FURP.ORG / PUBLIC DATA EXPLORER

BOONE MEMORIAL HOSPITAL INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
BOONE MEMORIAL HOSPITAL INC (EIN 55-0477361)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-13
IRS object ID
201631349349304753
Schema version
2014v6.0
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)
Return2016-05-13T13:15:25-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN550486667PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Arnett Carbis Toothman LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1P O Box 2629AddressLine1Txt
CityCharlestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25329ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550477361EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Boone Memorial Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBOONBusinessNameControlTxt
Phone3043691230PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 Madison AvenueAddressLine1Txt
CityMadisonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25130ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRandell FoxxPersonNm
Person TitleCFOPersonTitleTxt
Phone3043691230PhoneNum
Signature2016-05-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTessa W CarrPreparerPersonNm
PTINP01291277PTIN
Phone3043460441PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerVirgil UnderwoodPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 Madison AvenueAddressLine1Txt
CityMadisonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25130ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$28,551,213GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.bmh.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2010FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionBoone Memorial hospital strives to supply a comprehensive range of inpatient and outpatient services, including prevention, guidance, diagnosis, treatment, restoration, rehabilitation and other efforts to enable patients to lead healthy, productive lives, as may be needed by its community, and as its resources will permit. In carrying out its programs, Boone Memorial Hospital recognizes its responsibility to make services available to all persons who can benefit from them and to provide these in an economical manner in compliance with high professional standards. The hospital further recognizes responsibility to develop an organizational environment in which physicians, employees, volunteers and other individuals constituting its staff are stimulated to high standards of performance and can find maximum satisfaction, achievement and opportunity. As an equal opportunity employer it will not permit discrimination because of race, color, religion, sex, age, national origin or handicap.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee223TotalEmployeeCnt
Total Volunteers35TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$139,949PYContributionsGrantsAmt
CY Contributions Grants$480,271CYContributionsGrantsAmt
PY Program Service Revenue$28,657,487PYProgramServiceRevenueAmt
CY Program Service Revenue$27,143,518CYProgramServiceRevenueAmt
PY Investment Income$14,481PYInvestmentIncomeAmt
CY Investment Income$102,551CYInvestmentIncomeAmt
PY Other Revenue$250,993PYOtherRevenueAmt
CY Other Revenue$713,167CYOtherRevenueAmt
PY Total Revenue$29,062,910PYTotalRevenueAmt
CY Total Revenue$28,439,507CYTotalRevenueAmt
PY Grants And Similar Paid$22,220PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$45,097CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,566,069PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,544,537CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$150,000PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$50,051CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$84,733CYTotalFundraisingExpenseAmt
PY Other Expenses$18,088,332PYOtherExpensesAmt
CY Other Expenses$16,250,120CYOtherExpensesAmt
PY Total Expenses$28,826,621PYTotalExpensesAmt
CY Total Expenses$26,889,805CYTotalExpensesAmt
PY Revenues Less Expenses$236,289PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,549,702CYRevenuesLessExpensesAmt
Total Assets BOY$11,100,076TotalAssetsBOYAmt
Total Assets EOY$26,881,258TotalAssetsEOYAmt
Total Liabilities BOY$4,084,448TotalLiabilitiesBOYAmt
Total Liabilities EOY$18,315,928TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,015,628NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,565,330NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe basic mission of Boone Memorial Hospital is to create an environment in which qualified physicians and other health care personnel can work together to provide high quality health care service, in an atmosphere of brotherly love and concern, to the residents of Boone County and surrounding areas.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$22,255,177ExpenseAmt
