2016-08-11T14:08:10-05:00 2015-12-31 550357807 TETRICK & BARTLETT PLLC PO BOX 1916 CLARKSBURG WV 263021916 990 2015-01-01 550752788 UNITED SUMMIT CENTER INC UNIT 3046235661 6 HOSPITAL PLAZA CLARKSBURG WV 26301 ROBERT WILLIAMS EXECUTIVE DIRECTOR 3046235661 2016-08-09 1 TASHA R SINCLAIR P01333618 3046245564 2015 2016-12-15 16:53:06Z ROBERT WILLIAMS 6 HOSPITAL PLAZA CLARKSBURG WV 26301 26747047 0 X WWW.USCWV.ORG X 1996 WV THE MISSION OF UNITED SUMMIT CENTER IS TO PROVIDE QUALITY BEHAVIORAL HEALTH SERVICES TO PEOPLE WHO HAVE ACUTE AND CHRONIC PSYCHIATRIC DISABILITIES, DEVELOPMENTAL DISABILITIES, SUBSTANCE ABUSE PROBLEMS AND TO PEOPLE WHO ARE IN CRISIS IN AN EFFORT TO ASSIST IN THE ACHIEVEMENT OF THEIR FULLEST POTENTIAL WHERE THERE IS A SERVICE NEED WITHIN THE STATE OF WEST VIRGINIA AND TO THE EXTENT THAT WE ARE ECONOMICALLY CAPABLE. 8 8 751 8 0 0 4963407 4607513 20002441 20696083 291827 478843 133596 141645 25391271 25924084 0 0 0 0 19133483 19986572 0 0 0 4653895 5867291 23787378 25853863 1603893 70221 13943044 13689017 3234183 3389267 10708861 10299750 X THE MISSION OF UNITED SUMMIT CENTER IS TO PROVIDE QUALITY BEHAVIORAL HEALTH SERVICES TO PEOPLE WHO HAVE ACUTE AND CHRONIC PSYCHIATRIC DISABILITIES, DEVELOPMENTAL DISABLILITIES, SUBSTANCE ABUSE PROBLEMS AND TO PEOPLE WHO ARE IN CRISIS IN AN EFFORT TO ASSIST IN THE ACHIEVEMENT OF THEIR FULLEST POTENTIAL WHERE THERE IS A SERVICE NEED WITHIN THE STATE OF WEST VIRGINIA AND TO THE EXTENT THAT WE ARE ECONOMICALLY CAPABLE. 0 0 10189793 11032615 COMMUNITY SERVICES PROGRAMS - IN HOME AND COMMUNITY BASED TRAINING AND SUPPORTIVE SERVICES WHICH ARE INTENDED TO INCREASE THE PERSON'S LEVEL OF FUNCTIONING AND INDEPENDENCE. IN 2015, THE CENTER PROVIDED 596,406 HOURS OF SERVICE. 1165209 806696 MEDICAL SERVICES - PHYSICIAN, PHYSICIAN ASSISTANT, AND NURSING SERVICES. EVALUATION, PRESCRIPTION, ADMINISTRATION AND MONITORING OF AN INDIVIDUAL'S MENTAL STATUS AND PSYCHOTROPIC MEDICATIONS. IN 2015, THE CENTER PROVIDED 10,862 HOURS OF SERVICE. 1887980 2382348 COUNSELING SERVICES - VARIOUS OUTPATIENT THERAPY SERVICES, INCLUDING BUT NOT LIMITED TO, INDIVIDUAL THERAPY, GROUP THERAPY, FAMILY THERAPY, INTENSIVE OUTPATIENT PROGRAMS AND SUPPORTIVE COUNSELING SERVICES. IN 2015, THE CENTER PROVIDED 55,819 HOURS OF SERVICE. 6722862 6616069 MULTITUDE OF SERVICES INCLUDING CASE MANAGEMENT SERVICES, SUBSTANCE ABUSE OUTPATIENT AND RESIDENTIAL SERVICES, CRISIS STABILIZATION, SUPPORTIVE LIVING SERVICES, AND VARIOUS OTHER SERVICES 6722862 6616069 19965844 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 54 0 751 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X UNITED SUMMIT CENTER 3046235661 6 HOSPITAL PLAZA CLARKSBURG WV 26301 X PATRICK DEEM CHAIR 1.00 X 0 0 0 BRUCE CARTER BOARD MEMBER 1.00 40.00 X 0 407436 24328 CHERYL FRANCE BOARD MEMBER 1.00 X 0 0 0 JENNIFER MOMEN BOARD MEMBER 1.00 X 0 0 0 RICHARD YURKO BOARD MEMBER 1.00 X 0 0 0 ERIC RADCLIFF BOARD MEMBER 1.00 X 0 0 0 LARRY MAZZA BOARD MEMBER 1.00 X 0 0 0 MICHAEL TILLMAN BOARD MEMBER 1.00 40.00 X 0 458948 50467 ROBERT WILLIAMS EXECUTIVE DIRECTOR 30.00 10.00 X 0 199640 39928 FRANK