2015-08-13T15:07:43-05:00 2014-09-30 SOMERVILLE & COMPANY PLLC 501 5TH AVENUE HUNTINGTON WV 25701 990 2013-10-01 550675666 CABELL HUNTINGTON HOSPITAL INC % DAVID M WARD SENIOR VP/CFO CABE 3045262571 1340 HAL GREER BOULEVARD Suite HUNTINGTON WV 25701 KEVIN FOWLER PRESIDENT & CEO 3045262000 2015-08-13 true WADE S C NEWELL P01051041 3045262000 2013 2016-02-25 16:41:14Z KEVIN FOWLER 1340 HAL GREER BLVD HUNTINGTON WV 25701 639449611 false X WWW.CABELLHUNTINGTON.ORG X 1986 WV TO MEET LIFETIME HEALTHCARE NEEDS OF THOSE SERVED 18 18 2749 175 864774 19378 1505672 450000 457979595 484802600 12361521 15736007 3264013 4677753 475110801 505666360 9561379 9528962 0 0 195868851 206229938 0 0 0 245399031 266774688 450829261 482533588 24281540 23132772 482327119 514070390 318184851 348900626 164142268 165169764 X TO MEET LIFETIME HEALTHCARE NEEDS OF THOSE SERVED. TO PROVIDE THE HIGHEST LEVEL OF SERVICE, QUALITY, AND EFFICIENCY. TO ADVANCE HEALTHCARE THROUGH EDUCATION. false false 376976357 486834982 IT IS THE MISSION OF CABELL HUNTINGTON HOSPITAL TO PROMOTE HEALTH IN THE REGION THROUGH DEVELOPMENT AND DELIVERY OF A FULL SPECTRUM OF SERVICES THAT IMPROVE THE PHYSICAL, MENTAL, AND SPIRITUAL DIMENSIONS OF LIVES OF THOSE SERVED. THEREFORE, THE PRIMARY PROGRAM SERVICE ACCOMPLISHMENT IS THE INPATIENT AND OUTPATIENT SERVICES PERFORMED. CABELL HUNTINGTON HOSPITAL IS LICENSED FOR 303 BEDS AND STAFFED OVER 2,700 INDIVIDUALS. DURING FISCAL YEAR 2014, IN ADDITION TO ITS ADULT AND PEDIATRIC UNITS, IT OPERATES A COMPREHENSIVE CANCER CENTER, A PEDIATRIC INTENSIVE CARE UNIT, A NEONATAL INTENSIVE CARE UNIT, A BURN INTENSIVE CARE UNIT, A SURGICAL INTENSIVE CARE UNIT, A MEDICAL INTENSIVE CARE UNIT, AND A CORONARY CARE UNIT. ON JUNE 17, 2014, THE HOSPITAL OPENED ITS FIRST PHASE OF CONSTRUCTION OF THE CHILDREN'S HOSPITAL, A HOSPITAL WITHIN A HOSPITAL. THIS PHASE OPENED TREATMENT, PROCEDURE, AND PLAY ROOMS, AS WELL AS THE FIRST 8 PATIENT READY ROOMS. WHEN FINISHED, IT WILL BE A 72 BED FACILITY WITH 36 BEDS IN THE LEVEL III NEONATAL INTENSIVE CARE UNIT, 26 BEDS IN THE GENERAL PEDIATRICS UNIT, AND 10 BEDS IN THE PEDIATRIC INTENSIVE CARE UNIT. THE HOSPITAL IS GOVERNED BY A VOLUNTARY BOARD OF INDEPENDENT CITIZENS OF THE COMMUNITY. DURING THE FISCAL YEAR 2014, THE HOSPITAL PROVIDED SERVICES TO 18,483 INPATIENTS, WHICH RESULTED IN PROVIDING 91,116 DAYS OF CARE. THE ORGANIZATION ALSO PROVIDED CARE TO 598,316 OUTPATIENTS. THIS INCLUDED 62,267 PATIENT VISITS TO THE EMERGENCY ROOM, WHICH IS OPERATED 24 HOURS AND IS OPEN TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IT ALSO PROVIDED AN ADDITIONAL 22,082 OUTPATIENT SURGICAL PROCEDURES AND 21,203 HOME HEALTH VISITS. 45024199 87504 CABELL HUNTINGTON HOSPITAL IS VERY INVOLVED WITH THE COMMUNITY IT SERVES. DURING THE FISCAL YEAR 2014, IT HELD OVER 400 EVENTS, INCLUDING HEALTH SCREENINGS, EDUCATION OUTREACH, HEALTH FAIRS, AND COMMUNITY TRAINING. MORE THAN 9,500 PEOPLE ATTENDED THESE EVENTS. THE COSTS ASSOCIATED WITH THESE ACTIVITIES IS $107,925. THE ORGANIZATION ALSO GIVES TO THE COMMUNITY BY PARTICIPATING IN HUNTINGTON'S KITCHEN PROGRAM THAT PROMOTES HEALTHY EATING LIFESTYLES. IT ALSO PROMOTES KIDS HEALTHY EXERCISE BY PARTNERING WITH THE HUNTINGTON MALL TO PROVIDE A HEALTHY KIDS PLAYGROUND. DURING THE FISCAL YEAR 2014, CABELL HUNTINGTON HOSPITAL BEGAN SUPPORTING KIDS IN MOTION WITH THE LOCAL YMCA. THIS PROGRAM HAS THE GOAL OF GETTING KIDS AGES 5-17 MOVING AND HAVING FUN IN ORDER TO REDUCE CHILDHOOD OBESITY. THE KIDS WILL LEARN ABOUT PHYSICAL FITNESS AS WELL AS NUTRITION. ADDITIONALLY, THE ORGANIZATION PROVIDES ACUTE INPATIENT AND OUTPATIENT CARE INCLUDING SERVICES THAT ARE REIMBURSED FOR AND NOTED AS CHARITY CARE. ANY PERSON IS PROVIDED SERVICES REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL'S CHARITY CARE SERVICES WAS $17,047,255 (WHICH IS NETTED AGAINST REVENUES) AND BAD DEBT EXPENSE WAS $44,828,770. THE HOSPITAL CONSIDERS ALL OF THIS A COMMUNITY SERVICE. 