Revenue$27,789,295RevenueAmt
DescIn performing its mission, Boone Memorial Hospital had 476 acute care admissions and 117 skilled nursing care admissions. The Hospital also had 15 respite care patients, 12,116 emergency room visits, 19,543 out-patient visits and 22,855 visits in its two rural health clinics.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$6,249ExpenseAmt
Revenue$15,974RevenueAmt
DescBoone Memorial Hospital conducts an annual health fair. The Hospital uses the local Madison Civic Center and offers very low cost blood work to the community. Approximately 500 community members attended the health fair and approximately 250 received low cost blood work.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$135,461ExpenseAmt
Revenue$61,043RevenueAmt
DescBMH Respite Care Program. The Hospital had 15 respite care admissions and 642 respite days for its 6/30/15 fiscal year. The respite care program is a cash only program. It is not billed to insurance, but the rate is only $116 per day. We offer this as a community benefit.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$45,097ExpenseAmt
Grant$45,097GrantAmt
DescBoone Memorial Hospital provides student loans to medical professionals and and then grants loan forgiveness periodically during their employment. During the fiscal year ended June 30, 2015 10 individuals were granted forgiveness for a portion of their student loan.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$45,097TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$45,097TotalOtherProgSrvcGrantAmt
Total Program Service Expenses$22,441,984TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document45IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee223EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWVStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Randell D FoxxBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3043691230PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 Madison AvenueAddressLine1Txt
CityMadisonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25130ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Robert Brown
President1.30Yes (X)Yes (X)$0$0$0
James Hensley
Vice President1.30Yes (X)Yes (X)$0$0$0
Thomas Bias
Secretary1.30Yes (X)Yes (X)$0$0$0
Janet Yeager
Board Member1.30Yes (X)$0$0$0
Douglas Bell
Board Member1.30Yes (X)$0$0$0
William Stone
Board Member1.30Yes (X)$0$0$0
Shawn Miller
Board Member1.30Yes (X)$0$0$0
James Gore
Board Member1.30Yes (X)$0$0$0
HH Howell
Board Member1.30Yes (X)$0$0$0
Nada Woodie
Board Member1.30Yes (X)$0$0$0
Virgil Underwood
Board Member/CEO as of 2/9/151.30Yes (X)Yes (X)$0$0$0
Tommy H Mullins
CEO 7/2014 to 12/201440.00Yes (X)$199,713$0$118,308
Randell D Foxx
CFO/Interim Co-CEO 12/2014-2/201540.00Yes (X)$138,134$0$15,881
Mark Linville
Interim Co-CEO 12/2014-2/201540.00Yes (X)$92,238$0$14,553
Ziad Channa
Physician40.00$170,633$0$78,739Yes (X)
Kevin Hill
PA40.00$173,662$0$16,159Yes (X)
Tara Hager
PA40.00$132,024$0$11,360Yes (X)
Blitz Turner
NP40.00$113,755$0$13,170Yes (X)
Kristina Stover
PA40.00$119,314$0$6,615Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,139,473TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$274,785TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K9IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Neighborgall Construction Co
1216 Seventh AvenueHuntingtonWV25701General Contractor-New Hospital$5,947,935
Cherry River Construction LLC
85 Legacy RidgeRed HouseWV25168General Contractor-New Hospital$1,407,872
CPSI
PO Box 850309MobileAL36685System Software Vendor$1,025,840
Rehab One Ltd
1834 Park AvenueBelleWV25015Physical Therapy Services$862,271
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K41CntrctRcvdGreaterThan100KCnt
Fundraising$41,318FundraisingAmt
Government Grants$9,360GovernmentGrantsAmt
All Other Contributions$429,593AllOtherContributionsAmt
Total Contributions$480,271TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue622110$26,137,498$26,137,498
340B Program Revenue900099$1,006,020$1,006,020
FieldValueIRS element (for citing)
Total Program Service Revenue$27,143,518TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$180,100TotalRevenueColumnAmt
Exclusion$180,100ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$150RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$150RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$150TotalRevenueColumnAmt
Exclusion$150ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$22,500OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$100,049OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$77,549OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$77,549TotalRevenueColumnAmt
Exclusion-$77,549ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$1,880FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$41,318ContriRptFundraisingEventAmt
