CAMDEN-CLARK PHYSICIAN CORPORATION: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- CAMDEN-CLARK PHYSICIAN CORPORATION (EIN 26-4058719)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-13
- IRS object ID
- 201101339349303765
- Schema version
- 2009v1.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-13T13:42:31-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1747 | AddressLine1 |
| City | CHARLESTON | City |
| State | WV | State |
| ZIP Code | 25326 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264058719 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAMDEN-CLARK PHYSICIAN CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CAMD | NameControl |
| Phone | 3044242202 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 GARFIELD AVENUE | AddressLine1 |
| City | PARKERSBURG | City |
| State | WV | State |
| ZIP Code | 26102 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ALLEN BUTCHER | Name |
| Title | CFO | Title |
| Phone | 3044242202 | Phone |
| Date Signed | 2011-05-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RICK SLATER | Name |
| Phone | 3043430168 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | X | InitialReturn |
| Name Of Principal Officer Person | ALLEN BUTCHER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 GARFIELD AVENUE | AddressLine1 |
| City | PARKERSBURG | City |
| State | WV | State |
| ZIP Code | 26102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5241904 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.CCMH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2008 | YearFormation |
| State Legal Domicile | WV | StateLegalDomicile |
| Activity Or Mission Description | TO SUPPORT, MANAGE, AND FURNISH FACILITIES, PERSONNEL, AND MEDICAL SERVICES TO INDIVIDUALS IN NEED. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 47 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 5161852 | ProgramServiceRevenueCY |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 80052 | OtherRevenueCurrentYear |
| Total Revenue Current Year | 5241904 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 6731222 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expenses Current Year | 1622398 | OtherExpensesCurrentYear |
| Total Expenses Current Year | 8353620 | TotalExpensesCurrentYear |
| Revenues Less Expenses CY | -3111716 | RevenuesLessExpensesCY |
| Total Assets EOY | 1325297 | TotalAssetsEOY |
| Total Liabilities EOY | 1263237 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances EOY | 62060 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE GENERAL PURPOSES OF THE CORPORATION ARE AS FOLLOWS: TO ESTABLISH, SUPPORT, MANAGE, AND FURNISH FACILITIES, PERSONNEL, AND SERVICES TO PROVIDE DIAGNOSTIC, THERAPEUTIC, WELLNESS, HEALTH PROMOTION, SURGICAL, AND OTHER PROFESSIONAL MEDICAL SERVICES TO SICK, INJURED, OR DISABLED PERSONS WITHOUT REGARD TO RACE, CREED, COLOR, SEX, NATIONAL ORIGIN, OR FINANCIAL STATUS, AND TO OTHERWISE PROMOTE THE QUALITY, ACCESSIBILITY, AND AFFORDABILITY OF SUCH PROFESSIONAL MEDICAL SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 8039021 | Expense |
| Revenue | 5553045 | Revenue |
| Description | CAMDEN-CLARK PHYSICIAN CORPORATION CARRIED ON ACTIVITIES RELATED TO RENDERING PROFESSIONAL MEDICAL SERVICES TO THE SICK, INJURED, AND DISABLED AS JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS AND OTHER RESOURCES THAT WERE MADE AVAILABLE TO THE CORPORATION. THEY MANAGED, OPERATED, AND PARTICIPATED, SO FAR AS CORPORATION POLICIES, CIRCUMSTANCES, AND AVAILABLE RESOURCES WARRANTED, IN ACTIVITIES DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF PERSONS WITHIN CORPORATION'S SERVICE AREA. THEY HAVE MANY LOCATIONS WHERE SUCH SERVICES WERE PERFORMED: 1) WITHIN CAMDEN-CLARK MEMORIAL HOSPITAL, 2)WITHIN MEDICAL OFFICE BUILDING A, B, AND C OF CAMDEN-CLARK MEMORIAL HOSPITAL, AND 3) WITHIN SERVICE CLINICS OUTSIDE OF CAMDEN-CLARK MEMORIAL HOSPITAL BUT WITHIN THE CORPORATION'S SERVICE AREA. | Description |