17338229 9441458 CABELL HUNTINGTON HOSPITAL IS A TEACHING HOSPITAL THAT IS ASSOCIATED WITH MARSHALL UNIVERSITY SCHOOLS OF MEDICINE AND NURSING. WITH THAT, THE HOSPITAL IS LEADING THE WAY IN COMMUNITY HEALTH CARE AND WITH THAT COMES THE RESPONSIBILITY OF TRAINING OTHERS TO CONTINUE THE TRADITION OF EXCELLENCE. THE HOSPITAL RESIDENTS AND INTERNS GET THE OPPORTUNITY TO TRAIN WITH SOME OF THE MOST HIGHLY QUALIFIED MEDICAL SPECIALISTS IN THE AREA, SHARING INSIGHT INTO THE LATEST CONCEPTS IN MEDICAL EDUCATION AND PATIENT CARE. DURING THE FISCAL YEAR 2014, 170 INTERNS, FELLOWS, AND RESIDENTS ROTATED THROUGH THE HOSPITAL. . 439338785 true false false true false false false false false false true false false false true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true false true false true 104 0 true 2749 true true true false false false false false false false false false X 18 18 true false false false false true false true true false false true true true true true true true true true true WV X X X DAVID M WARD SENIOR VPCFO 3045262000 1340 HAL GREER BOULEVARD HUNTINGTON WV 25701 X STEVEN L BURTON CHAIRMAN 2.0 0.0 X X CARLOYN BAGBY VICE-CHAIRMAN 2.0 0.0 X X BETH HAMMERS SECRETARY 2.0 0.0 X X GARY WHITE TREASURER 2.0 0.0 X X DAVID PORTER MD 2.0 0.0 X MARIAN COX 2.0 0.0 X TIM MILNE 2.0 0.0 X GERALD OAKLEY MD 2.0 0.0 X LARRY DIAL MD 2.0 0.0 X CLARA ROSE SADLER 2.0 0.0 X VICKIE SMITH 2.0 0.0 X JOE WERTHAMMER MD 2.0 0.0 X EDUARDO PINO MD 2.0 0.0 X CLARENCE MARTIN 2.0 0.0 X JOHN LANDERS 2.0 0.0 X RANDIE LAWSON 2.0 0.0 X ANTHONY STRADWICK 2.0 0.0 X JOHN LILLER 2.0 0.0 X PETER CHIRICO THRU JAN 2014 2.0 0.0 X FLOYD HARLOW THRU JAN 2014 2.0 0.0 X DAVID FOX THRU JAN 2014 2.0 0.0 X SAMUEL MOORE THRU JAN 2014 2.0 0.0 X BRENT MARSTELLER PRESIDENT & CEO 45.0 0.0 X 904679 0 108091 DAVID M WARD SR VP & CFO 45.0 0.0 X 381699 146717 HOYT BURDICK SR VP & MEDICAL AFFAIRS 45.0 0.0 X 368232 94620 GLEN WASHINGTON SR VP & COO 45.0 0.0 X 334036 65863 KEVIN FOWLER VP CLINICAL SERVICES 45.0 0.0 X 30331 5048 PAUL SMITH VP GENERAL COUNCIL 45.0 0.0 X 232869 121694 ROSEMARY SMITH VP NURSING SERVICES 45.0 0.0 X 227988 125420 BARRY TOURIGNY VP HUMAN RESOURCES 45.0 0.0 X 254585 56364 DAVID GRALEY VP CHH FOUNDATION 45.0 0.0 X 278407 61398 DENNIS LEE VP CIO 45.0 0.0 X 208426 26469 LISA CHAMBERLIN VP MARKETING & BUSINESS DEV 45.0 0.0 X 175359 25356 TIM MARTIN VP ANCILLARY & SUPPORT 45.0 0.0 X 173032 31648 JOANNE MCAULIFFETHRU 614 VP CNO 45.0 0.0 X 153719 18662 AHMET OZTURK ANESTHESIOLOGIST 45.0 0.0 X 552505 42018 REHAN MEMON THRU 1213 ANESTHESIOLOGIST 45.0 0.0 X 438688 MICHAEL VEGA ANESTHESIOLOGIST 45.0 0.0 X 413514 61303 ALFREDO RIVAS ANESTHESIOLOGIST 45.0 0.0 X 412368 63350 MICKEY NEAL ANESTHESIOLOGIST 45.0 0.0 X 395672 70236 5936109 0 1124257 191 false true false UNIVERSITY PHYSICIANS AND SURGEONS 1600 MEDICAL CENTER DRIVE HUNTINGTON WV 25701 MEDICAL SERVICES 27650988 BAILES CRAIG AND YON 401 TENTH STREET HUNTINGTON WV 25701 LEGAL SERVICES 1394158 RADIOLOGY INC PO BOX 910 HUNTINGTON WV 25712 RADIOLOGY SERVICES 732356 TRI-STATE REHABILITATION 224 BUCKSAW JUNCTION GRAYSON KY 41143 MEDICAL SERVICES 504735 IMRAN KHAWAJA MD 130 LESLIE PLACE SCOTT DEPOT WV 25560 MEDICAL SERVICES 483278 25 450000 450000 NET PATIENT REVENUE 621990 474160963 474160963 LABORATORY REVENUE 621500 11771623 11571776 199847 AEROMED INCOME 621990 -1129986 -1129986 484802600 4855355 -5818 4861173 0 0 395639 183333 212306 0 212306 212306 143706859 773711 133599918 0 10106941 773711 10880652 10880652 0 0 0 CAFETERIA 624200 1836401 1836401 OUTSIDE SERVICES 621990 1923936 1923936 OTHER REVENUE 621990 705110 34365 670745 4465447 505666360 486773360 864774 17578226 9528962 9528962 0 0 0 4833108 501989 4331119 0 142320129 127628212 14691917 17750789 15975710 1775079 31086446 27834035 3252411 10239466 9215519 1023947 0 1457105 1457105 183064 183064 0 0 596638 596638 67508018 60757216 6750802 4469086 4469086 2558830 2302947 255883 3415871 3074284 341587 0 21273540 15955155 5318385 590480 531513 58967 0 0 5420487 4065365 1355122 0 15273626 13746263 1527363 2754141 2478727 275414 BAD DEBT 44828770 