2011-05-16T14:30:38-05:00 2010-06-30 Arnett & Foster PLLC P O Box 2629 Charleston WV 25329 990 2009-07-01 550387249 Weirton Medical Center Inc WEIR 3047976000 601 Colliers Way Weirton WV 260625014 Dr Joseph P Endrich 3047976000 2011-05-05 1 Harry C Harless 3043460441 2009 2016-02-24 21:20:13Z Weirton Medical Center Dr Joseph P Endrich 601 Colliers Way Weirton WV 260625014 108354680 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. 10 9 1194 0 10140 0 164941 125490 95693633 93354468 1197533 685502 860361 986133 97916468 95151593 0 0 53348162 50748045 0 0 47079791 48224835 100427953 98972880 -2511485 -3821287 78019795 80356791 53861543 58754671 24158252 21602120 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 92154726 93354468 The medical center provided inpatient, outpatient, emergency, psychiatric, home health, physician and skilled nursing services including 36,514 inpatient days, 151,247 outpatient visits, 40,046 emergency room visits and 8,954 home health visits. Charges foregone for charity amounted to $1,512,127. 92154726 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 72 0 1 1194 1 1 1 0 0 0 0 0 0 10 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Kellie Henwood 3047976440 601 South Colliers Way Weirton WV 26062 Joseph P Endrich 40.00 X X 326282 0 15197 William R Kiefer 3.00 X 0 0 0 John J York 3.00 X 0 0 0 Dorothy Donell 3.00 X 0 0 0 Jon M Rogers 3.00 X 0 0 0 Kris Kubicki 3.00 X 0 0 0 Arthur L Miser Jr 3.00 X 0 0 0 James R Shockley 3.00 X 0 0 0 David L Snyder 3.00 X 0 0 0 John A Spadafora Jr 3.00 X 0 0 0 Michael Miller 40.00 X 119608 0 8618 Leigh Scherich 40.00 X 150075 0 18607 Carl Jones 40.00 X 571255 0 20352 John Mitchell 40.00 X 268040 0 7828 Keith Bravo 40.00 X 477930 0 48326 Richard Ajayi 40.00 X 280300 0 18402 Kara O'Karma 40.00 X 327159 0 20352 2520649 0 157682 27 0 1 0 Quorum Health Resources 105 Continental Place Blvd Brentwood TN 37027 Consulting agency 529161 Helvey & Associates Inc 1029 E Center Warsaw IN 46580 Patient billing 384995 Lexicode Corporation PO Box 404219 Atlanta GA 30384 Coding outsourcing 225983 US Security Association Inc PO Box 931703 Atlanta GA 31193 Security 207327 Buck Consultants LLC Dept Ch 14061 Palatine IL 60055 Pension consulting 199638 10 125490 125490 Health care services 622110 93354468 93354468 93354468 953701 10140 943561 349868 349868 349868 349868 12934888 13167182 35905 -232294 -35905 -268199 -268199 Cafeteria Income 722210 371487 371487 Atrium Cafe Income 722210 57174 57174 Telephone Income 517110 21529 21529 186075 186075 636265 95151593 93354468 10140 1661495 565274 523444 41830 37858268 35056756 2801512 3107247 2877311 229936 5715472 5292527 422945 3501784 3242652 259132 241996 241996 85166 85166 45222 45222 11352905 10544806 808099 17223276 15948754 1274522 1785628 1653492 132136 107094 99169 7925 1061259 982726 78533 2859065 2647494 211571 1023888 948120 75768 Bad debts 10121390 10121390 0 Health care provider ta 1601492 1601492 0 Repairs & maintenance 274721 254392 20329 Books, dues, and subscr 187705 173815 13890 Recruitment 57823 53544 4279 196205 132842 63363 98972880 92154726 6818154 0 166242 3088734 5014535 15131843 14946620 171708 136339 1213388 1171024 1423486 1730544 90720085 70193211 22066154 20526874 32479167 34282381 605283 712915 1673790 1835559 78019795 80356791 9930395 14021147 5500 26315895 25055791 4093227 4143781 13516526 15533952 53861543 58754671 X 24158252 21602120 24158252 21602120 78019795 80356791 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 124015 124015 47408722 36001699 11407023 195889 195889 0 38257517 31735705 6521812 4733942 2259918 2474024 20526874 Estimated third-party settlements 704171 Estimated malpractice liability 3347420 Accrued pension liability 11482361 15533952 95151593 98972880 -3821287 3284867 -2019712 1265155 -2556132 95215524 308901 308901 94906623 244970 244970 95151593 98972880 0 98972880 0 98972880 Part XI, Line 8 - Other Adjustments: Defined benefit pension plan adjustment: -2083643. Equity Income: 63931. Part XII, Line 2d - Other Adjustments: Income per books: Premier Purchasing Partners LP: 308901. Part XII, Line 4b - Other Adjustments: Equity loss from AEIX: 2512. Excluded Dividend Income From Premier: 242458. 1 1 X 1 X 1 X 1 1 0 0 719772 719772 0.00810 14110854 8850311 5260543 0.05920 14830626 8850311 5980315 0.06730 18660 11833 6827 0.00010 18660 11833 6827 0.00010 14849286 8862144 5987142 0.06740 4817782 32488039 33380587 -892548 X 1 0 Weirton Medical Center