Fundraising Direct Expenses$11,657FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$9,777TotalRevenueColumnAmt
Exclusion-$9,777ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EHR Incentive Revenue900099$434,891$434,891
Pharmacy446110$119,111$119,111
Dietary Sales900099$53,780$53,780

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$115,012TotalRevenueColumnAmt
Related Or Exempt Func Income$115,012RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$722,794OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,439,507TotalRevenueColumnAmt
Related Or Exempt Func Income$27,866,312RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$92,924ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$45,097TotalAmt
Program Services$45,097ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$558,428TotalAmt
Program Services$411,952ProgramServicesAmt
Management And General$146,476ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,768,562TotalAmt
Program Services$5,730,868ProgramServicesAmt
Management And General$2,037,694ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$89,147TotalAmt
Program Services$65,764ProgramServicesAmt
Management And General$23,383ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,477,749TotalAmt
Program Services$1,090,135ProgramServicesAmt
Management And General$387,614ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$650,651TotalAmt
Program Services$479,985ProgramServicesAmt
Management And General$170,666ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$131,200TotalAmt
Management And General$131,200ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$72,167TotalAmt
Management And General$72,167ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$50,051TotalAmt
Fundraising$50,051FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,793,632TotalAmt
Program Services$7,349,729ProgramServicesAmt
Management And General$443,903ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$90,589TotalAmt
Management And General$90,589ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,832,347TotalAmt
Program Services$1,351,722ProgramServicesAmt
Management And General$480,625ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$41,416TotalAmt
Program Services$30,553ProgramServicesAmt
Management And General$10,863ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$196,767TotalAmt
Program Services$145,155ProgramServicesAmt
Management And General$51,612ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$11,579TotalAmt
Program Services$8,542ProgramServicesAmt
Management And General$3,037ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$35,665TotalAmt
Program Services$26,310ProgramServicesAmt
Management And General$9,355ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$10,979TotalAmt
Program Services$8,099ProgramServicesAmt
Management And General$2,880ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$486,854TotalAmt
Program Services$359,152ProgramServicesAmt
Management And General$127,702ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$512,629TotalAmt
Program Services$378,166ProgramServicesAmt
Management And General$134,463ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Bad debt expense$2,599,465$2,599,465
Medical supplies$1,522,203$1,522,203
Provider tax$537,102$537,102
Charity Care Expense$137,427$137,427

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$238,099TotalAmt
Program Services$164,558ProgramServicesAmt
Management And General$38,859ManagementAndGeneralAmt
Fundraising$34,682FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$26,889,805TotalAmt
Program Services$22,441,984ProgramServicesAmt
Management And General$4,363,088ManagementAndGeneralAmt
Fundraising$84,733FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$938,174BOYAmt
EOY$5,798,867EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,151,525BOYAmt
EOY$1,264,943EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$9,360EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,934,345BOYAmt
EOY$2,830,681EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$194,160BOYAmt
EOY$61,929EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$279,964BOYAmt
EOY$310,245EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$31,386BOYAmt
EOY$144,502EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$21,517,175LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,428,812LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,302,034BOYAmt
EOY$15,088,363EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$161,806BOYAmt
EOY$191,255EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,053,140BOYAmt
EOY$1,181,113EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$53,542BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$11,100,076BOYAmt
