SUMMERSVILLE REGIONAL MEDICAL CENTER: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- SUMMERSVILLE REGIONAL MEDICAL CENTER (EIN 55-0491651)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-16
- IRS object ID
- 201523209349310207
- Schema version
- 2014v5.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-16T14:25:59-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 550486667 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Arnett Carbis Toothman LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 2629 | AddressLine1Txt |
| City | Charleston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25329 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550491651 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Summersville Regional Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SUMM | BusinessNameControlTxt |
| Phone | 3048722891 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 Fairview Heights Road | AddressLine1Txt |
| City | Summersville | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 266519308 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK LOVELL | PersonNm |
| Person Title | Interim CFO | PersonTitleTxt |
| Phone | 3048722891 | PhoneNum |
| Signature | 2015-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Marlin Witt | PreparerPersonNm |
| PTIN | P00946392 | PTIN |
| Phone | 3043460441 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Randy Simmons | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 Fairview Heights Road | AddressLine1Txt |
| City | Summersville | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 266519308 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $47,114,540 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.summersvilleregional.org | WebsiteAddressTxt |
| Type Of Organization Other | Yes (X) | TypeOfOrganizationOtherInd |
| Other Organization Dsc | Municipal Public Work | OtherOrganizationDsc |
| Formation | 1968 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | Summersville Regional Medical Center provides acute care services through 53 licensed beds including Intensive Care Unit, Medical/Surgery, OB and Swing Bed. In addition there are 52 extended care beds providing Long Term Care services to the residents. Summersville Regional Medical Center operates an Emergency Room taking all patients regardless of insurance in conjunction with a regional medical center approach, connecting patients to tertiary care facilities as necessary for services. Ancillary diagnostic services are also provided including Lab, X-ray, CT, MRI, Ultrasound, PT/OT, Nuclear medicine, Surgery, and Emergency Room. Physician clinics include Rural Health Clinics, Surgery practice, Women's health practice and Orthopedics practice. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 604 | TotalEmployeeCnt |
| Total Volunteers | 26 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $44,460 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,660 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $40,586,823 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $44,644,258 | CYProgramServiceRevenueAmt |
| PY Investment Income | $90,158 | PYInvestmentIncomeAmt |
| CY Investment Income | $94,270 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,336,284 | PYOtherRevenueAmt |
| CY Other Revenue | $2,350,122 | CYOtherRevenueAmt |
| PY Total Revenue | $44,057,725 | PYTotalRevenueAmt |
| CY Total Revenue | $47,096,310 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $28,234,177 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $30,181,725 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,617,592 | PYOtherExpensesAmt |
| CY Other Expenses | $19,538,408 | CYOtherExpensesAmt |
| PY Total Expenses | $46,851,769 | PYTotalExpensesAmt |
| CY Total Expenses | $49,720,133 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,794,044 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,623,823 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $28,984,718 | TotalAssetsBOYAmt |
| Total Assets EOY | $25,556,926 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $18,461,781 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,641,231 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,522,937 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,915,695 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Above all else, Summersville Regional Medical Center is committed to the care and improvement of human life. In recognition of this commitment, we will strive to deliver quality, cost effective healthcare to the communities we serve. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $42,354,687 | ExpenseAmt |
| Revenue | $44,644,258 | RevenueAmt |
| Desc | The Hospital provided 25,099 inpatient days of care as follows: acute intensive care 6,128, 632 nursery, 2,116 swing and 16,233 long-term care. Other services provided include 41,175 outpatient visits, 23,283 emergency room visits, 29,493 rural health clinic visits and 3,429 ambulatory surgeries. The Hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Charges foregone for charity during the year amounted to $218,942 for hospital services. | Desc |
| Total Program Service Expenses | $42,354,687 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 604 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mark Lovell Interim CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3048728571 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 Fairview Heights Road | AddressLine1Txt |
| City | Summersville | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26651 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Robert Shafer | ||||||||
| Chairman | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Elizabeth Anderson | ||||||||
| Vice Chairman | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Mike Steadham | ||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Bandy Mullins MD | ||||||||
| Trustee/Chief of Staff | 40.00 | Yes (X) | $460,598 | $0 | $7,800 | |||
| Brad Dorsey | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Barbara LeRose | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Brian Johnson | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Bruce Tallamy | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Fred Reed | ||||||||