44828770 MEDICAL SUPPLIES 72472307 72472307 PROVIDER TAX 9773062 9773062 UNRELATED BUSINESS INCOME 53905 53905 14145758 14145758 482533588 439338785 43194803 0 4377 4377 71282454 60339517 0 0 67243592 72339511 0 0 0 0 3700444 4778477 6030701 7434449 1706453 1926858 429576842 234022959 181586062 195553883 123706828 134938743 9013890 9049750 0 0 3631000 3650105 14421318 24054720 482327119 514070390 45481439 54304738 0 0 0 0 116934869 113241795 0 0 0 0 2676346 1746949 0 0 153092197 179607144 318184851 348900626 X 164142268 165169764 0 0 0 0 164142268 165169764 482327119 514070390 X 23132772 -1963744 -20141532 X X false true X true false X false false false false false false false false true 30139 30139 false PART II-B, LINE 1 THE ORGANIZATION IS A MEMBER OF THE WEST VIRGINIA HOSPITAL ASSOCIATION (WVHA), WHICH ENGAGES IN LOBBYING EFFORTS ON BEHALF OF ITS MEMBERS. A PORTION OF THE DUES PAID TO WVHA HAVE BEEN ALLOCATED TO LOBBYING ACTIVITIES, WHICH AMOUNTED TO $30,139. THIS ASSOCIATION PROVIDES BOTH ADVOCACY AND REPRESENTATION FOR ITS MEMBERS. SPECIFIC INFORMATION REGARDING THE ADVOCACY AGENDAS OF THE ASSOCIATION CAN BE VIEWED AT THEIR WEBSITE, WWW.WVHA.ORG. 6415591 6415591 200272330 45009317 155263013 193786871 187853249 5933622 29102050 1160393 27941657 195553883 0 ESTIMATED THIRD PARTY SETTLEMENTS 104215 DERIVATIVE FINANCIAL INSTRUMENT 12534048 ACCRUED POST RETIREMENT BENEFITS 148864857 ACCRUED PROFESSIONAL LIABILITIES 14704677 DEFERRED GAIN 3399347 179607144 X 437685569 -1963744 -66200380 -68164124 505849693 -183333 -183333 505666360 436658075 183333 183333 436474742 46058846 46058846 482533588 PART X, LINE 2 THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2014 AND 2013. THE CORPORATION'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS AS INTEREST EXPENSE AND PENALTIES AS OPERATING EXPENSES. PART XI, LINE 2D INCREASE IN PENSION LIABILITY INCLUDED ON AFS IS $-25,142,131. INVESTMENT MANAGEMENT FEES NETTED WITH REVENUE ON AFS IS $-596,638. BAD DEBTS NETTED WITH REVENUE ON AFS IS $-44,828,770. RENTAL INCOME RECLASSED TO RENTAL EXPENSES ON FORM 990 IS $37,307. CHANGE IN EFFECTIVE INTEREST RATE SWAP NETTED WITH REVENUE ON AFS IS $-268,945. NET ASSETS RELEASED FROM RESTRICTION $5,269,542. MANAGEMENT FEE REVENUE NETTED WITH EXPENSES IS $-670,745. PART XI, LINE 4B RENTAL EXPENSES NETTED WITH REVENUE ON FORM 990 IS $-183,333. PART XII, LINE 2D RENTAL EXPENSES NETTED WITH REVENUE ON FORM 990 IS $183,333. PART XII, LINE 4B INVESTMENT MANAGEMENT FEES NETTED WITH REVENUE ON AFS IS $596,638. BAD DEBTS NETTED WITH REVENUE ON AFS IS $44,828,770. RENTAL INCOME RECLASSED TO RENTAL EXPENSES ON FORM 990 IS $-37,307. MANAGEMENT FEE REVENUE NETTED WITH EXPENSES IS $670,745. true true true X true X true true false false 8724346 0 8724346 0.01810 140357423 91286529 49070894 0.10180 149081769 91286529 57795240 0.11990 107925 0 107925 0.00020 15752644 2719224 13033420 0.02710 28769072 27598397 1170675 0.00240 402240 63551 338689 0.00070 45031881 30381172 14650709 0.03040 194113650 121667701 72445949 0.15030 25000 0 25000 0.00010 50000 0 50000 0.00010 343721 0 343721 0.00070 62559 0 62559 0.00010 481280 0 481280 0.00100 false 15223850 2283577 100696961 128127054 -27430093 X true true OCCUMED LLC OCCUPATIONAL HLTH/URGENT CARE 0.68460 0.31540 HUNTINGTON SURGERY P REAL ESTATE/LEASE TO SURG CTR 0.44000 0.56000 1 1 CABELL HUNTINGTON HOSPITAL INC 1340 HAL GREER BOULEVARD HUNTINGTON WV 25701 X X X CABELL HUNTINGTON HOSPITAL INC 1 true X X X X X X X X 12 true false true X WWW.CHHI.ORG X X X X X X X X true false true true 100 true 350. true X X X X true true X X X true false true X false false 12 CABELL HUNTINGTON SURGERY CENTER 1201 HAL GREER BLVD HUNTINGTON WV 25701 OUTPATIENT SURGERY CENTER CABELL HUNTINGTON PAIN MANAGEMENT CENTER 1634 13TH AVENUE HUNTINGTON WV 25701 PAIN MANAGEMENT CLINIC CABELL BREAST HEALTH CENTER 1400 HAL GREER BLVD HUNTINGTON WV 25701 DIAGNOSTIC CENTER COOK EYE CENTER 1300 THIRD AVENUE HUNTINGTON WV 25701 OUTPATIENT CATARACT CLINIC WOMEN'S HEALTH 