2014-05-13T09:27:59-05:00 2013-06-30 550486667 Arnett Foster Toothman PLLC P O Box 2629 Charleston WV 25329 990 2012-07-01 550387249 Weirton Medical Center Inc WEIR 3047976000 601 Colliers Way Weirton WV 260625014 Robert Frank 3047976000 2014-05-08 1 Dale Carpenter P00189642 3043460441 2012 2015-11-30 17:44:51Z Weirton Medical Center Charles O'Brien 601 Colliers Way Weirton WV 260625014 135562474 0 X www.weirtonmedical.com X 1949 WV Weirton Medical Center, in partnership with physicians, will lead the tri-state area in the provision of coordinated, safe, effective, quality healthcare services through a process of teamwork, innovation, and continuous improvement. 11 10 1364 62 7272 0 833695 169014 88606006 109766031 1809696 1367345 862430 1580873 92111827 112883263 0 0 0 0 50194205 56066317 0 0 0 51986697 55394342 102180902 111460659 -10069075 1422604 75258936 75688844 63629181 58961964 11629755 16726880 Weirton Medical Center, in partnership with physicians, will lead the tri-state area in the provision of coordinated, safe, effective, quality healthcare services through a process of teamwork, innovation, and continuous improvement. 0 0 105085663 109766031 The medical center provided inpatient, outpatient, emergency, psychiatric, home health, physician and skilled nursing services including 31,948 inpatient days, 185,859 outpatient visits, 38,181 emergency room visits and 9,438 home health visits. Charges foregone for charity amounted to $1,797,155. 119917 Abeyance reduction program including 55 programs at local schools, businesses, churches and in-house designed to provide community benefits including health fairs, BPW and laboratory blood analysis, health clinics, cholesterol screening, presentation to WV HFMA, and other health related events. 105205580 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 98 0 1 1364 1 1 1 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Kellie Henwood 3047976440 601 Colliers Way Weirton WV 26062 Charles M O'Brien Jr 40.00 16.00 X X 166750 0 0 Robert Frank 40.00 X 246436 0 0 Sherry Zisk 40.00 X 229473 0 17258 James R Shockley 10.00 10.00 X 0 0 0 Michael Wehr 4.00 4.00 X 0 0 0 John J York 4.00 X 0 0 0 Jon M Rogers 8.00 10.00 X 0 0 0 Richard Ajayi 8.00 8.00 X 0 0 0 William R Kiefer 2.00 2.00 X 0 0 0 Art L Miser Jr 2.00 2.00 X 0 0 0 David L Snyder 4.00 4.00 X 0 0 0 John A Spadafora 2.00 X 0 0 0 Sondra Weigel 2.00 X 0 0 0 Stephen Alatis 40.00 X 698561 0 17980 Keith Bravo 40.00 X 533698 0 24914 Criag Oser 40.00 X 386763 0 6675 Lisa Noble 40.00 X 276227 0 6659 Patricia Murphy 40.00 X 280050 0 0 2817958 0 73486 31 0 1 0 Siemans Medical Solutions Inc PO Box 12001 Dept 0733 Dallas TX 75312 Equipment maintenance and staff 3638778 R & V Associates 310 Grant St Suite 1120 Pittsburgh PA 15219 Contracted administrative services 1183015 Pharmacy Systems Inc PO Box 130 Dublin OH 43017 Contracted pharmacists 943450 Central Blood Bank Five Parkway Center Pittsburgh PA 15220 Lab 601259 Executive Health Resources Inc PO Box 822688 Philadelphia PA 19182 Consulting agency 371565 32 114214 54800 169014 Health care services 622110 109766031 109766031 109766031 351427 351427 379277 0 379277 379277 379277 23695129 22630007 49204 1065122 -49204 1015918 1015918 Premier K-1 income 900099 583685 7272 576413 Cafeteria & Vending Income 722100 488108 488108 Telephone 900099 32085 32085 97718 97718 1201596 112883263 109766031 7272 2940946 X 727949 679832 48117 42775008 39947580 2827428 1290467 1205167 85300 8349744 7797826 551918 2923149 2729929 193220 704385 704385 38745 38745 27140 27140 14775032 13835716 939316 3905714 3647546 258168 1687055 1575541 111514 138404 129255 9149 1139636 1064306 75330 3001921 2803494 198427 647902 605076 42826 Medical supplies 14093145 14093145 Bad debts 10081745 10081745 Health care provider ta 3004296 3004296 Sales taxes 1349489 1260288 89201 799733 744838 54895 111460659 105205580 6255079 0 9202406 643357 10223703 9870788 100931 0 1084312 1172862 1579688 1656141 105260935 78494650 20451661 26766285 26700986 29034110 1777475 4201605 4137774 2343696 75258936 75688844 15130900 16878577 22386333 0 7075646 26796620 19036302 15286767 63629181 58961964 X 11629755 16726880 11629755 16726880 75258936 75688844 X 1422604 -147083 3821604 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 124015 124015 53335070 38825640 14509430 211247 211247 0 45286250 36975544 8310706 6304353 2482219 3822134 26766285 Premier 2230000 C All About Women 619006 C Masico 150000 C Purewal 100000 C Mannino 50000 C Stateline Cardia 1052599 C 4201605 Estimated third-party settlements 1024211 Estimated malpractice liability 3358113 Accrued pension liability 10904443 15286767 102797925 0 102797925 10085338 10085338 112883263 101375321 0 101375321 10085338 10085338 111460659 Part XI, Line 4b - Other Adjustments: Bad debts netted against revenue on financials 10,081,745. Interest expense netted with revenue on financials 3,593. Part XII, Line 4b - Other Adjustments: Bad debts netted against revenue on financials 10,081,745. Interest expense netted with revenue on financials 3,593. 