CAMDEN-CLARK MEMORIAL HOSPITAL CORPORATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
CAMDEN-CLARK MEMORIAL HOSPITAL CORPORATION (EIN 31-1524546)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-15
IRS object ID
201743199349319309
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-11-15T09:17:43-00:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311524546EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Camden-Clark Memorial Hospital CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCAMDBusinessNameControlTxt
Phone3044242202PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 Garfield AvenueAddressLine1Txt
CityParkersburgCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26101ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCarolyn AllenPersonNm
Person TitleCFOPersonTitleTxt
Signature2017-11-10SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address157.182.216.2IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-16IPDt
IP Tm02:12:23IPTm
IP TimezoneESIPTimezoneCd
Federal Original Submission Id5504482017116qq3o8hhFederalOriginalSubmissionId
Federal Original Submission Id2017-11-15FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id301490902228FB36277D3D3837D95EF666DC4F65AtSubmissionCreationDeviceId
At Submission Filing Device Id234EA096CFDA6C5369FDA0DB45BC1B6247EDF7C0AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Camden Clark Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDavid K McClurePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 Garfield AvenueAddressLine1Txt
CityParkersburgCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26102ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$247,858,063GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.ccmh.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionTo operate an acute care and emergency hospital facility.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee2068TotalEmployeeCnt
Total Volunteers273TotalVolunteersCnt
Total Gross UBI$1,479,293TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$385,676NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$64,945PYContributionsGrantsAmt
CY Contributions Grants$111,375CYContributionsGrantsAmt
PY Program Service Revenue$235,020,558PYProgramServiceRevenueAmt
CY Program Service Revenue$239,975,989CYProgramServiceRevenueAmt
PY Investment Income$2,647,747PYInvestmentIncomeAmt
CY Investment Income$696,448CYInvestmentIncomeAmt
PY Other Revenue$1,389,585PYOtherRevenueAmt
CY Other Revenue$6,269,414CYOtherRevenueAmt
PY Total Revenue$239,122,835PYTotalRevenueAmt
CY Total Revenue$247,053,226CYTotalRevenueAmt
PY Grants And Similar Paid$284,043PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$11,010CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$86,849,302PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$86,568,577CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$145,522,445PYOtherExpensesAmt
CY Other Expenses$145,121,663CYOtherExpensesAmt
PY Total Expenses$232,655,790PYTotalExpensesAmt
CY Total Expenses$231,701,250CYTotalExpensesAmt
PY Revenues Less Expenses$6,467,045PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$15,351,976CYRevenuesLessExpensesAmt
Total Assets BOY$264,673,952TotalAssetsBOYAmt
Total Assets EOY$254,136,216TotalAssetsEOYAmt
Total Liabilities BOY$281,417,100TotalLiabilitiesBOYAmt
Total Liabilities EOY$275,993,931TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$16,743,148NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$21,857,715NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe mission of Camden-Clark Memorial Hospital is to meet the health care needs of our community for a lifetime.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$117,073,612ExpenseAmt
Grant$11,010GrantAmt
Revenue$122,252,256RevenueAmt
DescCamden Clark Memorial Hospital offers emergency room services as part of the hospitals mission of meeting the healthcare needs of the community for a lifetime. Due to the community that it serves, the majority of patients visiting the ER are either underinsured or uninsured. For the reporting period, there were approximately 51,854 ER visits, of this total, 9,958 were ultimately admitted to the hospital. This represents 77.4 of the total hospital admissions for 2016. Therefore, a significant portion of the hospitals inpatient volume comes directly from the ER.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$6,940,320ExpenseAmt
Revenue$12,296,391RevenueAmt
DescCamden-Clark Memorial Hospital is a leader in cancer care for the mid-ohio valley, providing cancer care to patients in a 45 mile radius from the hospital. In addition to a wide range of treatment options provided, the hospital offers a number of related services to its patients. Through the hospitals collaboration with the American Cancer Society, the development of the organizations cancer resource center, a hair restoration salon, a patient navigator and an oncology social, the hospital has enhanced the education, navigation and social support of its cancer patients and families. The hospitals community and social services provide a holistic healing environment which includes support groups for patients/families and aesthetic services to enhance the patients physical and emotional well-being.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$7,660,450ExpenseAmt
Revenue$9,567,929RevenueAmt
DescCamden-Clark Memorial Hospital offers behavioral health services for its immediate service area directly through the hospital. In addition, services are provided to underserved counties throughout the area via physicians that are employed by Camden Clark Physician Corporation, a related entity. There is a severe shortage of behavioral health services available in the mid-ohio valley, and Camden-Clark has made efforts to bridge that gap.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$62,403,051TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$101,197,375TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$194,077,433TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document183IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee2068EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCarolyn AllenPersonNm