EOY$26,881,258EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,860,704BOYAmt
EOY$5,569,688EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$392BOYAmt
EOY$383,595EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$231,067BOYAmt
EOY$8,835,974EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$992,285BOYAmt
EOY$3,526,671EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,084,448BOYAmt
EOY$18,315,928EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,015,628BOYAmt
EOY$8,160,858EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
EOY$404,472EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,015,628BOYAmt
EOY$8,565,330EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,100,076BOYAmt
EOY$26,881,258EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,549,702ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

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 D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$0BeginningYearBalanceAmt
Contributions$404,472ContributionsAmt
End Year Balance$404,472EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$216,178OtherCostOrOtherBasisAmt
Book Value$216,178BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,197,671OtherCostOrOtherBasisAmt
Depreciation$1,034,061DepreciationAmt
Book Value$163,610BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,815,604OtherCostOrOtherBasisAmt
Depreciation$5,307,615DepreciationAmt
Book Value$507,989BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,287,722OtherCostOrOtherBasisAmt
Depreciation$87,136DepreciationAmt
Book Value$14,200,586BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,088,363TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Deferred compensation$1,025,921
Third Party Payor Settlements$2,500,750
FieldValueIRS element (for citing)
Total Liability$3,526,671TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$25,714,272TotalRevEtcAuditedFinclStmtAmt
Other Revenue$11,657OtherRevenueAmt
Revenue Not Reported$11,657RevenueNotReportedAmt
Revenue Subtotal$25,702,615RevenueSubtotalAmt
Other Revenues Not Included$2,736,892OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,736,892RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$28,439,507TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$24,164,570TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$11,657OtherExpensesIncludedAmt
Expenses Not Reported$11,657ExpensesNotReportedAmt
Expenses Subtotal$24,152,913ExpensesSubtotalAmt
Other Expenses Not Included$2,736,892OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,736,892ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$26,889,805TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:The funds are to be used for capital improvements.
Part XI, Line 2d - Other Adjustments:Direct fundraising expense netted against fundraising income 11,657.
Part XI, Line 4b - Other Adjustments:Bad debt expense netted with revenue on financial statements 2,599,465. Charity care expense netted with revenue on financial statements 137,427.
Part XII, Line 2d - Other Adjustments:Direct fundraising expense netted against fundraising income 11,657.
Part XII, Line 4b - Other Adjustments:Bad debt expense netted with revenue on financial statements 2,599,465. Charity care expense netted with revenue on financial statements 137,427.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd
Phone SolicitationsYes (X)PhoneSolicitationsInd
In Person SolicitationsYes (X)InPersonSolicitationsInd
Agrmt Prof Fundraising ActyYes (1)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

Organization Business Name OrganizationBusinessName

FieldValueIRS element (for citing)
Business Name Line1D A Consulting LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16 Canyon Road Suite 300AddressLine1Txt
CityMorgantownCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26508ZIPCd
FieldValueIRS element (for citing)
ActivityRaise funds for construction of new hospital.ActivityTxt
Fundraiser Control Of Funds0FundraiserControlOfFundsInd
Gross Receipts$404,472GrossReceiptsAmt
Retained By Contractor$50,051RetainedByContractorAmt
Net To Organization$354,421NetToOrganizationAmt
FieldValueIRS element (for citing)
Total Gross Receipts$404,472TotalGrossReceiptsAmt
Total Retained By Contractors$50,051TotalRetainedByContractorsAmt
Total Net To Organization$354,421TotalNetToOrganizationAmt
Licensed StatesWVLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Golf TournamentEvent1Nm
Gross Receipts Event1$43,198GrossReceiptsEvent1Amt
Charitable Contri Event1$41,318CharitableContriEvent1Amt
Gross Revenue Event1$1,880GrossRevenueEvent1Amt
Cash Prizes Event1$3,000CashPrizesEvent1Amt
Rent Facility Costs Event1$6,657RentFacilityCostsEvent1Amt
Entertainment Event1$125EntertainmentEvent1Amt
Other Direct Expenses Event1$1,875OtherDirectExpensesEvent1Amt
Gross Receipts Total$43,198GrossReceiptsTotalAmt
