CAMDEN-CLARK PHYSICIAN CORPORATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- CAMDEN-CLARK PHYSICIAN CORPORATION (EIN 26-4058719)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201703199349310520
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-15T11:55:33-00:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264058719 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Camden-Clark Physician Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CAMD | BusinessNameControlTxt |
| Phone | 3044242817 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 604 Ann Street | AddressLine1Txt |
| City | Parkersburg | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26101 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Carolyn Allen | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2017-11-10 | 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 | 2017-11-15 | IPDt |
| IP Tm | 13:32:41 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 301490902228FB36277D3D3837D95EF666DC4F65 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 234EA096CFDA6C5369FDA0DB45BC1B6247EDF7C0 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Carolyn Allen | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Garfield Avenue | AddressLine1Txt |
| City | Parkersburg | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,218,306 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.ccmh.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | To support, manage, and furnish facilities, personnel, and medical services to individuals in need. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 206 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,822,951 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $23,123,757 | CYProgramServiceRevenueAmt |
| PY Investment Income | $169,551 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $9,237 | PYOtherRevenueAmt |
| CY Other Revenue | $94,549 | CYOtherRevenueAmt |
| PY Total Revenue | $20,001,739 | PYTotalRevenueAmt |
| CY Total Revenue | $23,218,306 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $2,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $22,796,169 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,260,580 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,241,456 | PYOtherExpensesAmt |
| CY Other Expenses | $12,937,803 | CYOtherExpensesAmt |
| PY Total Expenses | $31,040,125 | PYTotalExpensesAmt |
| CY Total Expenses | $37,198,383 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$11,038,386 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$13,980,077 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,850,612 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,075,245 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,392,154 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,231,837 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $458,458 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,843,408 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The general purposes of the corporation are as follows to establish, support, manage, and furnish facilities, personnel, and services to provide diagnostic, therapeautic, wellness, health promotion, surgical, and other professional medical services to sick, injured, or disabled persons | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $2,668,708 | ExpenseAmt |
| Revenue | $3,788,544 | RevenueAmt |
| Desc | Camden Clark Physician Corporation employs two medical oncologists and two radiation oncologists, and in conjunction with Camden Clark Memorial Hospital Corporation, these physicians provide a wide variety of cancer treatment options as well as education to residents of the mid-ohio valley service area. Through the hospitals collaboration with the American Cancer Society, the development of the organiztions cancer resource center, a hair restoration salon, a patient navigator and an oncology social worker, these physicians are able to help provide a holistic healing environment that includes support groups for patients and their families. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,708,062 | ExpenseAmt |
| Revenue | $5,752,484 | RevenueAmt |
| Desc | Camden Clark Physicians Corporation offers urological services through a team of employed physicians and in collaboration with Camden Clark Memorial Hospital Corporation. The team of physicians specializes in kidney stones,evaluation and treatment of prostate related issues, vasectomy, erectile dysfunction, kidney/bladder/prostate cancer, urinary track infections, and male and female incontinence. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,772,712 | ExpenseAmt |
| Revenue | $6,078,951 | RevenueAmt |