Phone3044242202PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 Garfield AvenueAddressLine1Txt
CityParkersburgCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26102ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Terry Capel MD
Board Member- Chairman001.00001.00Yes (X)Yes (X)$0$0$0
Joseph Campbell
Board Member001.00001.00Yes (X)$0$0$0
Gregory Gore
Board Member- Secretary001.00Yes (X)Yes (X)$0$0$0
Michael Morehead MD
Board Member001.00Yes (X)$0$0$0
Jennifer Leavitt MD
Board Member040.00Yes (X)$102,712$0$0
Kathy G Eddy
Board Member- Vice Chairman001.00001.00Yes (X)Yes (X)$0$0$0
David McClure
President / CEO038.00002.00Yes (X)$636,943$0$21,900
Thomas Heller
Vice President, Human Resources030.00010.00Yes (X)$346,590$0$15,747
Cynthia Kern
Vice President, Quality040.00Yes (X)$256,142$0$5,623
Carolyn Allen
Vice President, Finance033.00007.00Yes (X)$357,927$0$10,138
Tommy Mars
Chief Nursing Officer040.00Yes (X)$249,665$0$18,877
Joshua Woods
Chief Information Officer040.00Yes (X)$140,946$0$4,842
Todd Kruger
General Legal Counsel040.00$425,683$0$17,540Yes (X)
Gene Allen Sexton
Pharmacist040.00$134,472$0$21,664Yes (X)
Shaun Carter
Pharmacy Systems Analyst040.00$138,240$0$1,365Yes (X)
Michael Trimble
Pharmacist040.00$133,287$0$5,257Yes (X)
Frederick Moore
Pharmacist040.00$121,334$0$16,694Yes (X)
Tracy Hood
OVASC Administrator040.00$113,279$0$10,888Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,157,220TotalReportableCompFromOrgAmt
Total Other Compensation$150,535TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K28IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Marshall Medical Management LLC
1792 Alysheba Way Suite 150LexingtonKY40509ED Providers$2,849,316
Jackson Kelly
PO Box 553CharlestonWV25322Legal Services$976,547
Bowles Rice LLP
PO Box 1386CharlestonWV25325Legal Services$361,059
Dixon Hughes Goodman LL
PO Box 602828CharlotteNC282602828Accounting and Tax Services$283,803
Seyed Ghodsi
1212 Garfield Ave Suite 300ParkersburgWV26101Physician Services$256,578
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K37CntrctRcvdGreaterThan100KCnt
Related Organizations$110,925RelatedOrganizationsAmt
All Other Contributions$450AllOtherContributionsAmt
Total Contributions$111,375TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Service Revenue, Net621500$238,328,280$237,597,791$730,489
Pass-through income - OVASC HH900099$939,889$939,889
Pharmacy Sales - Patients900009$400,540$400,540
Ambulance Services621910$307,280$307,280
FieldValueIRS element (for citing)
Total Program Service Revenue$239,975,989TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$649,751TotalRevenueColumnAmt
Exclusion$649,751ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$46,496TotalRevenueColumnAmt
Exclusion$46,496ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$986,870RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$804,837RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$182,033RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$182,033TotalRevenueColumnAmt
Unrelated Business Revenue-$615UnrelatedBusinessRevenueAmt
Exclusion$182,648ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$201OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$201OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$201TotalRevenueColumnAmt
Exclusion$201ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Cafeteria Income624200$1,088,267$1,088,267
Health and Wellness Center900099$749,419$749,419
Electronic Health Record Incentive900099$1,232,966$1,232,966

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,016,729TotalRevenueColumnAmt
Related Or Exempt Func Income$3,016,729RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$6,087,381OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$247,053,226TotalRevenueColumnAmt
Related Or Exempt Func Income$243,495,195RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,479,293UnrelatedBusinessRevenueAmt
Exclusion$1,967,363ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$11,010TotalAmt
Program Services$11,010ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,508,923TotalAmt
Program Services$426,961ProgramServicesAmt
Management And General$2,081,962ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$65,626,080TotalAmt
Program Services$62,184,947ProgramServicesAmt
Management And General$3,441,133ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,135,062TotalAmt
Program Services$1,964,257ProgramServicesAmt
Management And General$170,805ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$10,108,476TotalAmt
Program Services$9,372,100ProgramServicesAmt
Management And General$736,376ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$6,190,036TotalAmt
Program Services$5,694,833ProgramServicesAmt
Management And General$495,203ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$131,543TotalAmt
Management And General$131,543ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$283,050TotalAmt
Management And General$283,050ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$24,813TotalAmt
Management And General$24,813ManagementAndGeneralAmt
FieldValueIRS element (for citing)
Fees For Services Prof FundraisingFeesForServicesProfFundraising

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$22,639,818TotalAmt
Program Services$20,183,281ProgramServicesAmt
Management And General$2,456,537ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$615,565TotalAmt
Program Services$566,320ProgramServicesAmt
Management And General$49,245ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$8,343,860TotalAmt
Program Services$7,676,351ProgramServicesAmt
Management And General$667,509ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$6,015TotalAmt
Program Services$5,534ProgramServicesAmt
Management And General$481ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,026,455TotalAmt
Program Services$2,784,339ProgramServicesAmt
Management And General$242,116ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$202,291TotalAmt
Program Services$186,108ProgramServicesAmt
Management And General$16,183ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,573TotalAmt