| Trustee | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| John Estep | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Kenny Baker | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Lewis Gilbert | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Valerie Phillips | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Saundra Kinser | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| James Marsh | ||||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Deborah A Hill | ||||||||
| CEO | 40.00 | $216,384 | $0 | $6,526 | Yes (X) | |||
| Brian Kelbaugh | ||||||||
| CFO | 40.00 | $119,427 | $0 | $0 | Yes (X) | |||
| Dan Ayres | ||||||||
| CEO | 40.00 | $49,094 | $0 | $0 | Yes (X) | |||
| Mark Lovell | ||||||||
| CFO | 40.00 | $43,075 | $0 | $0 | Yes (X) | |||
| Yancy S Short | ||||||||
| Physician | 40.00 | $460,115 | $0 | $7,800 | Yes (X) | |||
| Paul Conley | ||||||||
| Physician | 40.00 | $385,864 | $0 | $7,800 | Yes (X) | |||
| Lukasz Rostocki | ||||||||
| Physician | 40.00 | $378,392 | $0 | $7,800 | Yes (X) | |||
| John Baughman | ||||||||
| Physician's assistant | 44.00 | $387,282 | $0 | $7,800 | Yes (X) | |||
| Thomas J Reynolds | ||||||||
| CRNA | 40.00 | $378,698 | $0 | $7,800 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,878,929 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $53,326 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 35 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Rehab One | |||||
| 1834 Park Avenue | Belle | WV | 25215 | Physical Therapy | $1,011,948 |
| Weatherby Locums | |||||
| PO Box 972633 | Dallas | TX | 75397 | Locum Physicians | $401,222 |
| Precision Diagnostic Services | |||||
| 4152 30th Ave S Suite 103 | Fargo | ND | 58104 | Sleep Studies | $167,057 |
| Arnett Carbis Toothman | |||||
| PO Box 2629 | Charleston | WV | 25329 | Accounting Services | $137,283 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $7,660 | AllOtherContributionsAmt |
| Total Contributions | $7,660 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient service revenue | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $44,644,258 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,644,258 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $44,644,258 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $93,620 | TotalRevenueColumnAmt |
| Exclusion | $93,620 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $176,056 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $18,230 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $157,826 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $157,826 | TotalRevenueColumnAmt |
| Exclusion | $157,826 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $650 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $650 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $650 | TotalRevenueColumnAmt |
| Exclusion | $650 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Pharmacy | 446110 | $1,432,830 | $1,432,830 |
| Webster County Memorial Pharmacy | 446110 | $408,670 | $408,670 |
| Settlement | 900099 | $184,161 | $184,161 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $166,635 | TotalRevenueColumnAmt |
| Exclusion | $166,635 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,192,296 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,096,310 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,644,258 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,444,392 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $434,506 | TotalAmt |
| Program Services | $376,760 | ProgramServicesAmt |
| Management And General | $57,746 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,878,884 | TotalAmt |
| Program Services | $20,705,380 | ProgramServicesAmt |
| Management And General | $3,173,504 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $535,392 | TotalAmt |
| Program Services | $464,238 | ProgramServicesAmt |
| Management And General | $71,154 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,778,886 | TotalAmt |
| Program Services | $3,276,672 | ProgramServicesAmt |
| Management And General | $502,214 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,554,057 | TotalAmt |
| Program Services | $1,347,523 | ProgramServicesAmt |
| Management And General | $206,534 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $321,165 | TotalAmt |
| Management And General | $321,165 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,855 | TotalAmt |
| Management And General | $148,855 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,848,242 | TotalAmt |
| Program Services | $3,336,811 | ProgramServicesAmt |
| Management And General | $511,431 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,292 | TotalAmt |
| Program Services | $53,146 | ProgramServicesAmt |
| Management And General | $8,146 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $801,626 | TotalAmt |
| Program Services | $695,841 | ProgramServicesAmt |
| Management And General | $105,785 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $664,562 | TotalAmt |
| Program Services | $576,242 | ProgramServicesAmt |
| Management And General | $88,320 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,757 | TotalAmt |
| Program Services | $73,493 | ProgramServicesAmt |
| Management And General | $11,264 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $559,909 | TotalAmt |
| Management And General | $559,909 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,106,886 | TotalAmt |
| Program Services | $1,826,880 | ProgramServicesAmt |
| Management And General | $280,006 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,538,508 | TotalAmt |
| Program Services | $1,334,040 | ProgramServicesAmt |
| Management And General | $204,468 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $7,112,499 | $6,167,248 | $945,251 |
| Repairs and maintenance | $1,106,441 | $959,395 | $147,046 |
| Provider tax | $880,616 | $880,616 | |
| Recruitment | $132,637 | $132,637 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,413 | TotalAmt |
| Program Services | $147,765 | ProgramServicesAmt |
| Management And General | $22,648 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,720,133 | TotalAmt |
| Program Services | $42,354,687 | ProgramServicesAmt |
| Management And General | $7,365,446 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,045 | BOYAmt |
| EOY | $2,045 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,242,826 | BOYAmt |