1660 TWELFTH AVENUE HUNTINGTON WV 25701 OB GYN OUTPATIENT CLINIC WOMEN'S & FAMILY MEDICAL CENTER 1115 20TH STREET HUNTINGTON WV 25701 FAMILY OUTPATIENT CLINIC FAMILY MEDICAL CENTER KENOVA 750 OAK STREET KENOVA WV 25430 FAMILY OUTPATIENT CLINIC CENTER FOR SURGICAL WEIGHT CONTROL 1115 20TH STREET HUNTINGTON WV 25701 BARIATRIC CENTER FAMILY MEDICAL CENTER MERRITTS CREEK 100 MEADOW POINTE BARBOURSVILLE WV 25504 FAMILY OUTPATIENT CLINIC CABELL PEDIATRICS 1115 20TH STREET HUNTINGTON WV 25701 PEDIATRIC CLINIC CABELL HUNTINGTON BALANCE CENTER 1616 13TH AVENUE HUNTINGTON WV 25701 BALANCE DISORDER CENTER FAMILY MEDICAL CENTER PROCTORVILLE 7718 COUNTY ROAD 107 SUITE 100 PROCTORVILLE OH 45669 FAMILY OUTPATIENT CLINIC PART I, LINE 7 A COST-TO-CHARGE RATIO WAS CALCULATED USING THE IRS WORKSHEET 2 TO CALCULATE THE PERCENTAGE OF COST. THE TOTAL OPERATING EXPENSES WERE TAKEN AND ADJUSTED FOR NON-PATIENT ACTIVITIES INCLUDING MEDICAID TAXES. 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 $44,828,769. PART II THE HOSPITAL'S COMMUNITY BUILDING ACTIVITIES, AS REPORTED IN PART II, PROMOTES THE HEALTH OF THE COMMUNITIES THE ORGANIZATION SERVES. DURING FY 2014, THE HOSPITAL COMMUNITY BUILDING ACTIVITIES REACHED OUT TO OVER 49,000 INDIVIDUALS WITHIN THE DIRECT COMMUNITIES SERVED. FUTURE ACTIVITIES ARE DETERMINED BASED UPON THE COMMUNITY NEEDS ASSESSMENT, REQUESTS FROM PUBLIC AGENCIES OR COMMUNITY GROUPS, AND OTHER FACTORS. THE HOSPITAL ALSO WELCOMES INPUT FROM THE COMMUNITIES AS TO WHICH EVENTS IT SHOULD PURSUE. THE HOSPITAL SEEKS TO PROVIDE OR FUND ACTIVITIES WITH THE FOLLOWING OBJECTIVES: IMPROVING ACCESS TO HEALTH SERVICES, ENHANCING PUBLIC HEALTH, RELIEVING GOVERNMENT BURDEN, MAKING HEALTHCARE AVAILABLE TO THE PUBLIC AND SERVICING LOW-INCOME CONSUMERS, ADDRESSING FEDERAL, STATE, OR LOCAL PUBLIC HEALTH PRIORITIES, AND LEVERAGING OR ENHANCING PUBLIC HEALTH DEPARTMENT ACTIVITIES. SOME OF THE SPECIFIC COMMUNITY BUILDING ACTIVITIES FUNDED BY THE ORGANIZATION INCLUDE HUNTINGTON AREA DEVELOPMENT COUNCIL WHICH PROMOTES NEW BUSINESS IN THE COMMUNITY. THE ORGANIZATION BELIEVES THE NEW BUSINESSES WILL EMPLOY THE PEOPLE IN THE COMMUNITY AND WILL PROVIDE BETTER HEALTHCARE BENEFITS, MARSHALL UNIVERSITY FOUNDATION CONTRIBUTIONS TO PROMOTE HIGHER EDUCATION AND HEALTHIER WELL-BEING, RONALD MCDONALD HOUSE TO HELP PROVIDE TEMPORARY HOUSING FOR PARENTS OF PEDIATRIC PATIENTS, PAUL AMBROSE WALKING TRAIL TO PROMOTE EXERCISE AND HEALTHY LIFESTYLES, EBENEZER MEDICAL OUTREACH PROGRAM TO ASSIST THOSE WHO CANNOT AFFORD NEEDED MEDICATIONS, CONTINUE HOUSING A FREE CLINIC TO SERVE THE COMMUNITY, HUNTINGTON'S KITCHEN TO PROMOTE HEALTHY EATING HABITS, AND CHILDREN'S PLAY PLACE TO PROVIDE A SAFE ENVIRONMENT FOR CHILDREN IN THE COMMUNITY TO EXERCISE. PART III, LINE 4 FINANCIAL STATEMENT FOOTNOTE: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS. CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATION TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE ORGANIZATION HAS DEMONSTRATED SUCCESSFUL RESULTS IN COLLECTING RECEIVABLES FOR PATIENTS WHO HAVE AGREED TO A PAYMENT PLAN, THESE AMOUNTS WILL REMAIN IN PATIENT ACCOUNTS RECEIVABLE AT THEIR ESTIMATED NET REALIZABLE AMOUNTS AND WILL BE EVALUATED AS PART OF MANAGEMENT'S ASSESSMENT OF THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. METHODOLOGY: THE COSTING METHOD USED FOR LINE TWO IS THE METHOD SUGGESTED IN THE INSTRUCTIONS FOR WORKSHEET 1, FINANCIAL ASSISTANCE AT COST IN THE INTERNAL REVENUE INSTRUCTIONS FOR FORM 990 SCHEDULE H. THIS METHOD CALCULATES A COST RATIO BY USING TOTAL OPERATING EXPENSES LESS BAD DEBT AND OTHER EXPENSE ADJUSTMENTS DIVIDED BY GROSS PATIENT REVENUES. THE RATIO IS THEN APPLIED TO BAD DEBT EXPENSE TO GET THE ESTIMATED COST. LINE THREE IS A PERCENTAGE DERIVED BY LOOKING AT THE HISTORICAL PERCENTAGES OF UNINSURED AND SELF INSURED PATIENTS IN OUR COMMUNITY SERVED. THIS PERCENTAGE IS A DECREASE FROM PRIOR YEAR DUE TO MORE PATIENTS SIGNING UP FOR MEDICAID DUE TO THE AFFORDABLE CARE ACT. THERE ARE A NUMBER OF