Program Services$2,137ProgramServicesAmt
Management And General$436ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,990,419TotalAmt
Management And General$6,990,419ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$17,894,937TotalAmt
Management And General$17,894,937ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$13,511,669TotalAmt
Program Services$12,430,736ProgramServicesAmt
Management And General$1,080,933ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,084,030TotalAmt
Program Services$4,054,577ProgramServicesAmt
Management And General$29,453ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Provision for Doubtful Accounts$14,870,192$14,870,192
Medical Supplies Patient Chargables$42,110,894$42,110,894
Taxes, Licenses Fees$8,856,646$8,148,114$708,532
Dues, Education Training Recruiting$1,139,328$1,048,182$91,146

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$387,565TotalAmt
Program Services$356,560ProgramServicesAmt
Management And General$31,005ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$231,701,250TotalAmt
Program Services$194,077,433ProgramServicesAmt
Management And General$37,623,817ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,139,734BOYAmt
EOY$761,629EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,895,358BOYAmt
EOY$5,723,579EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$25,994,048BOYAmt
EOY$30,152,818EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$2,932,679BOYAmt
EOY$260,436EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$9,977,395BOYAmt
EOY$5,188,274EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,052,673BOYAmt
EOY$4,837,174EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$313,800,573LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$170,447,321LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$131,144,124BOYAmt
EOY$143,353,252EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$73,911,592BOYAmt
EOY$53,740,329EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,012,494BOYAmt
EOY$1,020,027EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$11,613,855BOYAmt
EOY$9,098,698EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$264,673,952BOYAmt
EOY$254,136,216EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$26,736,014BOYAmt
EOY$20,730,614EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$212,592,937BOYAmt
EOY$206,218,716EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$5,960,430BOYAmt
EOY$9,550,138EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$36,127,719BOYAmt
EOY$39,494,463EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$281,417,100BOYAmt
EOY$275,993,931EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$16,743,148BOYAmt
EOY-$21,857,715EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$16,743,148BOYAmt
EOY-$21,857,715EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$264,673,952BOYAmt
EOY$254,136,216EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$15,351,976ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,832,815NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$22,299,358OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd
Public Support CY1700.00000PublicSupportCY170Pct
Public Support CY5090.00000PublicSupportCY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$24,813OtherActivitiesAmt
Total Lobbying Expenditures$24,813TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceII-B 1FormAndLineReferenceDesc
ExplanationThe organization paid dues to the American Hospital Association AHA as well as the West Virginia Hospital Association WVHA. A portion of these dues, specifically 24,813, was related to lobbying activities of the AHA and WVHA.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$991,550OtherCostOrOtherBasisAmt
Book Value$991,550BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$147,722,384OtherCostOrOtherBasisAmt
Depreciation$54,580,871DepreciationAmt
Book Value$93,141,513BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$159,998,986OtherCostOrOtherBasisAmt
Depreciation$111,504,742DepreciationAmt
Book Value$48,494,244BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,087,653OtherCostOrOtherBasisAmt
Depreciation$4,361,708DepreciationAmt
Book Value$725,945BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$143,353,252TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc
Financial derivatives and other financial products
Closely-held equity interests

Other Liabilities Org OtherLiabilitiesOrgGrp (11 entries)

DescDescAmtAmt
Federal income taxes
Accrued wages, benefits and payroll taxes$8,818,926
Malpractice Liability$2,804,000
Accrued pension benefits$1,933,960
Accrued bond interest$211,617
Due to third party payors$1,276,003
Interest rate swaps$15,444,276
Self insurance liability$8,228,000
Debt Issuance Costs-$143,971
Deferred Compensation$921,652
Other
FieldValueIRS element (for citing)
Total Liability$39,494,463TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$233,769,149TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$1,832,092NetUnrealizedGainsInvstAmt
Other Revenue-$14,870,192OtherRevenueAmt
Revenue Not Reported-$13,038,100RevenueNotReportedAmt
Revenue Subtotal$246,807,249RevenueSubtotalAmt
Other Revenues Not Included$245,977OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$245,977RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$247,053,226TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$217,635,895TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$804,837OtherExpensesIncludedAmt
Expenses Not Reported$804,837ExpensesNotReportedAmt
Expenses Subtotal$216,831,058ExpensesSubtotalAmt
Other Expenses Not Included$14,870,192OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$14,870,192ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$231,701,250TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
X 2The 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. Management determined there were no tax uncertainties that met the recognition threshold in 2016 and 2015. The Systems policy is to recognize interest related to unrecognized tax benefits in interest expense and penalties in operating expenses.
