | 12a, I | false | WVU Hospitals Inc | |
| City Hospital Inc | |||||||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 550383321 | Patient Care | WV | 501c3 | 3 | false | West Virginia University Hospitals East Inc | |
| Jefferson Memorial Hospital | |||||||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 550359755 | Patient Care | WV | 501c3 | 3 | false | West Virginia University Hospitals East Inc | |
| University Healthcare Foundation | |||||||||||
| 2000 Foundation Way Suite 2310 | Martinsburg | WV | 25401 | 311118075 | Support City Hospital | WV | 501c3 | 12a, I | N/A | false | |
| United Summit Center | |||||||||||
| 6 Hospital Plaza | Clarksburg | WV | 26301 | 550752788 | Behavioral Health | WV | 501c3 | 3 | N/A | false | |
| United Hospital Center Inc | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550525724 | Patient Care | WV | 501c3 | 3 | false | West Virginia United Health System | |
| United Physicians Care Inc | |||||||||||
| 686 South Pike Street | Shinnston | WV | 26431 | 550638563 | Patient Care | WV | 501c3 | 3 | N/A | false | |
| United Health Foundation | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550621706 | Hospital Support | WV | 501c3 | 12a, I | false | United Hospital Center Inc | |
| WV Health Care Co-Op | |||||||||||
| PO Box 8059 | Morgantown | WV | 26506 | 550650441 | Support | WV | 501c3 | 12a, I | false | West Virginia United Health System | |
| Healthnet Inc | |||||||||||
| 419 Brooks Street | Charleston | WV | 25301 | 550681969 | Support | WV | 501c3 | 12a, I | N/A | false | |
| Camden-Clark Health Services | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26101 | 550769602 | Healthcare Access | WV | 501c3 | 12a, I | false | West Virginia United Health System | |
| Camden-Clark Foundation | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26101 | 550667789 | Hospital Support | WV | 501c3 | 12a, I | false | Camden-Clark Health Services | |
| Camden-Clark Memorial Hospital | |||||||||||
| 800 Garfield Ave | Parkersburg | WV | 26101 | 311524546 | Patient Care | WV | 501c3 | 3 | false | Camden-Clark Health Services | |
| Camden-Clark Physician Corp | |||||||||||
| 604 Ann Street | Parkersburg | WV | 26101 | 264058719 | Patient Care | WV | 501c3 | 12a, I | false | Camden-Clark Health Services | |
| West Virginia University Medical Corporation | |||||||||||
| PO Box 897 | Morgantown | WV | 26507 | 550492006 | Healthcare Access | WV | 501c3 | 3 | N/A | false | |
| St Joseph's Hospital of Buckhannon Inc | |||||||||||
| 1 Amalia Drive | Buckhannon | WV | 26201 | 550356996 | Patient Care Services | WV | 501c3 | 3 | false | West Virginia United Health System | |
| West Virginia University Hospitals Inc | |||||||||||
| PO Box 8034 | Morgantown | WV | 26506 | 550643304 | Patient Care Services | WV | 501c3 | 3 | false | West Virginia United Health System | |
| St Joseph's Foundation of Buckhannon Inc | |||||||||||
| 1 Amalia Drive | Buckhannon | WV | 26201 | 550727650 | Hospital Support | WV | 501c3 | 12b, II | false | St Joseph's Hospital of Buckhannon | |
| Reynolds Memorial Hospital Inc | |||||||||||
| 800 Wheeling Avenue | Glen Dale | WV | 26038 | 550357045 | Patient Care | WV | 501c3 | 3 | false | West Virginia United Health System | |
| Reynolds Memorial Foundation | |||||||||||
| 800 Wheeling Avenue | Glen Dale | WV | 26038 | 550710402 | Hospital Support | WV | 501c3 | 12a, I | false | West Virginia United Health System | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gateway Home Care LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1353 Edwin Miller Blvd | AddressLine1Txt |
| City | Martinsburg | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 254043703 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541965474 | EIN |
| Primary Activities | Durable Medical Equipment | PrimaryActivitiesTxt |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Allied Health Services Inc | |||||||||
| PO Box 782 | Morgantown | WV | 26507 | 550652017 | Medical Lab | WV | West Virginia United Health System | C Corp | false |
| West Virginia United Insurance Services Inc | |||||||||
| 3040 University Ave Suite 3200 | Morgantown | WV | 26505 | 550756055 | Provider Network | WV | West Virginia United Health System | C Corp | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Comments