PATIENTS THAT DO NOT APPLY FOR FINANCIAL ASSISTANCE AND ARE DEFINITELY UNABLE TO PAY FOR THEIR OUT OF POCKET MEDICAL EXPENSES. IF THESE PATIENTS WENT THROUGH THE FINANCIAL ASSISTANCE PROCESS, THEY WOULD QUALIFY. THESE PATIENTS STILL NEED TO BE TREATED AND THIS IS WHY THE ORGANIZATION BELIEVES THIS SHOULD BE TREATED AS A COMMUNITY BENEFIT. PART III, LINE 8 BECAUSE THE HOSPITAL IS A COMMUNITY BASED TEACHING HOSPITAL AND SERVES THE COMMUNITY WITHOUT REGARD TO ABILITY TO PAY, THIS AMOUNT SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE EXPENSES ALLOCATED TO THE MEDICARE REVENUE ARE DERIVED FROM THE MEDICARE COST REPORT AND ARE ALLOCATED TO CARRIER BY GROSS CHARGE RATIO AFTER THEY ARE ADJUSTED FOR COSTS ARE INCLUDED IN LINES 7F AND 7G. PART III, LINE 9B BECAUSE THE HOSPITAL IS A COMMUNITY BASED TEACHING HOSPITAL AND SERVES THE COMMUNITY WITHOUT REGARD TO ABILITY TO PAY, THIS AMOUNT SHOULD BE CONSIDERED A COMMUNITY BENEFIT. THE EXPENSES ALLOCATED TO THE MEDICARE REVENUE AND DERIVED FROM THE MEDICARE COST REPORT AND ARE ALLOCATED TO CARRIER BY GROSS CHARGE RATIO AFTER THEY ARE ADJUSTED FOR COSTS ARE INCLUDED IN LINES 7F AND 7G. PART V, SECTION B, LINE 3 AN ASSESSMENT SURVEY COLLECTED INFORMATION FROM CITIZENS IN EACH OF THE FOUR COUNTIES INCLUDED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA): CABELL, LAWRENCE (OHIO), LINCOLN, AND WAYNE. IT WAS POSTED ONLINE AND PAPER COPIES WERE DISTRIBUTED. KEY INFORMANTS WERE IDENTIFIED FROM THE FOUR COUNTY AREA THAT HAD CONSIDERABLE INVOLVEMENT IN THE COMMUNITY. SELECTED RESPONSES ARE INCLUDED FROM ONE-ON-ONE TELEPHONE INTERVIEWS WITH THE KEY INFORMANTS. THE KEY INFORMANTS WHOM THE HOSPITAL CONSULTED ARE AS FOLLOWS: CABELL HOSPITAL ADMINISTRATION, STATE GOVERNMENT COMMISSIONER FOR BUREAU FOR FAMILIES AND CHILDREN, RETIRED STATE HEALTH OFFICER, MARSHALL UNIVERSITY, DIRECTOR OF ORGANIZATIONAL DEVELOPMENT AND LEARNING, DIRECTOR OF MED SURGERY, DIRECTOR OF SPIRITUAL CARE, HOSPITAL SERVICES REPRESENTATIVE, ORTHOPEDIC SURGEON, SURGICAL ONCOLOGY, HOSPITAL BOARD MEMBERS, COMMUNITY ACTION ORGANIZATION REPRESENTATIVE, PRIMARY CARE PHYSICIAN, FAMILY RESOURCE NETWORK REPRESENTATIVE, BOARD OF EDUCATION, EXECUTIVE BEHAVIORAL HEALTH CENTER, WAYNE COUNTY COMMISSION MEMBER, WAYNE COUNTY ADMINISTRATORS, EMERGENCY MANAGER, AMONG OTHERS. PART V, SECTION B, LINE 20D THE HOSPITAL USES ONE RATE TO CHARGE ALL PATIENTS. THE PATIENTS THAT ARE ELIGIBLE FOR FINANCIAL ASSISTANCE (ESTABLISHED AFTER PROVIDING THE HOSPITAL WITH ALL INFORMATION REQUESTED ON APPLICATION) ARE THEN GIVEN A DISCOUNTED CHARGE BASED ON THE FINANCIAL ASSISTANCE POLICY. PART VI, LINE 2 THE HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES BY CONDUCTING ITS OWN NEEDS ASSESSMENT AND CONSULTING WITH HEALTHCARE PROVIDERS SUCH AS MARSHALL UNIVERSITY JOAN C EDWARDS SCHOOL OF MEDICINE AND VARIOUS COMMUNITY AGENCIES. A 2013 COMMUNITY NEEDS ASSESSMENT WAS CONDUCTED DURING THAT TAX YEAR. THE ASSESSMENT REPRESENTS THE COMMUNITY THE HOSPITAL SERVES WHICH INCLUDES CABELL, LINCOLN, AND WAYNE COUNTIES IN WV, AND LAWRENCE COUNTY IN OHIO. THE REPORT INCLUDES A COMPREHENSIVE REVIEW AND ANALYSIS OF DATA REGARDING THE HEALTH ISSUES AND NEEDS OF THESE COUNTIES. THE RESULTS OF THE ASSESSMENT ENABLE THE COUNTY PUBLIC HEALTH DEPARTMENTS, HEALTH SYSTEMS, AND OTHER PROVIDERS TO MORE STRATEGICALLY ESTABLISH PRIORITIES, DEVELOP INTERVENTIONS, AND COMMIT RESOURCES TO IMPROVE THE OVERALL HEALTH OF THESE COMMUNITIES. THE CURRENT NEEDS ASSESSMENT CAN BE FOUND ON THE HOSPITAL WEBSITE, HTTPS://CABELLHUNTINGTON.ORG. PART VI, LINE 3 THE HOSPITAL HAS INFORMATION ABOUT ITS CHARITY CARE POLICY AND APPLICATIONS AVAILABLE IN ALL REGISTRATION AREAS OF THE HOSPITAL AS WELL AS ITS OFFSITE LOCATIONS. THE HOSPITAL EMPLOYS FINANCIAL COUNSELORS WHO VISIT INPATIENTS IN ELIGIBLE FINANCIAL CLASSES TO PROVIDE INFORMATION ABOUT CHARITY CARE AS WELL AS RESPONDING TO INQUIRIES FROM OUTPATIENTS REGARDING CHARITY CARE AND PROVIDING ASSISTANCE WITH THE CHARITY CARE APPLICATION PROCESS. PATIENTS CAN COMMUNICATE