XI 2dLine 2d includes 14,870,192 allowance for doubtful accounts that were reported as an offset to revenue on the audited financial statements but are reported as an expense on the Form 990.
XI 4bContributions from Camden Clark Foundation of 110,925, rental expenses of 804,837 that were reported in Part VIII Line 6b as an offset to rental revenue, and pass through income of 939,889.
XII 2dLine 2d consists of 804,837 of expense related to rental revenue reported in Part VIII Line 6b as an offset to rental revenue.
XII 4bAllowance for Doubtful Accounts of 14,870,192 reported as an offset to revenue on the audited financial statements but are reported as an expense on the Form 990.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CarefalseFPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,369,717TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,369,717NetCommunityBenefitExpnsAmt
Total Expense0.00630TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$56,216,034TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$38,276,877DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,939,157NetCommunityBenefitExpnsAmt
Total Expense0.08240TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$303,626TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$304,949DirectOffsettingRevenueAmt
Net Community Benefit Expns-$1,323NetCommunityBenefitExpnsAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$57,889,377TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$38,581,826DirectOffsettingRevenueAmt
Net Community Benefit Expns$19,307,551NetCommunityBenefitExpnsAmt
Total Expense0.08870TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$335,758TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$335,758NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,276,445TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$914,398DirectOffsettingRevenueAmt
Net Community Benefit Expns$362,047NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,010TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,010NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,623,213TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$914,398DirectOffsettingRevenueAmt
Net Community Benefit Expns$708,815NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$59,512,590TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$39,496,224DirectOffsettingRevenueAmt
Net Community Benefit Expns$20,016,366NetCommunityBenefitExpnsAmt
Total Expense0.09200TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$4,798,424BadDebtExpenseAmt
Bad Debt Expense Attributable$337,395BadDebtExpenseAttributableAmt
Reimbursed By Medicare$93,490,812ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$111,762,548CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$18,271,736MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxtOrg Profit Or OwnershipOrgProfitOrOwnershipPct
Ohio Valley Ambulatory Surgery Center LLC
Ambulatory Services0.62500
Housecalls Home Health & Hospice LLC
Home Health Services0.10000
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Camden-Clark Memorial HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 Garfield AvenueAddressLine1Txt
CityParkersburgCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26102ZIPCd
FieldValueIRS element (for citing)
Website Addresshttp//wvumedicine.org/camden-clark/WebsiteAddressTxt
State License102StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherDisproportionate Share HospitalOtherDesc
Facility Reporting GroupAFacilityReportingGroupCd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ABusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp//wvumedicine.org/camden-clark/wp-content/uploads/sites/6/2016/04/Community-Health-Needs-AssessmOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttp//wvumedicine.org/camden-clark/wp-content/uploads/sites/6/2016/04/Community-Health-Needs-AssessmStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care0000000200.000000000000FPGFamilyIncmLmtFreeCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp//wvumedicine.org/camden-clark/wp-content/uploads/sites/6/2016/02/FINAFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp//wvumedicine.org/camden-clark/wp-content/uploads/sites/6/2016/02/FINAFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp//wvumedicine.org/wp-content/uploads/2015/11/plain-language-summary-10FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Group Camden-Clark Memorial Hospital Line Part V, Section B, Line 5The organization collected a vast amount of demographic data on the community served, met with United Way agencies and the Health Department, and used information garnered from studies performed by the Sisters of St. Joseph. In 2017 WV United Health System entered into a contract with the WVU School of Public Health to organize CHNAs for all System hospitals. In July 2017 CCMC leadership began meeting with WVU School of Public Health faculty and staff to begin the process of preparing the next CHNA for CCMC which is due in 2018.
Group Camden-Clark Memorial Hospital Line Part V, Section B, Line 11Based on the 2015 CHNA results CCMC leadership chose two priority areas which they felt CCMC could adequately target and address through the implementation plan. These areas were 1. Access to Wellness Opportunities and 2. Obesity/Diabetes. CCMC believes that utilizing the Diabetes Education, Cancer Services, Preventive Screenings, Community Education, Dinner with a Doc - lecture series, and Drug Abuse Education, Prevention, and Treatment programs they can make significant strides towards addressing the above mentioned priority areas. Please see the implementation plan available online at www.wvumedicine.org for details on how CCMC is addressing these needs. CCMC is working with area organizations to work toward addressing needs not being addressed by the most recent implementation plan.
Group Camden-Clark Memorial Hospital Line Part V, Section B, Line 15eA state medicaid representative was on site to help determine eligibility and help patients through the eligibility process.