| Total Program Service Expense | 8039021 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 9 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 47 | NumberOfEmployees |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WV | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRIAN STANDLEY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3044242202 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 GARFIELD AVENUE | AddressLine1 |
| City | PARKERSBURG | City |
| State | WV | State |
| ZIP Code | 26102 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| KATHY G EDDY | ||||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | ||
| TERRY CAPEL | ||||||||
| VICE CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | ||
| DANIEL MCGRAW | ||||||||
| BOARD MEMBER - SEE SCH. O | 40.00 | X | 361344 | 573578 | 13227 | |||
| JOE CAMPBELL | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| MICHAEL KING | ||||||||
| EX OFFICIO | 5.00 | X | 0 | 617776 | 64855 | |||
| ALLEN BUTCHER | ||||||||
| CFO/TREASURER | 5.00 | X | 0 | 365947 | 29383 | |||
| JASON LANDERS | ||||||||
| DIRECTOR/SECRETARY | 40.00 | X | 43766 | 53472 | 6132 | |||
| SHANE PARMER | ||||||||
| PHYSICIAN | 40.00 | 191837 | 169845 | 15233 | X | |||
| LISA CASALENUOVO | ||||||||
| PHYSICIAN | 40.00 | 180599 | 263092 | 11688 | X | |||
| JOSEPH DARROW JR | ||||||||
| PHYSICIAN | 40.00 | 234367 | 260584 | 4295 | X | |||
| GABOR ALTDORFER | ||||||||
| PHYSICIAN | 40.00 | 234290 | 260968 | 4289 | X | |||
| CHRISTOPHER BAILEY | ||||||||
| PHYSICIAN | 40.00 | 140375 | 0 | 2425 | X | |||
| TUAN NGUYEN | ||||||||
| PHYSICIAN | 40.00 | 139297 | 156769 | 3908 | X | |||
| JOSPEH BOGGS | ||||||||
| PHYSICIAN | 40.00 | 108937 | 0 | 2159 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1634812 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2722031 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 157594 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ALLSCRIPTS LLC | |||||
| 24630 NETWORK PLACE | CHICAGO | IL | 60673 | ELECTRONIC RECORD SOFTWARE | 178466 |
| THE CHARLES SCHWAB TRUST COMPANY | |||||
| 12401 RESEARCH BLVD BLDG 2 | AUSTIN | TX | 78759 | PENSION TRUSTEE | 122693 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT REVENUE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 5161852 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5161852 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5161852 | TotalProgramServiceRevenue |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 80052 | TotalRevenueColumn |
| Related Or Exempt Function Income | 80052 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 80052 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5241904 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5241904 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1709518 | Total |
| Program Services | 1656164 | ProgramServices |
| Management And General | 53354 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4134317 | Total |
| Program Services | 3980955 | ProgramServices |
| Management And General | 153362 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 259900 | Total |
| Program Services | 246905 | ProgramServices |
| Management And General | 12995 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 418891 | Total |
| Program Services | 397946 | ProgramServices |
| Management And General | 20945 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 208596 | Total |
| Program Services | 198166 | ProgramServices |
| Management And General | 10430 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 321268 | Total |
| Program Services | 305205 | ProgramServices |
| Management And General | 16063 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 146 | Total |
| Program Services | 139 | ProgramServices |
| Management And General | 7 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 190169 | Total |
| Program Services | 180661 | ProgramServices |
| Management And General | 9508 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 274355 | Total |
| Program Services | 260637 | ProgramServices |