| Desc | Camden Clark Physician Corporation offers OB/GYN services through a team of employed physicians and in collaboration with Camden Clark Memorial Hospital Corporation. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $25,227,163 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $7,598,316 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $33,376,645 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 | false | 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 | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | 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 | 26 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 206 | 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | 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 | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | 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 |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary F Russell | PersonNm |
| Phone | 3044242817 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Garfield Avenue | AddressLine1Txt |
| City | Parkersburg | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26102 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Kathy G Eddy | |||||||||
| Board Member, Chairman | 001.00 | 001.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Terry Capel MD | |||||||||
| Board Member, Vice Chairman | 001.00 | 001.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Joe Campbell | |||||||||
| Board Member | 001.00 | 001.00 | Yes (X) | $0 | $0 | $0 | |||
| Daniel J McGraw MD | |||||||||
| Board Member. Physician | 040.00 | Yes (X) | $928,390 | $0 | $29,486 | ||||
| Dave McClure | |||||||||
| Board Member | 001.00 | 039.00 | Yes (X) | Yes (X) | $0 | $636,943 | $21,900 | ||
| Carolyn Allen | |||||||||
| CFO CCMC/Treasurer | 001.00 | 039.00 | Yes (X) | $0 | $357,927 | $10,138 | |||
| Sean Smith | |||||||||
| Executive Director | 040.00 | $56,127 | $0 | $11,261 | Yes (X) | ||||
| Dr Lisa Casalenuovo | |||||||||
| Physician | 040.00 | $438,071 | $0 | $28,163 | Yes (X) | ||||
| Dr Steven Miller | |||||||||
| Physician | 040.00 | $868,592 | $0 | $17,324 | Yes (X) | ||||
| Dr Nik Shah | |||||||||
| Physician | 040.00 | $770,758 | $0 | $32,714 | Yes (X) | ||||
| Dr Abiy Kelil | |||||||||
| Physician | 040.00 | $745,399 | $0 | $17,301 | Yes (X) | ||||
| Dr Jose Cruzzavala | |||||||||
| Physician | 040.00 | $721,607 | $0 | $24,306 | Yes (X) | ||||
| Dr Sivamurthy Kyathari | |||||||||
| Physician | 040.00 | $632,792 | $0 | $29,455 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,161,736 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $994,870 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $222,048 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 45 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Weatherby Locums | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 972633 | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 753972633 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Staffing Services | ServicesDesc |
| Compensation | $1,015,490 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Net Patient Revenue | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $23,123,757 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,123,757 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $23,123,757 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Cash Discounts | 900099 | $11 | $11 | |
| Other Revenue | 621110 | $94,538 | $94,538 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $94,549 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,218,306 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,218,295 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $11 | 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 | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $1,491,498 | TotalAmt |
| Program Services | $1,424,110 | ProgramServicesAmt |
| Management And General | $67,388 | 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 | $19,963,615 | TotalAmt |
| Program Services | $19,356,769 | ProgramServicesAmt |
| Management And General | $606,846 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30 | TotalAmt |
| Program Services | $29 | ProgramServicesAmt |
| Management And General | $1 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,918,554 | TotalAmt |
| Program Services | $1,868,204 | ProgramServicesAmt |
| Management And General | $50,350 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $886,883 | TotalAmt |
| Program Services | $859,390 | ProgramServicesAmt |
| Management And General | $27,493 | 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 | $0 | TotalAmt |
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 | $9,389,991 | TotalAmt |
| Program Services | $6,413,369 | ProgramServicesAmt |
| Management And General | $2,976,622 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $308 | TotalAmt |
| Program Services | $298 | ProgramServicesAmt |
| Management And General | $10 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $393,743 | TotalAmt |
| Program Services | $381,537 | ProgramServicesAmt |