601 Colliers Way Weirton WV 260625014

X X X 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 US Citizenship, West Virginia Residency 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 200% 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 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 collectibility. 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 9b: There is no collection from patients who qualify for charity care. If a patient qualifies, they receive no bill. Part VI, Line 2: Weirton Medical Center conducts a community health needs assessment of the residents of its service area every five 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 self-patients are seen or called by the financial counselors to see 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 has 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 July 2010 unemployment rate was 13.3 percent. In FY 2010, Brooke County residents made up 26.9 percent of Weirton Medical Center's total patient volume.Hancock County, West Virginia has 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 13.7 percent of the population was unemployed in July 2010. Hancock County residents made up 35.7 percent of Weirton Medical Center's total patient volume in FY 2010.Jefferson County, Ohio has 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 August 2010 unemployment rate was 13.2 percent. In FY 2010, 19.4 percent of the total patient volume came from Jefferson County.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 6: The majority of the organization's governing body is comprised of persons who reside in the organization's primary service area, who are neither employees or contractors of the organization, nor family members thereof. The organization operates an emergency room available to all, regardless of ability to pay. 1 X X X X 0 0 0 0 0 1 0 0 0 Joseph P Endrich 326282 0 0 0 0 0 1107 0 15536 0 342925 0 0 0 Leigh Scherich 150075 0 0 0 0 0 4517 0 15424 0 170016 0 0 0 Carl Jones 571255 0 0 0 0 0 0 0 20772 0 592027 0 0 0 John Mitchell 268040 0 0 0 0 0 0 0 8248 0 276288 0 0 0 Keith Bravo 477930 0 0 0 0 0 1134 0 47612 0 526676 0 0 0 Richard Ajayi 280300 0 0 0 0 0 891 0 18923 0 300114 0 0 0 Kara O'Karma 327159 0 0 0 0 0 0 0 20562 0 347721 0 0 0 Part I, Line 6 Certain physicians receive a base pay and an incentive based on the net revenue in which they produce. Weirton Municipal Hospital Building Commission 556000623 2005-06-24 6700000 Capital expenditures, expansion of medical center and technology upgrades 0 0 6700000 6700000 2005 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 Form 990, Part VI, Section B, line 11 The 990 is reviewed by the Director, Finance Director, the CFO and the board 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 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. FORM 990, PART XI, LINE 2C CLARIFICATION OF ITEM MARKED YES The process for oversight of the audit has not changed since last year. Tri-State Community Care Network Inc 601 Colliers Way Weirton WV 26052 550731090 Healthcare WV N/A Weirton Medical Center Foundation 601 Colliers Way Weirton WV 26062 550689248 Supporting organization WV 501(c)(3) 11 N/A Weirton Medical Corporation 601 Colliers Way weirton WV 26062 550689267 Supporting organization WV 501(c)(3) 11, Type II N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0