1 1 X 1 X 1 X 1 1 0 1 1 1532327 1532327 0.01510 16181491 12030975 4150516 0.04090 17713818 12030975 5682843 0.05600 71001 5235 65766 0.00060 1904037 1008633 895404 0.00880 1975038 1013868 961170 0.00940 19688856 13044843 6644013 0.06540 0 3465096 23690344 23870280 -179936 X 1 0 1 1 Weirton Medical Center

601 Colliers Way Weirton WV 260625014

X X X Weirton Medical Center 1 0 1 X X X X X 1 1 200.000000000000 1 300.000000000000 1 X X X X X X X 1 1 X X X X X X 1 0 X X X X 1 0 0 Part I, Line 3c: Weirton Medical Center is required by law to give a reasonable amount of services without charge to eligible persons who cannot afford to pay for care. Eligibility for financial assistance is based upon U.S. Citizenship and the U.S. Government's Federal Poverty Guidelines. These guidelines are updated each year. A person may qualify for financial assistance if their household income is at or below 300% of the current guidelines. Part I, Line 7: The cost of charity care was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions. The unreimbursed cost of Medicaid was estimated using a cost to charge ratio derived from Worksheet 2 of the 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 $ 10081745. Community Benefit Report Availability Schedule H, Part I, Line 6b The Organization makes its community benefit report available through the WVHCA and its website. The report is also available upon request. Part III, Line 4: Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectible accounts. In evaluating the collectability of accounts receivable, the Medical Center analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. 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. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Medical Center records a provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. 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 does not consider the shortfall reported in Medicare revenue to be community benefits since some years have shortfalls and others have overages. The unreimbursed cost of Medicare was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H Instructions. Part III, Line 9b: There is no collection from patients who qualify for charity care. If a patient qualifies, they receive no bill. Late filing of Community Health Needs Assessment Part V, Section B, Line 1 Weirton Medical Center was late filing its Community Health Needs Assessment as defined by code section 501(r)-3. This memo outlines the factors contributing to the late filing and the corrective actions taken by the Hospital. The Hospital engaged the accounting firm of Arnett Foster Toothman, PLLC (AFT) to assist with the preparation of their Community Health Needs Assessment in March 2013. Work on the CHNA began immediately and substantial progress was made in April, May and June towards the completion of the CHNA. There were challenges in obtaining demographic and patient utilization data because the Hospital, located in Weirton, West Virginia is also adjacent to the states of Ohio and Pennsylvania. Obtaining demographic and patient utilization data from those states was much more difficult than from the home state of West Virginia. At, or around, June 30, 2013, the actual due date of the CHNA filing there was a misunderstanding of the due date by the firm AFT resulting from language in the Proposed Rules dated April 2013. Eventually, the information needed to finish the CHNA was obtained and the final report was completed and approved by the Board of Directors in December 2013, as was the adoption of an implementation strategy to meet the community health needs identified in the CHNA. The CHNA was filed (made widely available) by including it on the Hospital's website in early January 2014. The Hospital's 990 tax return is under its second extension until May 15, 2014. The Hospital has taken corrective