| Management And General | $12,206 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $631,700 | TotalAmt |
| Program Services | $612,117 | ProgramServicesAmt |
| Management And General | $19,583 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,683 | TotalAmt |
| Program Services | $45,236 | ProgramServicesAmt |
| Management And General | $1,447 | 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 | $1,741 | TotalAmt |
| Program Services | $1,687 | ProgramServicesAmt |
| Management And General | $54 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,003 | TotalAmt |
| Program Services | $93,608 | ProgramServicesAmt |
| Management And General | $26,395 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $749,786 | TotalAmt |
| Program Services | $726,544 | ProgramServicesAmt |
| Management And General | $23,242 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Provision for Doubtful Accounts | $576,077 | $576,077 | |
| Medical Supplies | $701,943 | $701,943 | |
| Dues, Education, Taxes and Fees | $175,458 | $170,019 | $5,439 |
| Recruiting | $134,049 | $129,893 | $4,156 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,321 | TotalAmt |
| Program Services | $15,815 | ProgramServicesAmt |
| Management And General | $506 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,198,383 | TotalAmt |
| Program Services | $33,376,645 | ProgramServicesAmt |
| Management And General | $3,821,738 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1 | BOYAmt |
| EOY | $905,277 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $743,916 | BOYAmt |
| EOY | $744,696 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,699,779 | BOYAmt |
| EOY | $1,446,119 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,000 | BOYAmt |
| EOY | $70,500 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,597 | BOYAmt |
| EOY | $738,937 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,379,730 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,210,014 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $266,319 | BOYAmt |
| EOY | $169,716 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,850,612 | BOYAmt |
| EOY | $4,075,245 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,392,154 | BOYAmt |
| EOY | $575,657 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,656,180 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,392,154 | BOYAmt |
| EOY | $2,231,837 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $458,458 | BOYAmt |
| EOY | $1,843,408 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $458,458 | BOYAmt |
| EOY | $1,843,408 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,850,612 | BOYAmt |
| EOY | $4,075,245 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$13,980,077 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $15,365,027 | 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 |
| Facts And Circumstances Test | Part I Section A Line 3 Although the organization qualifies as a hospital under IRC Section 170B1AIII as shown on Schedule A, Part I, Line III, the organization is not a licensed hospital in the state of West Virginia, and therefore, it is not required to complete Form 990, Schedule H. | FactsAndCircumstancesTestTxt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,379,730 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,210,014 | DepreciationAmt |
| Book Value | $169,716 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $169,716 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc |
|---|
| Financial derivatives and other financial products |
| Closely-held equity interests |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Federal income taxes | |
| Accrued wages, benefits, and payroll taxes | $1,394,319 |
| Accrued pension benefits | |
| State income taxes | $261,861 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,656,180 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| X 2 | WVUHS, WVUH, PVH, CCHS, CCF, CCPC, University Healthcare, BMC, JMC, University Healthcare Foundation, UHC, USC, UHF, UPC, SJH, and STF 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 and WVUIS are organizations subject to federal and/or state income taxes. |
| 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. 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | false | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (true) | 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 (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Daniel J McGraw MD | ||||||||||||
| Board Member. Physician | $924,211 | $4,179 | $7,950 | $21,536 | $957,876 | |||||||
| Dave McClure | ||||||||||||
| Board Member | $466,232 | $107,136 | $63,575 | $7,950 | $13,950 | $658,843 | ||||||
| Carolyn Allen | ||||||||||||
| CFO CCMC/Treasurer | $296,949 | $43,862 | $17,116 | $7,272 | $2,866 | $368,065 | ||||||
| Dr Lisa Casalenuovo | ||||||||||||
| Physician | $358,780 | $1,388 | $6,857 | $21,306 | $466,234 | $77,903 | ||||||
| Dr Steven Miller | ||||||||||||