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
Patriot Point Diagnostic
2838 Pike StreetParkersburgWV26101Radiology/Lab
Garfield Diagnositc
2012 Garfield Ave Bdng 2 Ste 1ParkersburgWV26101Radiology/Lab
Sleep Lab
19th Street CampusParkersburgWV26101Diagnostic

Supplemental Information Detail SupplementalInformationDetail (21 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I Line 3cCamden-Clark Medical Center CCMC uses 200 Federal Poverty Guideline FPG to determine free care eligibility. However, CCMC does not offer discounted care to individuals who fail the 200 FPG test.
Part I Line 6aWVU Medicine prepared a System wide summary report of 2016 Community Benefits which can be found online http//wvumedicine.org/about/community-benefit/.
Part I Line 7Total community benefit expense for 2016 is 59,512,590 and is 27.45 of total net expenses. To calculate net expense, bad debt of 14,870,192 was deducted from total expenses of 231,701,250 as shown in Part IX line 25 of the core Form 990, for a net expense of 216,831,058.
Part I Line 7Worksheet 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.
Part III Line 2Bad Debt Expense at cost was calculated by multiplying bad debt expense of 14,870,192 by our cost to charge ratio of 32.14 derived from Worksheet 2 in the IRS Schedule H instructions for a total of 4,779,427.
Part III Line 3Estimated bad debt attributable to patients eligible for charity care was calculated by running a report within our patient revenue software of all bad debt account balances greater than 25,000. The total of that report was 1,045,578 which we then multiplied by our cost to charge ratio of 32.14 for a total of 336,059.
Part III Line 3The estimated bad debt attributable to patients eligible for charity care of 336,059 should be considered community benefit due to the fact that anyone with outstanding balances of 25,000 or greater usually qualifies as catastrophic if the patient completes the application process.
Part III Line 3In 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. Regardless, that bad debt should be considered community benefit as we provide services to those in need regardless of their ability to pay.
Part III Line 4WVUHS consolidated footnote for Accounts Receivable Patients states Account receivables are reported at net realizable value. Accounts are written off when they are determined to be uncollectable based upon managements assessment of individual accounts. In evaluating the collectability of patient accounts receivable, the System analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. For receivables associated with services provided to patients who have third-party coverage the System analyzes contractual amounts due and provides an allowance for doubtful accounts and a provision for bad debts, if necessary.
Part III Line 4For 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 debts 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 8The amount reported in Part III Line 6 111,762,548 was calculated using the total Medicare allowable cost from the Medicare cost report, less Medicare reimbursement of direct GME.
Part III Line 8CCMCs shortfall, 18,271,736 of Medicare program reimbursement should be considered a community benefit because we are relieving a government burden by providing care in excess of our costs to these patients.
Part III Line 9bCCMC 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, 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 2CCMC is part of the Mid-Ohio Valley Rural Health Alliance. The Alliance members jointly assess the needs of the region and work with a consultant to ensure needs are addressed. CCMC conducted a Community Health Needs Assessment CHNA in 2015 that was adopted by the Board of Directors on May 2016. The 2015 CHNA was used to develop an Implementation Plan that was approved by the CCMC Board of Directors in May 2017, that plan can be found online http//wvumedicine.org/camden-clark/wp-content/uploads/sites/6/2016/04/Community-Health-Needs-Assessment-2015.pdf.
Part VI Line 3CCMC provides, in writing, all options for possible financial assistance. This information is also available on CCMCs website. CCMC also has representatives that are available to discuss options with inpatients and outpatients on a daily basis. WV State Medicaid workers are onsite to help determine patient eligibility and to assist patients through the eligibility process.
Part VI Line 4CCMC, located in Parkersburg, WV, serves the Mid-Ohio Valley region of West Virginia and Ohio. The Primary Service Area consists of four counties with an estimated total population of 85,643 and a median household income of 41,884. CCMC serves an aging population and there is a declining corporate presence in the area which negatively impacts the unemployment rate. In addition, the community includes several federally designated medically underserved areas or populations. There is one other hospital in the primary service area, located in Marietta, OH.
Part VI Line 5A majority of the organizations governing body is comprised of persons who reside in the primary service area and who are neither employees nor independent contractors of the hospital, not family members thereof. The organization extends medical staff privileges to all qualified physicians in the community to many of its departments.
Part VI Line 5Any surplus of funds is used primarily to enhance patient care. While no research is done in this facility, a residency program was started in 2009.
Part VI Line 6CCMC is a part of the WV United Health System WVUHS. WVUHS is a not-for-profit corporation formed to serve as part of an integrated health science and healthcare delivery team. WVUHS serves as the parent corporation to an affiliated group of healthcare providing entities. The strategic plan of the System states intent to build a regional health care delivery system in its services area, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves. As a university medical center and the largest hospital of the System, WVUH plays a significant role in improving the general health care of the community.