ANGOTTI III PHYSICIAN 40.00 X 246501 0 49300 LESA FEATHER PHYSICIAN ASSISTANT 40.00 X 108124 0 21625 MUHAMMAD SALMAN PHYSICIAN 40.00 X 267000 0 53400 SANDRA RUSH PHYSICIAN 40.00 X 195124 0 39025 816749 1066024 278073 4 0 1 0 MOUNTAINEER MEDICAL OFFICE BUILDING LLC 120 MEDICAL PARK DRIVE STE 200 BRIDGEPORT WV 26330 RENT 363330 ALPHA TECHNOLOGIES PO BOX 1114 SCOTT DEPOT WV 25560 IT SERVICES 185977 BRIDGEPORT BEHAVIORAL 527 MEDICAL PARK DR 105 BRIDGEPORT WV 26330 BEHAVIORAL HEALTH SERVICES 128750 3 4607513 4607513 PROG.SERV.REVENUE-RELATED-990 624100 20696083 20696083 20696083 248475 248475 1053331 822963 230368 230368 230368 MISC. REVENUE-RELATED-990 900099 141645 141645 141645 25924084 20837728 0 478843 14185061 12004408 2180653 181530 150162 31368 4534975 3537626 997349 1085006 901654 183352 2458 2458 5879 5879 2205 2205 48890 4529 44361 1321392 594912 726480 712183 623663 88520 433952 47124 386828 87729 -802 88531 BAD DEBTS 1008843 1008843 CONTRACT SERVICES 911171 447949 463222 SUPPLIES 640226 420800 219426 EQUIP RENTAL & MAINTENA 382779 6424 376355 309584 218552 91032 25853863 19965844 5888019 0 2301650 1981016 1448560 1237115 3218859 3774612 95166 107320 6151717 4423888 1901976 1727829 4976833 4861125 13943044 13689017 3234183 3389267 3234183 3389267 X 10708861 10299750 10708861 10299750 13943044 13689017 70221 -479332 0 X X 0 1 X 1 0 X SCHEDULE A, ITEM 3 ALTHOUGH THE ORGANIZATION QUALIFIES AS A HOSPITAL UNDER IRC SECTION 170(B)(1)(A)(III) AS SHOWN ON SCHEDULE A ITEM 3, THE ORGANIZATION DOES NOT QUALIFY AS A HOSPITAL FOR SCHEDULE H OR STATE OF WEST VIRGINIA PURPOSES. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 85096 85096 35962 35962 0 2282836 1273943 1008893 3191795 2591630 600165 556028 522353 33675 1727829 X 25624752 -479332 180000 -299332 25924084 0 25924084 26033863 180000 180000 25853863 0 25853863 PART X, LINE 2: THE CENTER 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 THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2015 AND 2014. 0 0 0 0 0 0 0 0 0 BRUCE CARTER BOARD MEMBER 0 407436 0 0 0 0 0 0 0 24328 0 431764 0 0 MICHAEL TILLMAN BOARD MEMBER 0 458948 0 0 0 0 0 0 0 50467 0 509415 0 0 ROBERT WILLIAMS EXECUTIVE DIRECTOR 0 199640 0 0 0 0 0 0 0 39928 0 239568 0 0 FRANK ANGOTTI III PHYSICIAN 246501 0 0 0 0 0 0 0 49300 0 295801 0 0 0 MUHAMMAD SALMAN PHYSICIAN 267000 0 0 0 0 0 0 0 53400 0 320400 0 0 0 SANDRA RUSH PHYSICIAN 195124 0 0 0 0 0 0 0 39025 0 234149 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE FORM 990 IS REVIEWED AND APPROVED BY THE CONTROLLER AND BOARD OF DIRECTORS BEFORE THE FINAL VERSION IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS ALL MEMBERS OF THE UNITED SUMMIT CENTER'S BOARD, ITS COMMITTEES, AND ALL OFFICERS AND IS MONITORED BY ANNUAL WRITTEN INFORMATION QUESTIONNAIRES WHICH ARE REVIEWED AND MAINTAINED BY THE EXECUTIVE DIRECTOR OR DESIGNEE. THE EXECUTIVE TEAM REVIEWS EACH TRANSACTION THAT MAY HAVE THE POTENTIAL OR ACTUAL CONFLICTS OF INTEREST. IF POTENTIAL OR ACTUAL CONFLICTS ARE IDENTIFIED (PAST, PRESENT OR FUTURE) THE PERSON(S) DETERMINED TO HAVE A CONFLICT IS/ARE RECUSED FROM DELIBERATIONS AND VOTING WITH REGARDS TO THAT ISSUE. THE IDENTIFIED CONFLICTS OF INTEREST AND APPROPRIATE RECUSALS ARE DOCUMENTED IN THE MINUTES OF EACH BOARD MEETING. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORM 990 IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAIALABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A BRUCE CARTER AND MICHAEL TILLMAN SERVE AS MEMBERS OF THE BOARD OF DIRECTORS OF UNITED SUMMIT CENTER. THEY ARE EMPLOYED BY UNITED HOSPITAL CENTER. THEY ARE COMPENSATED FOR THEIR WORK BY THEIR RESPECTIVE EMPLOYER AND NOT FOR THEIR SERVICE ON THE BOARD OF DIRECTORS. FORM 990, PART XII, LINE 2C THE PROCESS FOR ASSUMING RESPONSIBILITY FOR THE AUDITED FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT DID NOT CHANGE FROM THE PRIOR YEAR. WV UNITED HEALTH SYSTEM 3040 UNIVERSITY AVENUE MORGANTOWN WV 26505 550175471 HEALTHCARE ACCESS WV 501(C)(3) 11A 0 WEST VIRGINIA UNIVERSITY HOSPITALS INC PO BOX 8034 MORGANTOWN WV 26506 550643304 PATIENT CARE SERVICES WV 501(C)(3) 3 WV UNITED HEALTH SYSTEM 0 WEST VIRGINIA UNIVERSITY HOSPITALS EAST 2000 FOUNDATION WAY MARTINSBURG WV 25401 202337985 HEALTHCARE ACCESS WV 501(C)(3) 11A WEST VIRGINIA UNIVERSITY HOSPITALS INC 0 CITY HOSPITAL INC 2000 FOUNDATION WAY MARTINSBURG WV 25401 550383321 PATIENT CARE SERVICES WV 501(C)(3) 3 WEST VIRGINIA UNIVERSITY HOSPITALS - EAST INC 0 JEFFERSON MEMORIAL HOSPITAL 2000 FOUNDATION WAY MARTINSBURG WV 25401 550359755 PATIENT CARE SERVICES WV 501(C)(3) 3 WEST VIRGINIA UNIVERSITY HOSPITALS - EAST INC 0 UNIVERSITY HEALTHCARE FOUNDATION 2000 FOUNDATION WAY MARTINSBURG WV 25401 311118075 HOSPITAL SUPPORT WV 501(C)(3) 11A 0 UNITED HOSPITAL CENTER INC 327 MEDICAL PARK DRIVE BRIDGEPORT WV 26330 550525724 PATIENT CARE SERVICES WV 501(C)(3) 3 WV UNITED HEALTH SYSTEM 0 UNITED PHYSICIANS CARE INC 686 SOUTH PIKE STREET SHINNSTON WV 25431 550638563 PATIENT CARE SERVICES WV 501(C)(3) 3 0 UNITED HOSPITAL FOUNDATION 327 MEDICAL PARK DRIVE BRIDGEPORT WV 26330 550621706 HOSPITAL SUPPORT WV 501(C)(3) 11A UNITED HOSPITAL CENTER INC 0 WV HEALTH CARE CO-OP PO BOX 8059 MORGANTOWN WV 26506 550650441 SUPPORT WV 501(C)(3) 11A WV UNITED HEALTH SYSTEM 0 CAMDEN-CLARK HEALTH SERVICES 800 GARFIELD AVE PARKERSBURG WV 26102 550769602 HEALTHCARE ACCESS WV 501(C)(3) 11A,I WV UNITED HEALTH SYSTEM 0 CAMDEN-CLARK FOUNDATION 800 GARFIELD AVE PARKERSBURG WV 26102 550667789 HOSPITAL SUPPORT WV 501(C)(3) 11A CAMDEN-CLARK HEALTH SERVICES 0 CAMDEN-CLARK MEMORIAL HOSPITAL 800 GARFIELD AVE PARKERSBURG WV 26102 311524546 PATIENT CARE WV 501(C)(3) 3 CAMDEN-CLARK HEALTH SERVICES 0 CAMDEN-CLARK PHYSICIAN CORP 604 ANN STREET PARKERSBURG WV 26102 264058719 PATIENT CARE WV 501(C)(3) 11A,I CAMDEN-CLARK HEALTH SERVICES 0 POTOMAC VALLEY HOSPITALS OF WVA INC 100 PIN OAK LANE KEYSER WV 26726 550420956 PATIENT CARE WV 501(C)(3) 3 WEST VIRGINIA UNIVERSITY HOSPITALS INC 0 ALLIED HEALTH SERVICES INC PO BOX 782 MORGANTOWN WV 26507 550652017 MEDICAL LAB WV C 0 WEST VIRGINIA UNITED INSURANCE SERVICES INC 3040 UNIVERSITY AVENUE MORGANTOWN WV 26505 550756055 PROVIDER NETWORK WV C 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0