| Physician | $645,269 | $3,440 | $7,950 | $9,374 | $885,916 | $219,883 | ||||||
| Dr Nik Shah | ||||||||||||
| Physician | $762,621 | $8,137 | $7,950 | $24,764 | $803,472 | |||||||
| Dr Abiy Kelil | ||||||||||||
| Physician | $471,210 | $2,569 | $7,950 | $9,351 | $762,700 | $271,620 | ||||||
| Dr Jose Cruzzavala | ||||||||||||
| Physician | $397,493 | $324,114 | $7,950 | $16,356 | $745,913 | |||||||
| Dr Sivamurthy Kyathari | ||||||||||||
| Physician | $413,576 | $1,652 | $7,950 | $21,505 | $662,247 | $217,564 | ||||||
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I Line 1a | Memberships at the health and wellness center are offered to each member of the senior leadership team. These dues are covered in the applicable employment contracts. |
| Part I Line 3 | Compensation is established by West Virginia Health System WVUHS for Camden-Clark Physician Corporation. |
| Part I Line 5 | Each physician has a productivity bonus in their contract. This bonus is based on producing over a set relative value unit RVU during the year. There is also a component for each physician based on collections. Physician compensation is capped at the 90 MGMA or at an alternative amount as determined by and independent third party valuation firm. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4d | Program Service Expenses 25,227,163, Grants and allocations 0, Revenue 7,598,316 Camden Clark Physician Corporation strives to offer a comprehensive range of inpatient, outpatient, and outreach clinic services, including prevention, guidance, diagnosis, treatment, restoration, rehabilitation and other efforts as may be required to meet the health care needs of the community in which it serves. In addition to the cancer, urological and OB/GYN programs described above, the organization employs physicians who specialize in surgery, diabetes and nutritional management, behaviroal health and has begun to build a network of employed primary care physicians throughout the community in an effort to address what is believed to be a significant shortage of available primary care for the residents of the mid-ohio valley. Although reimbursement for services rendered is critial to the operation and stability of the organization, it is recognized that not all individuals possess the ability to purchase essential medical services. Our mission, in conjunction with Camden Clark Medical Hospital, is to serve the community by providing health care services and health care education |
| Form 990, Part III, Line 1 | without regard to race, creed, color, sex, national origin, or financial status, and to otherwise promote the quality, accessibility, and affordability of such professional medical services. |
| Form 990, Part VI, Section A, Line 6 | Camden-Clark Health Services, Inc. As of March 1, 2011, affiliated with West Virginia United Health System, a non-profit, tax-exempt corporation is the sole member of the organization. |
| Form 990, Part VI, Section A, Line 7a | Camden-Clark Health Services Inc., the organizations sole member, nominates all board members of the organization. Board members are elected by West Virginia Health System, WVUHS from the CCHS nominations. |
| Form 990, Part VI, Section A, Line 7b | Camden-Clark Health Services, Inc., the organizations sole member, shall approve all matters regarding Camden-Clark Physician Corporation. |
| Form 990, Part VI, Section B, Line 11 | The 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 12c | To 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 15a | The systems CEO and top management officials are employed by Camden-Clark Memorial Hospital CCMH and have roles throughout Camden-Clark Health Services CCHS which is also affiliated with West Virginia United Health System WVUHS. This organization does not have a CEO. The executive directors pay and other top management officials pay is reviewed and approved by the CCMH/CCHS board of directors. |
| Form 990, Part VI, Section B, Line 15b | For the physicians, their contracts are based on individual fair market evaluations utilizing medical group management association standards and other data. |
| Form 990, Part VI, Section C, Line 19 | The organizations governing documents, conflict of interest policy, and financial statements are made available upon request. The organizations financial statements are also available on the WV Healthcare Authoritys website. |
| Form 990, Part VI, Section A, Line 1 | Dr. McGraw and David McClure are not independent. Dr. McGraw was compensated by CCPC, and David McClure was compensated as CEO by the related organization, Camden Clark Memorial Hospital. Dr. McGraw and David McClure are compensated for their work for their respective organizations, not for serving on the board of directors. |