Part VI Line 6System management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. Other hospitals in the System include West Virginia University Hospitals, Inc. in Morgantown, WV, United Hospital Center in Bridgeport, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Potomac Valley Hospital located in Keyser, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Hospital, in Glen Dale, WV, which joined the System in October 2016.
Part VI Line 6The System also includes the physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp that operate in conjunction with the System hospitals along with United Summit Center, a behavioral health center located in Clarksburg, WV. In addition to these practices, the System also includes WVUH-East, Inc. and Camden-Clark Health Services which operate as management companies for their respective hospitals. The System also includes University Healthcare Foundation in Martinsburg, WV, United Health Foundation in Clarksburg, WV, Camden-Clark Foundation in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation in Glen Dale, WV which perform various fundraising activities for their respective hospitals.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
American Red Cross
220 8th StreetParkersburgWV26101530196605501c3$5,000Operations
Wood County Development
PO Box 1683ParkersburgWV26101310965347501c4$5,500Operations
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I Line 2FormAndLineReferenceDesc
ExplanationContributions are discretionary and decisions on which organizations Camden-Clark Memorial Hospital supports are made by the CEO in conjunction with the Director of Marketing. Typically, local organizations are supported throughout the year and the donations are typically not specifically restricted, so there is no follow up process for monitoring the use of the funds.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
David McClure
President / CEO$466,232$107,136$63,575$7,950$13,950$658,843
Thomas Heller
Vice President, Human Resources$271,175$47,339$28,076$7,924$7,823$362,337
Todd Kruger
General Legal Counsel$311,656$70,590$43,437$739$16,801$443,223
Cynthia Kern
Vice President, Quality$198,820$41,728$15,594$5,015$608$261,765
Carolyn Allen
Vice President, Finance$296,949$43,862$17,116$7,272$2,866$368,065
Tommy Mars
Chief Nursing Officer$211,970$30,704$6,991$6,487$12,390$268,542
Gene Allen Sexton
Pharmacist$133,442$30$1,000$4,173$17,491$156,136

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I Line 1aMemberships at the health and wellness center are offered to each member of the senior leadership team. These are covered in the applicable employment contracts.
Part I Line 3Compensation is established by West Virginia Health System WVUHS for Camden-Clark Memorial Hospital Corporation. WVUHS utilizes compensation consultants, who review 990s of related organizations, review employment contracts for similar positions, compensation surveys. The results of the before mentioned research are provided to the System Compensation Committee for reivew and approval.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
West Virginia Hospital Finance Authority
A621256910956622VY72004-06-30$19,350,0002004 B Series - Refund prior issuance and fund improvementsfalsefalsefalse
West Virginia Hospital Finance Authority
B621256910956622VY72004-06-30$57,900,0002004 C Series - Refund prior issuancefalsefalsefalse
West Virginia Hospital Finance Authority
C621256910956622VY72013-10-03$47,037,8602013 A Series - Refund 2004 A bonds and fund improvementsfalsefalsefalse
West Virginia Hospital Finance Authority
D621256910956622L852016-06-15$19,440,9242016 A - Refunding of 2007 A Bondsfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndUnspentUnspentAmtRefunding EscrowRefundingEscrowAmt
A$7,650,000$19,350,000$1,618,092$1,167,255$95,902$11,468,751$5,000,0002008Yes (true)falseYes (true)Yes (true)
B$6,350,000$57,900,000$4,854,274$3,343,149$286,963$32,615,614$16,800,0002008Yes (true)falseYes (true)Yes (true)
C$3,955,000$47,037,860$5,335,549$411,600Yes (true)falsefalseYes (true)$2,437,641
D$19,440,924$149,8892016Yes (true)Yes (true)Yes (true)Yes (true)$19,291,035

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
AfalsefalseYes (true)falsefalsefalseYes (true)
BfalsefalseYes (true)falsefalsefalseYes (true)
CfalsefalseYes (true)falsefalsefalseYes (true)
DfalsefalseYes (true)falsefalsefalseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndTerm Of GICTermOfGICPctRegulatory Safe Harbor StsfdRegulatorySafeHarborStsfdIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
UBS AG
AfalsefalseYes (true)falseYes (true)Yes (true)0000000029.600000000000falsefalseYes (true)0000000029.600000000000Yes (true)Yes (true)Yes (true)
UBS AG
BfalsefalseYes (true)falseYes (true)Yes (true)0000000029.600000000000falsefalseYes (true)0000000029.600000000000Yes (true)Yes (true)Yes (true)
Cantor Fitzgerald
CfalseYes (true)falsefalsefalsefalseYes (true)Yes (true)falseYes (true)
Raymond James Financial Products
DfalseYes (true)falsefalsefalseYes (true)0000000026.420000000000falsefalseYes (true)0000000002.670000000000Yes (true)falseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)
CYes (true)
DYes (true)

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I Line ABThe 2004 Bonds were issued in a series with the 2004 A bonds which were refunded through the 2013 A Series refunding reported in Line C.