action by completing and filing the CHNA, as well as adopting the implementation strategy. It has also adopted a Corrective Action Plan that included many initiatives that were underway prior to June 30, 2013.In accordance with Notice 2014-3 and through discussion with its author, the Hospital has self-corrected the deficiencies as outlined above without being contacted by the Internal Revenue Service. The Hospital believes the deficiencies to be minor and inadvertant and, therefore, would not be considered to be egregious. As a result of the process, the Hospital is now aware of the practices and procedures necessary to eliminate any future deficiencies. The Hospital believes the deficiencies had no effect on affected persons and that once the deficiencies were discovered, which was in November 2013, efforts were made to make timely corrections as described above. Based upon the above discussion, the Hospital believes it would not be subject to the excise tax under IRS Code Section 4959 and has not filed Form 4720. Part VI, Line 2: Weirton Medical Center conducts a community health needs assessment of the residents of its service area every three years. The assessment results are tabulated and analyzed to determine the health needs. The health needs are then prioritized and a plan is developed to address the needs. Part VI, Line 3: A charity care policy is posted at all registration areas. All patients are seen or called by the financial counselors and/or the Customer Service Department to determine what services can be offered. The patients are screened for charity care and provided education about the state Medicaid application. Part VI, Line 4: Weirton Medical Center serves the counties of Brooke and Hancock in West Virginia, and portions of Washington County in Pennsylvania and Jefferson County in Ohio.Brooke County, West Virginia had a 2014 projected population of 18,564. The median age is 40.6 years and 18.7 percent of the population is age 65 or older. The median household income is $43,361. The December 2011 unemployment rate was 10.2 percent. Brooke County residents make up 26.9 percent of the Medical Center's total patient volume.Hancock County, West Virginia had a 2014 projected population of 31,594. The median age is 44.6 and 20.0 percent of the population is age 65 or older. The median household income is $44,478 and 10.6 percent of the population was unemployed in December 2011. Hancock County residents make up 35.7 percent of the Medical Center's total patient volume.Jefferson County, Ohio had a 2014 projected population of 67,320 with a median age of 45.0 years. The percentage of population that is 65 years or older is 19.5 percent. The median household income is $43,471. The December 2011 unemployment rate was 10.6 percent. Jefferson County residents make up 19.4 percent of the Medical Center's total patient volume.The total service area population was 107,207 in 2009 and is projected to be 102,362 in 2014 - a decline of 4.5 percent. The region is also served by Trinity Health System in Steubenville, Ohio. Patients from the area also use Wheeling Hospital, Ohio Valley Medical Center in Wheeling, and Washington Hospital in Washington, Pennsylvania. Patients also seek medical care from tertiary hospitals located in Pittsburgh, Pennsylvania. Part VI, Line 5: 1. All members of the Weirton Medical Center's governing board reside within its service area. Two of the board members are contractors of the organization. The current president of the medical staff, who has a two year tenure, has a seat on the board by virtue of this office and is employed by a contractor with the hospital. There are no family members on the governing board. 2. The organization extends privileges to all qualified physicians in its community; three departments have granted exclusivity to physician groups. 