WITH FINANCIAL COUNSELORS IN PERSON OR BY TELEPHONE, MAIL, OR FAX IN ORDER TO LEARN MORE ABOUT THE HOSPITAL'S CHARITY CARE POLICY AND OBTAIN INFORMATION REGARDING THEIR ELIGIBILITY FOR CHARITY CARE. THE HOSPITAL ALSO CONTRACTS WITH MEDICAID ELIGIBILITY SPECIALISTS TO ASSIST THOSE PATIENTS WHO QUALIFY FOR MEDICAID. INFORMATION ABOUT THE HOSPITAL'S CHARITY CARE POLICY AND PROCESS IS POSTED ON THE HOSPITAL'S WEBSITE, HTTPS://CABELLHUNTINGTON.ORG. PART VI, LINE 4 THE HOSPITAL IS LOCATED IN HUNTINGTON, CABELL COUNTY, WV. CABELL COUNTY IS LOCATED IN THE WESTERN PORTION OF WV AND IS BORDERED ON THE NORTHWEST BY OHIO AND ON THE SOUTHWEST BY KY (REGION REFERRED TO AS THE TRI-STATE AREA). HUNTINGTON IS ONE OF THE THREE METROPOLITAN CENTERS IN THE TRI-STATE AREA. DUE TO SPECIALIZED SERVICES SUCH AS ITS BURN UNIT, PEDIATRIC INTENSIVE CARE AND NEONATAL INTENSIVE CARE UNITS, THE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF CABELL, WAYNE, AND LINCOLN COUNTIES IN WV AND LAWRENCE COUNTY IN OHIO. ALL OF WHICH CONTAIN MEDICALLY UNDERSERVED AREAS AS DESIGNATED BY THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE HOSPITAL'S PRIMARY SERVICE AREA HAS A POPULATION OF OVER 220,800 AND APPROXIMATELY 65% OF THE TOTAL DISCHARGES ORIGINATE FROM THE PRIMARY SERVICE AREA. THE HOSPITAL'S SECONDARY SERVICE AREA, WHICH INCLUDES COUNTIES IN WV, EASTERN KY, AND SOUTHERN OHIO, ACCOUNTS FOR AN ADDITIONAL 27% OF DISCHARGES WITH THE REMAINING 8% COMING FROM OUTSIDE THE SERVICE AREA. ACCORDING TO OUR RECENT CHNA, 30.5% OF THE POPULATION IN THE PRIMARY SERVICE AREA IS 55 YEARS AND OLDER. THE AVERAGE MEDIAN HOUSEHOLD INCOME FOR THIS AREA IS APPROXIMATELY $35,500, WHILE APPROXIMATELY 21% OF THE POPULATION IS CLASSIFIED AS BEING AT THE POVERTY LEVEL BY THE US CENSUS BUREAU. THE UNEMPLOYMENT RATE IS APPROXIMATELY 8.9%. THE HOSPITAL IS AFFILIATED WITH THE MARSHALL UNIVERSITY JOAN C. EDWARDS SCHOOL OF MEDICINE AND ITS GRADUATE MEDICAL EDUCATION PROGRAMS, WHICH TRAINS PRIMARY CARE AND SPECIALTY PHYSICIANS FOR WV AND THE REGION. THE HOSPITAL'S AFFILIATION ALSO ENABLES IT TO PROVIDE SPECIALIZED HEALTHCARE SERVICES SUCH AS HIGH RISK OBSTETRICS, NEONATAL INTENSIVE CARE, PEDIATRIC INTENSIVE CARE, AND COMPREHENSIVE ONCOLOGY CARE. THE HOSPITAL ALSO SERVES AS A CLINICAL TRAINING SITE FOR A NUMBER OF HEALTH PROFESSION EDUCATION PROGRAMS, INCLUDING NURSING, PHARMACY, PHYSICAL & OCCUPATIONAL THERAPY, AND RADIOLOGICAL TECHNOLOGY. PART VI, LINE 5 THE HOSPITAL IS GOVERNED BY A COMMUNITY-BASED BOARD OF DIRECTORS THAT INCLUDES REPRESENTATIVES OF SMALL BUSINESSES, ORGANIZED LABOR, THE ELDERLY AND LOWER-INCOME CONSUMERS. IN COMPLIANCE WITH STATE LAW, A MAJORITY OF THE HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA, WHO ARE NEITHER EMPLOYEES, CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS. THEREOF THE HOSPITAL PROVIDES SPECIALIZED SERVICES NOT OTHERWISE AVAILABLE TO MEMBERS OF THE COMMUNITY, SUCH AS ITS NEONATAL AND PEDIATRIC SERVICES. THE HOSPITAL OPERATES AN EMERGENCY DEPARTMENT AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY AS NOTED ABOVE. THE HOSPITAL PARTICIPATES IN THE EDUCATION AND TRAINING OF HEALTHCARE PROFESSIONALS AND PROVIDES SUPPORT FOR MEDICAL RESEARCH CARRIED OUT BY MEDICAL SCHOOL FACULTY AND PHYSICIANS IN TRAINING. THE HOSPITAL PARTICIPATES IN GOVERNMENT-SPONSORED HEALTH PROGRAMS. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR ALL DEPARTMENTS. ANY SURPLUS OF FUNDS IS REINVESTED INTO REPLACEMENT OF EQUIPMENT OR NEW EQUIPMENT TO PROVIDE UPDATED SERVICES TO THE HOSPITAL'S PATIENTS OR TO PROVIDING NEW AND EXPANDED HEALTHCARE PROGRAMS. true EBENEZER MEDICAL OUTREACH CENTER 1448 TENTH AVENUE HUNTINGTON WV 25701 550745033 501(C)(3) 50004 FMV MEDICAL/PHARMACY OUTREACH HUNTINGTON YMCA 935 TENTH AVENUE HUNTINGTON WV 25701 550397261 501(C)(3) 37500 FMV KID'S IN MOTION PROGRAM MARSHALL UNIVERSITY ONE JOHN MARSHALL DRIVE HUNTINGTON WV 25701 556000789 501(C)(3) 9441458 FMV MEDICAL SCHOOL 3 0 SCHEDULE I, PART I, LINE 2 THE ORGANIZATION HAS THE FOLLOWING PLAN