Charitable Contributions Tot$41,318CharitableContributionsTotAmt
Gross Revenue Total Events$1,880GrossRevenueTotalEventsAmt
Cash Prizes Total Events$3,000CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$6,657RentFcltyCostsTotalEventsAmt
Entertainment Total Events$125EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$1,875OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$11,657DirectExpenseSummaryEventsAmt
Net Income Summary-$9,777NetIncomeSummaryAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule G, Part I, Line 2b, Column (v)FormAndLineReferenceDesc
ExplanationThe Hospital contracted with a professional fundraiser, D. A. Consulting, LLC, to organize and implement a feasibility study and develop a comprehensive capital campaign plan and strategy to raise $5,000,000 for construction of a new hospital.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$589,458TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$589,458DirectOffsettingRevenueAmt

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,844,708TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,844,708DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,434,166TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,434,166DirectOffsettingRevenueAmt

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$141,810TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$77,017DirectOffsettingRevenueAmt
Net Community Benefit Expns$64,793NetCommunityBenefitExpnsAmt
Total Expense0.00270TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,784TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,784NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$147,594TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$77,017DirectOffsettingRevenueAmt
Net Community Benefit Expns$70,577NetCommunityBenefitExpnsAmt
Total Expense0.00290TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,581,760TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,511,183DirectOffsettingRevenueAmt
Net Community Benefit Expns$70,577NetCommunityBenefitExpnsAmt
Total Expense0.00290TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$990,321BadDebtExpenseAmt
Reimbursed By Medicare$4,536,436ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$4,536,436CostOfCareReimbursedByMedcrAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Boone Memorial Hospital IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 Madison AvenueAddressLine1Txt
CityMadisonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25130ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.bmh.orgWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherTwo rural health clinics, SNF/NF bedsOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Boone Memorial Hospital IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)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
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://bmh.org/OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt12ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care200.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
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
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Boone Memorial Hospital, Inc.Part V, Section B, Line 5: Assembled an Advisory Panel comprised of representatives from community leaders, health care providers, and local citizens to assist with the assessment process.
Boone Memorial Hospital, Inc.Part V, Section B, Line 11: Boone Memorial Hospital developed an implementation plan that addressed the majority of the significant community needs identified in the CHNA. The areas addressed included alcohol and drug abuse, drunk driving and lack of recreational programs. The Hospital sponsored multiple community events/educational seminars that included health fairs, monthly diabetic educational classes, drug and alcohol abuse prevention forums and a low cost fitness center program for the community.
Boone Memorial Hospital, Inc.Part V, Section B, Line 16i: MEASURES TO PUBLICIZE THE FINANCIAL ASSISTANCE POLICYThe following measures are used to publicize the financial assistance available from BMH to the community and patients in accordance with Federal and State law: a. Providing information when a patient calls BMH at (304) 369-1230;b. Annually posting an article in a newspaper of local circulation and/or other means as deemed reasonably necessary;d. Posting of a notice in the emergency department admitting areas and business offices at BMH; and/ore. Financial Counselors visiting with BMH inpatients.
Boone Memorial Hospital, Inc.Part V, Section B, Line 22d: FAP eligible individuals are billed the same rates as every other patient with insurance. A prompt pay discount of 15% is offered if the account is paid in full within 30 days of the first statement.