| Management And General | 13718 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8603 | Total |
| Program Services | 8173 | ProgramServices |
| Management And General | 430 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75713 | Total |
| Program Services | 71927 | ProgramServices |
| Management And General | 3786 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 348499 | Total |
| Program Services | 331074 | ProgramServices |
| Management And General | 17425 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PROVISION FOR BAD DEBTS | 352125 | 352125 | |
| TAXES AND LICENSES | 20807 | 19767 | 1040 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30713 | Total |
| Program Services | 29177 | ProgramServices |
| Management And General | 1536 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8353620 | Total |
| Program Services | 8039021 | ProgramServices |
| Management And General | 314599 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 146038 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 648378 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 732597 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 234847 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 497750 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 33131 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 1325297 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 1263237 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 1263237 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 62060 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 62060 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 1325297 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 732597 | OtherCostOrOtherBasis |
| Depreciation | 234847 | Depreciation |
| Book Value | 497750 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 497750 | TotalOfBookValueLandBuildings |
| Total Revenue | 5241904 | TotalRevenue |
| Total Expenses | 8353620 | TotalExpenses |
| Excess Or Deficit For Year | -3111716 | ExcessOrDeficitForYear |
| Other | $3,173,776 | OtherAmount |
| Total Adjustments | 3173776 | TotalAdjustments |
| Excess Or Deficit Per FS | 62060 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 8415680 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 3173776 | OtherRevenues |
| Revenue Not Rptd F990 | 3173776 | RevenueNotRptdF990 |
| Revenue Subtotal | 5241904 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 5241904 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 8353620 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 8353620 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 8353620 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part XI, Line 8 - Other Adjustments: | TRANSFERS FROM CAMDEN-CLARK MEMORIAL HOSPITAL: 3173776. |
| Part XII, Line 2d - Other Adjustments: | TRANSFERS FROM CAMDEN-CLARK MEMORIAL HOSPITAL |
| PART X, LINE 2: EFFECTIVE JULY 1, 2009, THE ORGANIZATION ADOPTED THE FINANCIAL ACCOUNTING STANDARDS BOARD'S ("FASB") AUTHORITATIVE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR THE RECOGNITION AND MEASUREMENT OF THE BENEFITS OF INDIVIDUAL TAX POSITIONS IN THE FINANCIAL STATEMENTS. TAX POSITIONS MUST MEET A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT IN ORDER FOR THE BENEFIT OF THOSE TAX POSITIONS TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS EXIST AS OF JUNE 30, 2010, AND THE ADOPTION OF THE GUIDANCE DID NOT HAVE A MATERIAL EFFECT ON THE FINANCIAL POSITION OR RESULTS OF OPERATIONS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DANIEL MCGRAW | |||||||||||||
| 354234 | 565659 | 0 | 0 | 7110 | 7919 | 0 | 11122 | 1058 | 1047 | 362402 | 585747 | 0 | 0 |
| MICHAEL KING | |||||||||||||
| 0 | 579276 | 0 | 0 | 0 | 38500 | 0 | 62761 | 0 | 2094 | 0 | 682631 | 0 | 0 |
| ALLEN BUTCHER | |||||||||||||
| 0 | 332947 | 0 | 0 | 0 | 33000 | 0 | 27298 | 0 | 2085 | 0 | 395330 | 0 | 0 |
| SHANE PARMER | |||||||||||||
| 189012 | 166420 | 0 | 0 | 2825 | 3425 | 0 | 13141 | 1047 | 1045 | 192884 | 184031 | 0 | 0 |
| LISA CASALENUOVO | |||||||||||||