| Form 990, Part IX, Line 11g | Other expenses consist of the following items Consulting and Professional- Med Staff expense of 6,413,369 which is all program service expense, Contracted Labor of 2,964,216 as well as collection agency fees of 12,406 all of which is considered management and general expenses. |
| Form 990, Part XI, Line 9 | Other changes in net assets includes 15,365,029 of related organization capitalization and 2 for rounding. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Camden-Clark Health Services Inc | |||||||||||
| 800 Garfield Avenue | Parkersburg | WV | 26102 | 550769602 | Aids, strengthens, and supports Camden-Clark Memorial Hospital. | WV | 501c3 | Line 12A, I | West Virginia United Health System | false | |
| Camden-Clark Memorial Hospital Corporation | |||||||||||
| 800 Garfield Avenue | Parkersburg | WV | 26102 | 311524546 | Operates an acute care and emergency hospital facility. | WV | 501c3 | Line 3 | false | N/A | |
| Auxiliary of Camden-Clark Memorial Hospital | |||||||||||
| 800 Garfield Avenue | Parkersburg | WV | 26102 | 550386283 | Promotes advancement and welfare of Camden-Clark Memorial Hospital. | WV | 501c3 | Line 12A | false | N/A | |
| Camden-Clark Foundation Inc | |||||||||||
| 800 Garfield Avenue | Parkersburg | WV | 26102 | 550667789 | Raise and manage funds for Camden-Clark Memorial Hospital. | WV | 501c3 | Line 12A | false | N/A | |
| WV United Health System | |||||||||||
| 3040 University Avenue | Morgantown | WV | 26505 | 550175471 | Healthcare Access | WV | 501c3 | Line 12A | false | N/A | |
| West Virginia University Hospitals Inc | |||||||||||
| PO Box 8034 | Morgantown | WV | 26506 | 550643304 | Patient Care | WV | 501c3 | Line 3 | West Virginia United Health System | false | |
| West Virginia University Hospitals East | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 202337985 | Healthcare Access | WV | 501c3 | Line 12A | West Virginia University Hospitals Inc | false | |
| City Hospital Inc | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 550383321 | Patient Care | WV | 501c3 | Line 3 | West Virginia University Hospitals East | false | |
| Jefferson Memorial Hospital | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 550359755 | Patient Care | WV | 501c3 | Line 3 | West Virginia University Hospitals East | false | |
| University Healthcare Foundation | |||||||||||
| 2000 Foundation Way | Martinsburg | WV | 25401 | 311118075 | Hospital Support | WV | 501c3 | Line 12A | false | N/A | |
| United Hospital Center Inc | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550525724 | Patient Care | WV | 501c3 | Line 3 | West Virginia United Health System | false | |
| United Physicians Care Inc | |||||||||||
| 686 South Pike Street | Shinnston | WV | 26431 | 550638563 | Patient Care | WV | 501c3 | Line 3 | false | N/A | |
| United Hospital Foundation | |||||||||||
| 327 Medical Park Drive | Bridgeport | WV | 26330 | 550621706 | Hospital Support | WV | 501c3 | Line 12A | false | N/A | |
| WV Healthcare Co-Op | |||||||||||
| PO Box 8059 | Morgantown | WV | 26506 | 550650441 | Support | WV | 501c3 | Line 12A | West Virginia United Health System | false | |
| United Summit Center | |||||||||||
| 6 Hospital Plaza | Clarksburg | WV | 26301 | 550752788 | Behavioral Health | WV | 501c3 | Line 3 | false | N/A | |
| Potomac Valley Hospital of WVa Inc | |||||||||||
| 100 Pin Oak Lane | Keyser | WV | 26726 | 550420956 | Patient Care | WV | 501c3 | Line 3 | West Virginia University Hospitals Inc | false | |
| St Joseph's Hospital of Buckhannon Inc | |||||||||||
| 1 Amalia Drive | Buckhannon | WV | 26201 | 550356996 | Patient Care | WV | 501c3 | Line 3 | West Virginia United Health System | false | |
| Reynolds Memorial Hospital Inc | |||||||||||
| 800 Wheeling Ave | Glen Dale | WV | 26038 | 550357045 | Patient Care | WV | 501c3 | Line 3 | West Virginia University Hospitals Inc | false | |
| Reynolds Memorial Foundation | |||||||||||
| 800 Wheeling Ave | Glen Dale | WV | 26038 | 550710402 | Hospital Support | WV | 501c3 | Line 12A | false | N/A | |
| St Josephs Foundation of Buckhannon | |||||||||||
| 1 Amalia Drive | Buckhannon | WV | 26201 | 550727650 | Hospital Support | WV | 501c3 | Line 12b II | false | N/A | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ohio Valley Ambulatory | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 608 Washington Blvd | AddressLine1Txt |
| City | Belpre | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45714 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208671724 | EIN |
| Primary Activities | Outpatient Surgical Services | PrimaryActivitiesTxt |
| Legal Domicile State | WV | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | NA | C Corp | false |
| West Virginia United Insurance Services | |||||||||
| 3040 University Avenue Suite 3040 | Morgantown | WV | 26505 | 550756055 | Provider Network | WV | NA | 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 | Yes (true) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
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