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:Patients must provide their "Total Yearly Income" in order to be considered for financial assistance.a. Adults: If the patient is an adult, the term "Total Yearly Income" means the sum of the total yearly gross income of the patient and the patient's spouse.b. Minors: If the patient is a minor, the term "Total Yearly Income" means the sum of the total yearly gross income of the patient, the patient's mother and the patient's father.The patient, immediate family member or patient representative shall verify the patient's reported Total Yearly Income, as provided on the Application. The Total Yearly Income may be verified through any of the following mechanisms:a. Income Indicators. By the provision of third party financial documentation including IRS Form W-2, Wages and Tax Statement; pay check remittance; individual tax return; telephone verification by employer; bank statements; Social Security payment remittance; Worker's Compensation payment remittance; unemployment insurance payment notice; Unemployment Compensation Determination Letters; or other appropriate indicators of the patient's Total Yearly Income.b. Participation in a Benefit Program. By the provision of documentation showing current participation in a public benefit program such as Medicaid; Food Stamps; WIC; or other similar means tested programs. Proof of Participation in any of the above programs indicates that the patient has been deemed Financially Indigent and therefore, is not required to provide his or her income on the Assistance Application.c. In cases where the patient or responsible party is unable to provide third party verification of patient's Total Yearly Income, verification of the patient's Total Yearly Income can be done in either of the following ways:1. Obtaining the patient's or responsible party's Written Attestation. By obtaining an Application signed by the patient or responsible party attesting to the veracity of the patient's Total Yearly Income information provided: or2. Obtaining the patient's or responsible party's Verbal Attestation. Through the written attestation of the BMH employee completing the Assistance Application that the patient or responsible party verbally verified the patient's Total Yearly Income information provided.3. In instances where the patient or responsible party is unable to provide the requested third party verification of patient's Total Yearly Income, the patient or responsible party is required to provide a reasonable explanation of why the patient or responsible party is unable to provide the required third party verification. Sound business practices will be employed to verify patients attestation and supporting information.Unmarried expired patients may be deemed to have no income for purposes of calculation of Total Yearly Income. Documentation of Total Yearly Income is not required for expired patients; however, documentation of estate assets may be required. If an expired patient is married, the surviving spouse may apply for financial assistance.Patients, immediate family members or patient representatives applying for financial assistance must verify the number of people in the patient's household ("Number in Household").a. Adults: In calculating the Number in Household, include the patient, the patient's spouse, and any dependents (as defined by the Internal Revenue Code).b. Minors: In calculating the Number in Household, include the patient, the patient's mother, the patient's father, dependents of the patient's mother, and dependents of the patient's father.During the verification process, while information to determine a patient's Total Yearly Income is being collected, the patient may be treated as a private pay patient.
Part I, Line 7, Column (f):The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 2,599,465.
Part III, Line 2:The cost of bad debts was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.
Part III, Line 4:Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectible accounts. The allowance is based upon a review of the outstanding balances aged by financial class. Management uses collection percentages based upon historical collection experience to determine collectibility. Management also reviews troubled, aged accounts to determine collection potential. Patient accounts receivable are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received. Interest is not charged on patient accounts receivable.
Part III, Line 8:Medicare allowable costs were derived from the Medicare care cost report for the period ended 6/30/15.
Part III, Line 9b:After the patient's account is reduced by the discounts based on the Financial Assistance Eligibility Discount Guidelines, the patient is responsible for the remainder of their outstanding account. Patients will be invoiced for any remaining amounts in accordance with other BMH Debt Collection Policies regarding this matter.
Part VI, Line 2:The BMH project team completed the community needs assessment using the following strategies:-Assembled an Advisory Panel comprised of representatives from community leaders, health care providers, and local citizens to assist with the assessment process.-Conducted primary data collection through surveys of providers, key informants, and the general population. Phone interviews were also conducted.-Collected secondary data sources such as information from the Boone County Health Department Community Needs Assessment, State health statistics and behavioral risk assessments, US Census Data, Centers for Disease Control statistics and data, etc.-Created a comprehensive database including answers to each survey question which was used to track and calculate the data.-Held focus groups, some of which included youth representation in order to obtain a diverse range of responses in an open discussion format.
Part VI, Line 3:Measures to publicize the Financial Assistance Policy:The following measures are used to publicize the financial assistance available from BMH to the community and patients in accordance with Federal and State law: a. Posting on the BMH website at the following location: www.bmh.org; b. Providing information when a patient calls BMH at (304) 369-1230; c. Annually posting an article in a newspaper of local circulation and/or other means as deemed reasonably necessary; d. Posting of a notice in the emergency department admitting areas and business offices at BMH; and/or e. Financial Counselors visiting with BMH inpatients.