3. If there are surplus funds, the organization, based on its priorities and identified needs, may elect to use those for new clinical programs, the acquisition of new or replacement equipment or other specific purposes. Management recommends such initiatives to the board for approval. The organization does not conduct medical education or research.4. Weirton Medical Center operates a 24 hour, seven day a week emergency room available to all, regardless of ability to pay.5. During 2013 Weirton Medical Center operated an inpatient geriatric-psychiatric unit that was not available elsewhere in the surrounding communities.6. Weirton Medical Center does not actively solicit charitable support; rather the Weirton Medical Center Foundation, a related entity, supports the hospital in its pursuit of a strong, healthy community, by engaging in fundraising activities and providing direct and supplemental funding to Weirton Medical Center. Weirton Medical Center benefits from a strong volunteer program whose members provide approximately 16,000 annual hours of assistance to the organization. Weirton Medical Center also provides numerous community classes and screenings, some of which benefit from volunteer participation.7. On the Weirton Medical Center website there is a link to its Community Benefits Report. 1 X X X X 1 0 0 0 0 0 0 0 0 Charles M O'Brien Jr 166750 0 0 0 0 0 0 0 0 0 166750 0 0 0 Robert Frank 246436 0 0 0 0 0 0 0 896 0 247332 0 0 0 Sherry Zisk 229473 0 0 0 0 0 0 0 18842 0 248315 0 0 0 Stephen Alatis 698561 0 0 0 0 0 0 0 18220 0 716781 0 0 0 Keith Bravo 533698 0 0 0 0 0 0 0 26498 0 560196 0 0 0 Criag Oser 386763 0 0 0 0 0 0 0 6915 0 393678 0 0 0 Lisa Noble 276227 0 0 0 0 0 0 0 7019 0 283246 0 0 0 Patricia Murphy 280050 0 0 0 0 0 0 0 957 0 281007 0 0 0 Part I, Line 4a The former CEO, Dr. Endrich received a $227,532.02 severance payment. Form 990, Part VI, Section A, line 6 Weirton Medical Corporation, Inc., a nonprofit corporation organized under the laws of the State of West Virginia, is the sole member of Weirton Medical Center, Inc. Form 990, Part VI, Section A, line 7a The Hospital's board of directors is elected by its sole member, Weirton Medical Corporation, Inc. Form 990, Part VI, Section B, line 11 The 990 is reviewed by the Finance Director, the CFO and the board of directors before approval is given and it is submitted to the IRS. Form 990, Part VI, Section B, line 12c The board and medical staff executive are required to complete conflict of interest statements annually. The compliance committee oversees the process. Form 990, Part VI, Section B, line 15 A board designated compensation committee is utilized not only for the CEO but for all of senior management. Comparability data is obtained through the Director of Human Resources and a performance evaluation is completed. Form 990, Part VI, Section C, line 19 The financial statements are available through the West Virginia Health Care Authority as part of the freedom of information act/sunshine laws and are also published in the legal section of the newspaper annually. The governing documents, conflict of interest policy and financial statements are available upon request. Other Fees Form 990, Part IX, line 11g Security: Program service expenses 192,863. Management and general expenses 13,651. Fundraising expenses 0. Total expenses 206,514. Cost review: Program service expenses 119,621. Management and general expenses 8,467. Fundraising expenses 0. Total expenses 128,088. Collections: Program service expenses 60,712. Management and general expenses 4,297. Fundraising expenses 0. Total expenses 65,009. Service contract: Program service expenses 3,906,162. Management and general expenses 276,472. Fundraising expenses 0. Total expenses 4,182,634. Miscellaneous service: Program service expenses 8,828,966. Management and general expenses 624,901. Fundraising expenses 0. Total expenses 9,453,867. Consulting: Program service expenses 162,880. Management and general expenses 11,528. Fundraising expenses 0. Total expenses 174,408. Physician fees: Program service expenses 564,512. Management and general expenses 0. Fundraising expenses 0. Total expenses 564,512. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Defined benefit pension plan adjustment 3,821,604. Weirton Medical Center Foundation 601 Colliers Way Weirton WV 26062 550689248 Supporting organization WV 501(c)(3) 11 Weirton Medical Corporation 0 Weirton Medical Corporation 601 Colliers Way weirton WV 26062 550689267 Supporting organization WV 501(c)(3) 11, Type II N/A 0 All About Women Health Associates Inc 651 Colliers Way Box 300 Weirton WV 26062 562356850 Office of physicians WV Weirton Medical Center Inc C -105634 62881 1.00000 1 WMC Physician Practices Inc 601 Colliers Way Weirton WV 26062 461883875 Office of physicians WV Weirton Medical Center Inc C -491528 299695 1.00000 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 All About Women Health Associates Inc D 60000 FMV - Cash WMC Physician Practices Inc B 300000 FMV - Cash WMC Physician Practices Inc D 226644 FMV - Cash