Part I Line C2013 A Bond - The total issue price reported on Line 3 varies from the total of Lines 4 through 12 by 931,322, this variance is due to the 2004 Series A bonds that were defeased via the 2013A issuance. These funds were sitting in debt service, interest, and the project fund accounts at the time of the 2013 issuance and were rolled into the 2013 A funds.
Part I Line D2016 A Bond - The 2016 A Bonds were issued on behalf of the West Virginia United Health System Obligated Group with an issue price of 288,869,596 per Form 8038. The 2016 A Bonds were issued to refund certain outstanding bonds. Per internal allocations based on the balance of the refunded bonds in the general ledger CCMC received 19,440,923 in proceeds to refund the 2007A bond issuance as an advanced refunding. The remaining amounts allocated from this issuance are reported on Form 990 for WVUH and UHC.
Part ISchedule K - For purposes of reporting bond issuance allocations on Schedule K to the Internal Revenue Service, West Virginia University Hospitals, Inc. WVUH as parent company to City Hospital, Inc. CHI, The Charles Town General Hospital dba Jefferson Medical Center JMC, University Healthcare Foundation, Inc. UHF, and Potomac Valley Hospital is reporting bond issuances allocated to WVUH and its subsidiaries on a consolidated basis on Schedule K attached to their tax return. United Hospital Center, Inc. UHC EIN 55-0525724 and Camden-Clark Memorial Hospital Corporation CCMH EIN 31-1524546 are reporting bond allocations issued to them on the return filed by such taxpayer. Several bond issuances were issued in multiple series and each series is reported in this tax return separately. For each series identified in Schedule K, Part I, the taxpayer will reconcile the series amount reported in this tax return and the tax return filed by UHC and CCMC to the applicable 8038 filed with the IRS for each bond issuance. Each bond series is reported on the appropriate Form 990, Schedule K, only once in this manner.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 4dProgram Service Expenses 62,403,051, Grants and allocations 0, Revenue 101,197,375 The hospital strives to supply a comprehensive range of inpatient, outpatient, outreach clinics and emergency room services, including prevention, guidance, diagnosis, treatment, restoration, rehabilitation and other efforts as may be required to meet the health care need of the community and as the hospitals resources will permit. Although reimbursement for services rendered is critical to the operation and stability of the hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. Our mission is to serve the community by providing health care services and health care education. Therefore, in keeping with this commitment to service all members of the community, Camden-Clark Memorial Hospital will provide the following where the individuals need and/or an inability to pay coexist free care and/or subsidized care, and care provided to persons covered by governmental programs at or below cost.
Form 990, Part IV, Line 20bThe organization must attach a copy of its most recent audited financial statements. Attached are the consolidated financial statements of West Virginia United Health System, Inc. WVUHS and controlled entities. WVUHS became the sole member of Camden Clark Health Services, Inc., the parent corporation of Camden-Clark Memorial Hospital on March 1, 2011. The financial position, results of operations, and cash flows of Camden-Clark Memorial Hospital are included in the aforementioned consolidated audited financial statements.
Form 990, Part VI, Section A, Line 6Camden-Clark Health Services, Inc., a non-profit, tax-exempt corporation, is the sole member of the organization.
Form 990, Part VI, Section A, Line 7aCamden-Clark Health Services Inc., the organizations sole member, nominates all board members of the organization. Board members are elected by West Virginia United Health System, WVUHS from the CCHS nominations. WVUHS elects all CCHS, CCMC, CCPC and CCF Board members from a slate of Director Nominees submitted to them by CCHS. CCHS will consider the underlying nominations of CCMC,CCPC and CCF before they submit their nominations.
Form 990, Part VI, Section A, Line 7bAs the sole member of Camden Clark Health Services, Inc., WVUHS through its affiliation agreement, holds power to approve certain decisions such as annual budget, capital expenditures over 1 million, new debt over 1 million, new programs, and extraordinary filings.
Form 990, Part VI, Section B, Line 11The chief financial officer, director of finance, and the board of directors review the completed form prior to filing.
Form 990, Part VI, Section B, Line 12cTo identify and monitor any conflicts, a signed conflict of interest statement is required from board members of the organization and key individuals that are in a position to make or influence decisions. If an actual or possible conflict of interest is observed or disclosed, the organization invokes the procedures set out in the policy, bylaws for addressing the conflict of interest. For key individuals employees, a specific conflict of interest standard in the organizations code of ethics and business conduct also exists.