Part VI, Line 4:BMH serves primarily Boone County, WV and portions of Logan and Lincoln Counties in WV. Boone County had an estimated population of 24,224 in 2013. The median household income was $41,359 with 18.9% below the federal poverty guideline. 15% of the population is over 65 and 28.9% is under 18 with 40.7 years as the median age. 79% of the hospital's patients were from Boone County is FY 13.Logan County had an estimated population of 35,987 in 2013. The median household income was $36,698 with 20.8% below the federal poverty guideline. 16% of the population is over 65 and 26% is under 18. 12% of the hospital's patients were from Logan County in FY 13. Lincoln County had an estimated population of 21,559 in 2013. The median household income was $34,066 with 26.9% below the federal poverty guideline. 16% of the population is over 65 and 28% is under 18. 7% of the hospital's patients were Lincoln County in FY 13. 23% of the hospital's patients were age 65+ for FY 2013.
Part VI, Line 5:Each member of the Board of Trustees is a local, lifelong Boone County resident. The ER is always available to all patients, regardless of ability to pay. Boone Memorial has made the most recent Community Needs Assessment report available on its website for all patients to have easy access to read. BMH offers patients access to our own MRI seven days a week instead of having to travel to other larger hospitals in Charleston or Logan. Most other Critical Access Hospitals in WV only offer a mobile MRI service one or two days a week. We have a fully digital radiology department with a PACS system. Our lab has just recently expanded to incorporate additional testing equipment. We also operate two RHCs with extended hours (one has Saturday hours) to help serve the community.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeStudent Loan AssistanceGrantTypeTxt
Recipient10RecipientCnt
Cash Grant$45,097CashGrantAmt
Valuation Method UsedCash - FMVValuationMethodUsedDesc
Non Cash AssistanceStudent loan assistance to professional employeesNonCashAssistanceDesc

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Tommy H Mullins
CEO 7/2014 to 12/2014$199,713$0$0$0$0$0$110,841$0$10,368$0$320,922$0$0$0
Randell D Foxx
CFO/Interim Co-CEO 12/2014-2/2015$138,134$0$0$0$0$0$3,141$0$15,845$0$157,120$0$0$0
Ziad Channa
Physician$170,633$0$0$0$0$0$66,000$0$12,907$0$249,540$0$0$0
Kevin Hill
PA$173,662$0$0$0$0$0$3,420$0$13,998$0$191,080$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 4bFormAndLineReferenceDesc
ExplanationTommy H. Mullins, CEO, participated in a 457(f) plan during 2014 and $107,973 was contributed to the plan during the year.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, line 11Randell Foxx, CFO will review the Form 990 for accuracy prior to filing with the IRS. A copy of the final Form 990 will be provided to the Board of Directors prior to filing with the IRS.
Form 990, Part VI, Section B, line 12cCompliance is enforced and monitored when trustees recuse themselves on conflict of interest issues.
Form 990, Part VI, Section B, line 15aAn outside firm (Yaffe & Company) is consulted. The CEO presents recommendations to the board. The board will hold an executive session and decide the CEO's compensation.
Form 990, Part VI, Section C, line 19Financial statements are published annually in the local newspaper. The governing documents and conflict of interest policy are available upon request.
Form 990, Part IX, line 11gSurgery: Program service expenses 446,214. Management and general expenses 0. Fundraising expenses 0. Total expenses 446,214. Radiology: Program service expenses 475,635. Management and general expenses 0. Fundraising expenses 0. Total expenses 475,635. Pharmacy: Program service expenses 656,242. Management and general expenses 0. Fundraising expenses 0. Total expenses 656,242. Physicians: Program service expenses 2,713,952. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,713,952. Lab: Program service expenses 644,713. Management and general expenses 0. Fundraising expenses 0. Total expenses 644,713. Emergency room: Program service expenses 66,084. Management and general expenses 0. Fundraising expenses 0. Total expenses 66,084. Physical therapy: Program service expenses 1,098,442. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,098,442. Administrative: Program service expenses 774,858. Management and general expenses 275,512. Fundraising expenses 0. Total expenses 1,050,370. All other: Program service expenses 473,589. Management and general expenses 168,391. Fundraising expenses 0. Total expenses 641,980.