| 171374 | 255898 | 0 | 0 | 9225 | 7194 | 0 | 9605 | 1042 | 1041 | 181641 | 273738 | 0 | 0 |
| JOSEPH DARROW JR | |||||||||||||
| 222906 | 250046 | 0 | 0 | 11461 | 10538 | 0 | 2200 | 1051 | 1044 | 235418 | 263828 | 0 | 0 |
| GABOR ALTDORFER | |||||||||||||
| 228329 | 250429 | 0 | 0 | 5961 | 10539 | 0 | 2200 | 1051 | 1038 | 235341 | 264206 | 0 | 0 |
| TUAN NGUYEN | |||||||||||||
| 126613 | 152953 | 0 | 0 | 12684 | 3816 | 0 | 1835 | 1042 | 1031 | 140339 | 159635 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 5 | ReturnReference |
| Explanation | EACH PHYSICIAN HAS A PRODUCTIVITY BONUS IN THEIR CONTRACT. THIS BONUS IS BASED ON PRODUCING OVER A SET RELATIVE VALUE UNIT (RVU) DURING THE YEAR AND COLLECTIONS FOR EACH PHYSICIAN. THE AMOUNT OF THE BONUS IS INCLUDED IN THE INDIVIDUALS' BASE COMPENSATIONS ON SCHEDULE J, PART II, COLUMN (B)(I). | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | CAMDEN-CLARK HEALTH SERVICES, INC., A NON-PROFIT, TAX-EXEMPT CORPORATION IS THE SOLE MEMBER OF THE ORGANIZATION. | |
| Form 990, Part VI, Section A, line 7a | CAMDEN-CLARK HEALTH SERVICES, INC., THE ORGANIZATION'S SOLE MEMBER, ELECTS NO LESS THAN FIVE BUT NO MORE THAN NINE INDIVIDUALS OF THE BOARD AT THE ANNUAL MEETING. THE TERM FOR EACH DIRECTOR IS THREE YEARS. | |
| Form 990, Part VI, Section A, line 7b | CAMDEN-CLARK HEALTH SERVICES, INC., THE ORGANIZATION'S SOLE MEMBER, SHALL APPROVE ALL MATTERS REGARDING CAMDEN-CLARK PHYSICIAN CORPORATION. | |
| Form 990, Part VI, Section B, line 11 | THE CHIEF FINANCIAL OFFICER AND DIRECTOR OF FINANCE REVIEWED THE COMPLETED FORM PRIOR TO FILING. AFTER THE RETURN WAS FILED, A COPY WAS SENT TO THE BOARD OF DIRECTORS FOR THEIR REVIEW. | |
| Form 990, Part VI, Section B, line 12c | TO IDENTIFY AND MONITOR ANY CONFLICTS, A SIGNED CONFLICT OF INTEREST STATEMENT IS REQUIRED FROM BOARD MEMBERS OF THE ORGANIZATION AND KEY INDIVIDUALS THAT ARE IN A POSITION TO MAKE OR INFLUENCE DECISIONS. IF AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST IS OBSERVED OR DISCLOSED, THE ORGANIZATION INVOKES THE PROCEDURES SET OUT IN THE POLICY/BYLAWS FOR ADDRESSING THE CONFLICT OF INTEREST. FOR KEY INDIVIDUALS (EMPLOYEES), A SPECIFIC CONFLICT OF INTEREST STANDARD IN THE ORGANIZATION'S CODE OF ETHICS AND BUSINESS CONDUCT ALSO EXISTS. | |
| Form 990, Part VI, Section B, line 15 | THE EXECUTIVE DIRECTOR'S PAY IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. A COMPENSATION COMMITTEE CONSISTING OF ALL NON-PHYSICIAN MEMBERS OF THE BOARD REVIEW AND APPROVE PAY FOR THE PHYSICIANS. THEIR CONTRACTS ARE BASED ON MEDICAL GROUP MANAGEMENT ASSOCIATION STANDARDS. | |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO AVAILABLE ON THE WV HEALTHCARE AUTHORITY'S WEBSITE. | |
| THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. | FORM 990, PART XI, LINE 2C: | |
| FORM 990, PART VII | DANIEL MCGRAW IS COMPENSATED FOR HIS POSITION AS A PHYSICIAN WITH THE ORGANIZATION, NOT FOR SERVING ON THE BOARD OF DIRECTORS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| CAMDEN-CLARK HEALTH SERVICES INC | |||||||||
| 800 GARFIELD AVENUE | PARKERSBURG | WV | 26102 | 550769602 | AIDS, STRENGTHENS, AND SUPPORTS CAMDEN-CLARK MEMORIAL HOSPITAL. | WV | 501(c)(3) | Line 11a, I | N/A |
| CAMDEN-CLARK MEMORIAL HOSPITAL CORPORATION | |||||||||
| 800 GARFIELD AVENUE | PARKERSBURG | WV | 26102 | 311524546 | OPERATES AN ACUTE CARE AND EMERGENCY HOSPITAL FACILITY. | WV | 501(c)(3) | Line 3 | N/A |
| AUXILIARY OF CAMDEN-CLARK MEMORIAL HOSPITAL OF PARKERSBURG | |||||||||
| 800 GARFIELD AVENUE | PARKERSBURG | WV | 26102 | 550386283 | PROMOTES ADVANCEMENT AND WELFARE OF CAMDEN-CLARK MEMORIAL HOSPITAL. | WV | 501(c)(3) | Line 11a, I | N/A |
| CAMDEN-CLARK FOUNDATION INC | |||||||||
| 800 GARFIELD AVENUE | PARKERSBURG | WV | 26102 | 550667789 | RAISE AND MANAGE FUNDS FOR CAMDEN-CLARK MEMORIAL HOSPITAL. | WV | 501(c)(3) | Line 7 | N/A |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 1 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
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