Form 990, Part VI, Section B, Line 15The organization utilizes an executive compensation consultant to survey data and make recommendations. The compensation of the CEO is determined by using an independent compensation consultant, as well as a compensation survey or study. It is supported by a written employment contract which is then reviewed and approved by a compensation committee and the WVUHS board of directors. Compensation of other officers and key employees is reviewed and approved by the board of directors. Minutes from meetings of the compensation committee and board of directors are documented and kept on file.
Form 990, Part VI, Section C, Line 19The organizations financial statements are made available on request and are also available on the West Virginia Healthcare Authority website. The organizations governing documents and conflict of interest policy are made available upon request.
Form 990, Part XI, Line 9Changes in Net AssetsTransfers to related organizations 20,876,544, Pass-Through Income from OVASC HH 939,889, and Impairment Loss of 372,000 and contributions of net assets released from restriction of 110,925 from CCF.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Camden-Clark Health Services Inc
800 Garfield AvenueParkersburgWV26102550769602Healthcare AccessWV501c3Line 12A, IWest Virginia United Health Systemfalse
Camden-Clark Foundation
800 Garfield AvenueParkersburgWV26102550667789Hospital SupportWV501c3Line 12ACamden-Clark Health Servicesfalse
Auxiliary of Camden-Clark Memorial Hospital
800 Garfield AvenueParkersburgWV26102550386283Patient CareWV501c3Line 3falseN/A
Camden-Clark Physician Corporation
604 Ann StreetParkersburgWV26101264058719Patient CareWV501c3Line 12A, ICamden-Clark Health Servicesfalse
West Virginia United Health System
3040 University AvenueMorgantownWV26505550175471Healthcare AccessWV501c3Line 12AfalseN/A
West Virginia University Hospitals Inc
PO Box 8034MorgantownWV26506550643304Patient CareWV501c3Line 3West Virginia United Health Systemfalse
West Virginia University Hospitals East
2000 Foundation WayMartinsburgWV25401202337985Healthcare AccessWV501c3Line 12AWest Virginia University Hospitals Incfalse
City Hospital Inc
2000 Foundation WayMartinsburgWV25401550383321Patient CareWV501c3Line 3West Virginia University Hospitals Eastfalse
Jefferson Memorial Hospital
2000 Foundation WayMartinsburgWV25401550359755Patient CareWV501c3Line 3West Virginia University Hospitals Eastfalse
University Healthcare Foundation
2000 Foundation WayMartinsburgWV25401311118075Hospital SupportWV501c3Line 12AfalseN/A
United Hospital Center Inc
327 Medical Park DriveBridgeportWV26330550525724Patient CareWV501c3Line 3West Virginia United Health Systemfalse
United Physicians Care Inc
686 South Pike StreetShinnstonWV26431550638563Patient CareWV501c3Line 3falseN/A
United Hospital Foundation
327 Medical Park DriveBridgeportWV26330550621706Hospital SupportWV501c3Line 12AfalseN/A
WV Healthcare Co-Op
PO Box 8059MorgantownWV26506550650441SupportWV501c3Line 12AWest Virginia United Health Systemfalse
United Summit Center
6 Hospital PlazaClarksburgWV26301550752788Behavioral HealthWV501c3Line 3falseN/A
Potomac Valley Hospital Inc
100 Pin Oak LaneKeyserWV26726550420956Patient CareWV501c3Line 3West Virginia University Hospitals Incfalse
St Joseph's Hospital of Buckhannon Inc
1 Amalia DriveBuckhannonWV26201550356996Patient CareWV501c3Line 3West Virginia United Health Systemfalse
Reynolds Memorial Hospital Inc
800 Wheeling AveGlen DaleWV26038550357045Patient CareWV501c3Line 3West Virginia University Hospitals Incfalse
Reynolds Memorial Foundation
800 Wheeling AveGlen DaleWV26038550710402Hospital SupportWV501c3Line 12AfalseN/A
St Joseph's Foundation of Buckhannon Inc
1 Amalia DriveBuckhannonWV26201550727650Hospital SupportWV501c3Line 12b, IISt Joseph's Hospital of Buckhannonfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Ohio Valley Ambulatory Surgery CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1608 Washington BlvdAddressLine1Txt
CityBelpreCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45714ZIPCd
FieldValueIRS element (for citing)
EIN208671724EIN
Primary ActivitiesOutpatient Surgical ServicesPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Camden-Clark Memorial Hospital CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRelatedPredominantIncomeTypeTxt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
Ownership0.62500OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Allied Health Services Inc
PO Box 782MorgantownWV26507550652017Medical LabWVWV United Health SystemC Corpfalse
West Virginia United Insurance Services
3040 University Avenue Suite 3200MorgantownWV26505550756055Provider NetworkWVWV United Health SystemC Corpfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangeYes (true)AssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.