| EOY | $1,638,619 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,755,950 | BOYAmt |
| EOY | $5,607,787 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,413,840 | BOYAmt |
| EOY | $1,444,844 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $287,462 | BOYAmt |
| EOY | $511,341 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $45,027,406 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $28,858,641 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,282,595 | BOYAmt |
| EOY | $16,168,765 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $183,525 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,984,718 | BOYAmt |
| EOY | $25,556,926 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,922,577 | BOYAmt |
| EOY | $5,932,153 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,640,758 | BOYAmt |
| EOY | $10,343,839 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $898,446 | BOYAmt |
| EOY | $1,365,239 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,461,781 | BOYAmt |
| EOY | $17,641,231 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,850,317 | BOYAmt |
| EOY | $7,907,227 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $672,620 | BOYAmt |
| EOY | $8,468 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,522,937 | BOYAmt |
| EOY | $7,915,695 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,984,718 | BOYAmt |
| EOY | $25,556,926 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,623,823 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $16,581 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $288,184 | OtherCostOrOtherBasisAmt |
| Book Value | $288,184 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,164,207 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,097,293 | DepreciationAmt |
| Book Value | $11,066,914 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,892,706 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,071,067 | DepreciationAmt |
| Book Value | $3,821,639 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,682,309 | OtherCostOrOtherBasisAmt |
| Depreciation | $690,281 | DepreciationAmt |
| Book Value | $992,028 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $16,168,765 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Capital leases | $743,882 |
| Due to third party payors | $621,357 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,365,239 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $47,131,121 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $16,581 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $18,230 | OtherRevenueAmt |
| Revenue Not Reported | $34,811 | RevenueNotReportedAmt |
| Revenue Subtotal | $47,096,310 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $47,096,310 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $49,738,363 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $18,230 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $18,230 | ExpensesNotReportedAmt |
| Expenses Subtotal | $49,720,133 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $49,720,133 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 2d - Other Adjustments: | Rental expenses netted with income on form 990 18,230. |
| Part XII, Line 2d - Other Adjustments: | Rental expenses netted with income on form 990 18,230. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| Most Hospitals Policy | Yes (X) | MostHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 225.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | 0 | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,386 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $91,386 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,665,202 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,895,405 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $769,797 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01800 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,756,588 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,895,405 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $861,183 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,278,930 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,278,930 | DirectOffsettingRevenueAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,278,930 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,278,930 | DirectOffsettingRevenueAmt |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,035,518 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,174,335 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $861,183 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,888,371 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $8,798,041 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,120,396 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$322,355 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Summersville Regional Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 Fairview Heights Road | AddressLine1Txt |
| City | Summersville | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26651 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Long-term nursing care | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Summersville Regional Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | 0 | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | 0 | ImplementationStrategyAdoptInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 225.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Summersville Regional Medical Center | FormAndLineReferenceDesc |
| Explanation | Part V, Section B, Line 11: Financial constraints prevent the Hospital from addressing all needs. | ExplanationTxt |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | Charity care is administered to all individuals based upon filing an application for charity care, sliding fee scale, etc. To qualify for the finance assistance, patients must show proof of coverage of Medicare, Medicaid or other type of financial sponsorship. Financial assistance is based upon family size and income. Unreimbursed Medicaid revenues not reimbursed are not collected but written off as contractual adjustment. Charity care at cost and unreimbursed Medicare are computed using the cost to charge ratio method in worksheet 2 of the Schedule H instructions. |