ESTABLISHED TO MONITOR THE USE OF THE GRANT FUNDS. THE GRANTS AND FINANCIAL ASSISTANCE PROVIDED BY THE HOSPITAL ARE APPROVED BY THE HOSPITAL'S BOARD AND THE CEO/PRESIDENT. THEY ARE APPROVED BASED ON THE NEEDS OF THE ORGANIZATION APPLYING FOR THEM AND HOW THEY WILL USE THE FUNDS RELATED TO THE HOSPITAL'S MISSION. THE GRANTS AND ASSISTANCE GIVEN TO MARSHALL UNIVERSITY ARE TO AID IN THE EDUCATIONAL MISSION OF THE HOSPITAL THROUGH THE INTERN AND RESIDENT PROGRAMS. ASSISTANCE IS GIVEN TO A COMMUNITY MEDICAL OUTREACH PROGRAM FOR HEALTH SERVICES AND A HEALTHY EATING PROGRAM THAT WAS BEGUN IN THE PREVIOUS YEAR. VARIOUS STAFF MEMBERS OF THE HOSPITAL REVIEW THE FINANCIAL INFORMATION GIVEN TO THEM AND REPORT BACK TO THE BOARD AND PRESIDENT/CEO. THE FUNDS DISPERSED FOR THIS ASSISTANCE IS REQUESTED WITH AN INVOICE AND CHECK REQUEST SIGNED BY THE APPROPRIATE HOSPITAL REPRESENTATIVE. SCHEDULE I, PART 1, LINE 1 AND 2 THE ORGANIZATION RESPONDS TO REQUESTS FOR ASSISTANCE FROM LEGITIMATE ORGANIZATIONS IN THE COMMUNITY THAT ARE KNOWN TO THE FILING ORGANIZATION. ELIGIBILITY IS BASED ON THE ORGANIZATIONS' MISSIONS (EDUCATION, HEALTHCARE, OR RELATED COMMUNITY BENEFITS), AND SELECTION IS BASED ON WHETHER THE FILING ORGANIZATION BELIEVES THE NEED FOR THE ASSISTANCE IS RESPONSIVE TO ITS MISSION. X true true X X X X X X false true false false false true false false false BRENT MARSTELLER PRESIDENT & CEO 537879 0 189420 177380 87573 20518 1012770 0 DAVID M WARD SR VP & CFO 313450 67073 1176 134600 12117 528416 HOYT BURDICK SR VP & MEDICAL AFFAIRS 317318 49876 1038 74102 20518 462852 GLEN WASHINGTON SR VP & COO 280752 52246 1038 45345 20518 399899 PAUL SMITH VP GENERAL COUNCIL 204077 27754 1038 110148 11546 354563 ROSEMARY SMITH VP NURSING SERVICES 198474 28338 1176 114140 11280 353408 BARRY TOURIGNY VP HUMAN RESOURCES 222038 31509 1038 36153 20211 310949 DAVID GRALEY VP CHH FOUNDATION 219880 57351 1176 41187 20211 339805 DENNIS LEE VP CIO 177226 30360 840 6258 20211 234895 LISA CHAMBERLIN VP MARKETING & BUSINESS DEV 174519 840 5145 20211 200715 TIM MARTIN VP ANCILLARY & SUPPORT 164138 8279 615 11437 20211 204680 JOANNE MCAULIFFETHRU 614 VP CNO 140507 12500 712 3483 15179 172381 AHMET OZTURK ANESTHESIOLOGIST 552109 396 21500 20518 594523 REHAN MEMON THRU 1213 ANESTHESIOLOGIST 438688 438688 MICHAEL VEGA ANESTHESIOLOGIST 413376 138 40785 20518 474817 ALFREDO RIVAS ANESTHESIOLOGIST 411132 1236 42832 20518 475718 MICKEY NEAL ANESTHESIOLOGIST 395276 396 49718 20518 465908 PART 1, LINE 1A THE ORGANIZATION PAID DUES TO GUYAN COUNTRY CLUB FOR THE MEMBERSHIP OF BRENT MARSTELLER. THIS WAS NOT CONSIDERED TAXABLE INCOME TO HIM. PART 1, LINE 4B A 457(F) PLAN EXISTS FOR EXECUTIVES OF THE ORGANIZATION. A PAYMENT OF $161,438 WAS MADE TO THE CEO DURING THE FISCAL YEAR. NO OTHER PAYMENTS OR ACCRUALS WERE MADE FROM THE PLAN. PART 1, LINE 6 A BONUS PLAN EXISTS FOR EXECUTIVES OF THE ORGANIZATION. DETAIL OF PAYMENTS MADE ARE DISCLOSED IN SCHEDULE J, PART II, COLUMN II. BONUSES ARE BASED ON MEETING MULTIPLE GOALS SET FORTH FOR EACH EXECUTIVE. BONUSES ARE ONLY ACCRUED AND PAID WHEN THE ORGANIZATION HAS NET INCOME. A WV HOSPITAL FINANCE AUTHORITY 2008 SERIES A 621256910 956622YU2 2008-10-16 48480000 REFUND SERIES 2004B BONDS false false false B WV HOSPITAL FINANCE AUTHORITY 2008 SERIES B 621256910 956622YU0 2008-10-16 48475000 REFUND SERIES 2004C BONDS false false false C WV HOSPITAL FINANCE AUTHORITY 2009 SERIES A 621256910 2009-01-27 14415000 REFUND TAXABLE DEBT false false false D THE CITY OF HUNTINGTON WV SERIES 2008 556000187 2008-12-30 9685000 HOSPITAL IMPROVEMENTS false false false A 2790000 0 48480000 0 0 0 806255 644009 0 0 0 0 true false true true B 4100000 0 48475000 0 0 0 0 0 0 0 0 0 true false true true C 2006840 0 14415000 0 0 0 127348 0 0 0 14287652 0 false false true true D 1459725 0 9685000 0 0 0 87796 0 0 9597204 0 0 false false true true A false false false false 0 false false false true B false false false false 0 false false false true C false false false false 0 false false false true D false false false false 0 false false false true A false true true true CITIBANK 25.8 false false false 0 false true B false true true true CITIBANK 25.8 false false false 0 false true C false true false false 0 false 0 false true D false true false false 0 0 false true A true B true C true D true A THE COUNTY COMMISSION OF CABELL CNTY SERIES 2009 556000305 2009-02-12 6500000 HOSPITAL IMPROVEMENTS false false false A 931086 0 6500000 0 0 0 62856 0 0 5384787 1052357 0 false false true true A false false false false 0 false false false true A false true false false 0 false 0 false true A true FORM 990, PART VI, SECTION A, LINE 2 PAUL SMITH, OFFICER, AND ROSEMARY SMITH, OFFICER, ARE MARRIED. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATIONS BYLAWS SPECIFICALLY ALLOW OUTSIDE ENTITIES TO APPOINT INDIVIDUALS TO THE BOARD OF DIRECTORS. THE MAYOR OF THE CITY OF HUNTINGTON CAN APPOINT THREE MEMBERS, THE CABELL COUNTY COMMISSION CAN APPOINT THREE MEMBERS, AND THE ORGANIZED LABOR UNION CAN APPOINT TWO MEMBERS. THE CHAIRMAN OF THE BOARD MAY ALSO APPOINT FOUR DIRECTORS WITH MAJORITY APPROVAL OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE FORM 990 IS REVIEWED BY DREW HEFNER, DIRECTOR OF FINANCIAL DECISION SUPPORT, BARBARA GUNN, FINANCIAL MANAGER, MONTE WARD, CFO, PAUL SMITH, GENERAL COUNSEL, AND JIM BAILES, ATTORNEY. THE FINAL COPY OF FORM 990 IS APPROVED BY THESE INDIVIDUALS AND THEN SENT TO THE BOARD MEMBERS FOR THEIR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C IN THE FALL OF EACH YEAR, OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE SENT AN ANNUAL QUESTIONNAIRE ADDRESSING THE CONFLICT OF INTEREST POLICY. EACH COMPLETED QUESTIONNAIRE IS REVIEWED BY THE VICE PRESIDENT OVER THE RESPECTIVE INDIVIDUAL'S DEPARTMENT AND GENERAL COUNSEL TO DETERMINE IF A CONFLICT EXISTS. IF A CONFLICT DOES EXIST, AN IN-DEPTH ANALYSIS IS PERFORMED TO DETERMINE ANY IMPACT TO THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS OF THE ORGANIZATION HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION POLICY SETTING FORTH THE BOARD PHILOSOPHY WITH RESPECT TO THE COMPENSATION OF ITS OFFICERS. A COMPENSATION COMMITTEE COMPRISED OF BOARD MEMBERS HAS BEEN DELEGATED THE RESPONSIBILITY FOR ESTABLISHING COMPENSATION OF THE CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, AND CHIEF MEDICAL OFFICER OF THE ORGANIZATION IN KEEPING WITH THE PHILOSOPHY ESTABLISHED BY THE BOARD. THE COMPENSATION COMMITTEE HAS ENGAGED THE OUTSIDE CONSULTING FIRM OF YAFFE AND ASSOCIATES, A FIRM WHICH SPECIALIZES IN ANALYZING NON-PROFIT EXECUTIVE COMPENSATION. THE OUTSIDE CONSULTING FIRM PERIODICALLY PROVIDES THE COMMITTEE WITH RELEVANT DATA CONCERNING THE COMPENSATION LEVELS OF EXECUTIVES OF HOSPITALS SIMILAR IN SIZE TO THE ORGANIZATION AND IN COMPARABLE GEOGRAPHIC AREAS. THE COMPENSATION COMMITTEE CONSIDERS THIS DATA TOGETHER WITH THE EXTENT TO WHICH PRE-ESTABLISHED GOALS HAVE BEEN ACCOMPLISHED AND THE FINANCIAL PERFORMANCE OF THE HOSPITAL AND ESTABLISHES THE COMPENSATION LEVEL FOR THE CHIEF EXECUTIVE OFFICER. THIS INFORMATION, AS WELL AS THE RECOMMENDATION OF THE CHIEF EXECUTIVE OFFICER IS CONSIDERED BY THE COMPENSATION COMMITTEE IN ESTABLISHING THE COMPENSATION OF THE CHIEF OPERATION OFFICER, CHIEF FINANCIAL OFFICER, AND CHIEF MEDICAL OFFICER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST THROUGH THE IN-HOUSE GENERAL COUNSEL'S OFFICE. THE FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990, AND THUS, CAN BE ALSO FOUND ON GUIDESTAR. FORM 990, PART IX, LINE 11G OUTSIDE PHYSICIANS FEES $30,442,699; MISCELLANEOUS MEDICAL CONSULTING $27,152,625; COLLECTION SERVICES $1,488,076; ANESTHESIA MANAGEMENT $1,332,442; VARIOUS OUTSIDE LABOR $7,092,176 FORM 990, PART XI, LINE 9 INCREASE IN PENSION LIABILITY $-25,142,130; CHANGE IN EFFECTIVE INTEREST RATE SWAP $-268,945; AND NET ASSETS RELEASED FROM RESTRICTIONS $5,269,543. FORM 990, PART XII, LINE 2C THIS PROCESS REMAINS UNCHANGED FROM THE PRIOR YEAR. 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