| Part I, Line 7: | Charity care is administered to all individuals based upon filing an application for charity care, sliding fee scale, etc. To qualify for the financial assistance, patients must show proof of coverage of Medicare, Medicaid or other type of financial sponsorship. Financial assistance is based upon family size and income. Unreimbursed Medicaid revenues not reimbursed are not collected but written off as contractual adjustments. Charity care at cost and unreimbursed medicare are computed using the cost to charge ratio method in worksheet 2 of Schedule H instructions. |
| 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 $ 6,919,912. |
| Part I, Line 6a | The organization makes its community benefit report available to the public through public meetings. |
| 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 collectability. 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: | The organization used the Medicare cost report information for revenues and expenses. The organization does not consider this to be a community benefit expense due to fluctuations in reimbursements related to Medicare audits. |
| Part III, Line 9b: | See Part III, line 4b explanation above. |
| Part VI, Line 4: | We are a small rural hospital which is surrounded by Critical Access hospitals and also the only remaining hospital in Nicholas County as the other hospital closed in bankruptcy in 2008. We have a group of volunteers who are able to gain charitable support in order to encourage charitable donations by providing activities throughout our facility and through the State of West Virginia NIPS program that were not previously available to our community. As of 2012, the population of Nicholas county was 26,229. The estimated median household income in 2009 was $34,003 versus a median of $37,435 for the whole state of West Virginia. An estimated 19.2% of residents lived below the poverty level in 2009 while 7.7% were estimated to live below 50% of the poverty level. |
| Part VI, Line 5: | Our Board of Directors all reside in our primary care area of Nicholas County, West Virginia. The Board is comprised of small business, union, low income, members at large, medical staff director, and mayor of the City of Summersville. Board members are not employees, contractors of the organization nor family members. We extend medical staff privileges to all qualified physicians in our community or providers who have a visiting clinic in our community. Any surplus funds are reinvested back into the organization through capital expenditure projects, or payment on existing debt, which has been secured on a tax-free basis. Our emergency room is available to all clients regardless of ability to pay. |
| Part VI, Line 6: | The organization is not part of a health care system. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bandy Mullins MD | ||||||||||||||
| Trustee/Chief of Staff | $434,047 | $0 | $26,551 | $0 | $0 | $0 | $7,800 | $0 | $0 | $0 | $468,398 | $0 | $0 | $0 |
| Deborah A Hill | ||||||||||||||
| CEO | $38,881 | $0 | $0 | $0 | $177,503 | $0 | $6,526 | $0 | $0 | $0 | $222,910 | $0 | $0 | $0 |
| Yancy S Short | ||||||||||||||
| Physician | $371,436 | $0 | $88,679 | $0 | $0 | $0 | $7,800 | $0 | $0 | $0 | $467,915 | $0 | $0 | $0 |
| Paul Conley | ||||||||||||||
| Physician | $133,109 | $0 | $252,755 | $0 | $0 | $0 | $7,800 | $0 | $0 | $0 | $393,664 | $0 | $0 | $0 |
| Lukasz Rostocki | ||||||||||||||
| Physician | $378,392 | $0 | $0 | $0 | $0 | $0 | $7,800 | $0 | $0 | $0 | $386,192 | $0 | $0 | $0 |
| John Baughman | ||||||||||||||
| Physician's assistant | $133,831 | $0 | $253,451 | $0 | $0 | $0 | $7,800 | $0 | $0 | $0 | $395,082 | $0 | $0 | $0 |
| Thomas J Reynolds | ||||||||||||||
| CRNA | $378,698 | $0 | $0 | $0 | $0 | $0 | $7,800 | $0 | $0 | $0 | $386,498 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| City of Summersville Building Commission | |||||||
| A | 550716940 | 2006-09-29 | $7,750,000 | Debt refunding and hospital improvements | 0 | 0 | 0 |
| City of Summersville Building Commission | |||||||
| B | 550716940 | 2008-03-03 | $5,000,000 | Hospital facilities | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|
| A | $1,672,224 | $7,750,000 | $3,843,860 | $3,906,140 | 2007 | 0 | Yes (1) | Yes (1) | Yes (1) |
| B | $733,937 | $5,000,000 | $5,000,000 | 2009 | 0 | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11 | The board reviews and approves the 990 form before it is filed with the IRS. If this cannot be accomplished at a regularly scheduled meeting, a special meeting will be held to uphold this board action. |
| Form 990, Part VI, Section B, line 12c | Conflict of interest statements require a board member with a conflict to excuse themselves from the discussion and boardroom if a matter of discussion and voting would be a conflict of interest with them individually. Statements completed by other board members are reviewed by the Chairman. The vice-chairman reviews the chairman's conflict of interest statement. |
| Form 990, Part VI, Section B, line 15 | Compensation for the CEO is reviewed by a CEO compensation committee. They are responsible to help set goals, review achievement of goals and make a recommendation to the board for the incentive compensation. At a separate time, they review the CEO compensation contract and make recommendations to the board based on comparative CEO compensation using Yaffee, WVHA Compensation Survey and other applicable and available compensation tools. The CFO's compensation is reviewed and benchmarked against other compensation tools and is set by the CEO on an annual basis. |
| Form 990, Part VI, Section C, line 19 | Governing documents, conflict of interest policy and financial statements are available upon request by persons. They are not posted on the website at the present time. This has been discussed in public session of the board meetings. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Summersville Building Commission | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 Fairview Heights Road | AddressLine1Txt |
| City | Summersville | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26651 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550716940 | EIN |
| Primary Activities | Building Commission | PrimaryActivitiesTxt |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 6 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments