STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY (EIN 55-0422958)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-07-08
- IRS object ID
- 201131899349300713
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-07-08T14:23:35-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Arnett & Foster PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 2629 | AddressLine1 |
| City | Charleston | City |
| State | WV | State |
| ZIP Code | 25329 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550422958 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stonewall Jackson Memorial Hospital Company | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STON | NameControl |
| Phone | 3042698050 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1 |
| City | Weston | City |
| State | WV | State |
| ZIP Code | 26452 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dodie Arbogast | Name |
| Title | CFO | Title |
| Phone | 3042698050 | Phone |
| Date Signed | 2011-07-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Harry C Harless | Name |
| Phone | 3043460441 | 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) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | David D Shaffer | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1 |
| City | Weston | City |
| State | WV | State |
| ZIP Code | 26452 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 50381121 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.stonewallhospital.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1959 | YearFormation |
| State Legal Domicile | WV | StateLegalDomicile |
| Activity Or Mission Description | The mission is to provide quality medical care to the citizens of Lewis and surrounding counties regardless of the patient's ability to pay. To enable the citizens of our service area to receive quality care close to home. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 560 | TotalNbrEmployees |
| Total Nbr Volunteers | 45 | TotalNbrVolunteers |
| Total Gross UBI | 5474 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 4474 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 35598 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 56866 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 39977663 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 39331770 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 731463 | InvestmentIncomePriorYear |
| Investment Income Current Year | 989387 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 198451 | OtherRevenuePriorYear |
| Other Revenue Current Year | 203771 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 40943175 | TotalRevenuePriorYear |
| Total Revenue Current Year | 40581794 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 20000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 35400 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 20856151 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 21776127 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 18526984 | OtherExpensePriorYear |
| Other Expenses Current Year | 16750135 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 39403135 | TotalExpensesPriorYear |
| Total Expenses Current Year | 38561662 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1540040 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2020132 | RevenuesLessExpensesCY |
| Total Assets BOY | 54889849 | TotalAssetsBOY |
| Total Assets EOY | 57875135 | TotalAssetsEOY |
| Total Liabilities BOY | 8945066 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 8198777 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 45944783 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 49676358 | NetAssetsOrFundBalancesEOY |
| Mission Description | It is the mission of Stonewall Jackson Memorial Hospital to provide the best possible combination of primary care in a safe, efficient, and compassionate manner. It is, and always shall be, our duty to assess the quality of care provided and to continue to seek methods of improving both our evaluation of and delivery of patient care. It is our unswerving faith in this mission that assures our role as a vital community hospital and as an economic resource for our community. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 26378101 | Expense |
| Revenue | 39289395 | Revenue |
| Description | Stonewall Jackson Memorial Hospital provides Acute medical and outpatient services to residents of Weston, West Virginia and surrounding communities which covers 9 different counties. Including 11,161 hospital days, 59,046 outpatient visits, 11,458 emergency room visits, 2,072 Ambulatory surgery visits, 4,744 Home Health visits and 34,560 Physician Clinic visits. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 42375 | Expense |
| Grants | 16400 | Grants |
| Revenue | 42375 | Revenue |
| Description | Annual Blood Screening - Provide low-cost laboratory diagnostic tests to approximately 1,050 individuals. Stonewall Jackson Memorial Hospital provides all supplies and staff to operate the program. Excess revenue is forwarded to the local Rotary Club to promote charitable services.Other programs include: Glucose & Blood Pressure screenings at local Senior Center, Scoliosis Screening at county elementary and middle schools, Cardiac Project aimed at 5th graders to educate and monitor heart health, October fest program to promote healthy choices to children under 12 years old, school physicals for middle school and high school athletes, events for free Osteoporosis screenings, events for free Dermascans for screen for skin cancer and Weston Walk-Run to promote exercise as a way to improve cardiac health. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 19000 | Expense |
| Grants | 19000 | Grants |
| Revenue | 18183 | Revenue |
| Description | William Adler Scholarship Fund - Stonewall Jackson Memorial Hospital sponsored program to provide scholarships to local graduating high school seniors who are pursuing a career in the health care field through an accredited program. It is hoped that this program will encourage more students to seek health care professions and lessen the health care staffing shortage. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 26439476 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | 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 | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | 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 | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 52 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 560 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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 | 1 | 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 |
| 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 | Dodie Arbogast | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3042698050 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1 |
| City | Weston | City |
| State | WV | State |
| ZIP Code | 264528558 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| John E Law | |||||||
| President | 1.00 | X | 0 | 0 | 0 | ||
| John L Spiker | |||||||
| Vice President | 1.00 | X | 0 | 0 | 0 | ||
| R Gerald Wood | |||||||
| Secretary | 1.00 | X | 0 | 0 | 0 | ||
| Denver R Turner | |||||||
| Treasurer | 1.00 | X | 0 | 0 | 0 | ||
| Richard Cronin | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| RG Lockard | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| Jean Bennett | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| J A Snead | |||||||
| Director | 37.50 | X | 237984 | 0 | 26302 | ||
| Debbie Bennett | |||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||
| David Shaffer | |||||||
| CEO | 37.50 | 271374 | 0 | 25864 | X | ||
| Avah Stalnaker | |||||||
| Assistant CEO | 37.50 | 160182 | 0 | 13468 | X | ||
| Delphia Arbogast | |||||||
| CFO | 37.50 | 116703 | 0 | 17400 | X | ||
| Peter Edgerton | |||||||
| Physician | 37.50 | 421485 | 0 | 33420 | X | ||
| John Wyllie | |||||||
| Physician | 37.50 | 381455 | 0 | 24552 | X | ||
| Mario Estolano | |||||||
| Physician | 37.50 | 285282 | 0 | 0 | X | ||
| Salvatore Lanasa | |||||||
| Physician | 37.50 | 326301 | 0 | 28661 | X | ||
| Jack Marcum | |||||||
| Physician | 37.50 | 274996 | 0 | 26095 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2475762 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 195762 | TotalOtherCompensation |
| Number Individuals GT100 K | 24 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Mountain Radiology Services | |||||
| 21 W Third Street | Washington | MO | 63090 | Radiology | 445200 |
| Lab Corp | |||||
| PO Box 12140 | Burlington | NC | 27216 | Laboratory Services | 268911 |
| CPS | |||||
| PO Box 1000 | Memphis | TN | 38148 | Consulting | 264857 |
| Michael Gregory MD | |||||
| 230 Hospital Plaza | Weston | WV | 26452 | Medical | 222219 |
| Steptoe & Johnson | |||||
| P O Box 1732 | Clarksburg | WV | 26302 | Legal | 181447 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Fundraising Events | 13500 | FundraisingEvents |
| All Other Contributions | 43366 | AllOtherContributions |
| Total Contributions | 56866 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Services | Description |
| Business Code | 622110 | BusinessCode |
| Total Revenue Column | 39331770 | TotalRevenueColumn |
| Related Or Exempt Function Income | 39331770 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 39331770 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 946861 | TotalRevenueColumn |
| Exclusion | $946,861 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 47148 | Real |
| Personal | 8400 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 74214 | Real |
| Personal | 2926 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -27066 | Real |
| Personal | 5474 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -21592 | TotalRevenueColumn |
| Unrelated Business Revenue | 5474 | UnrelatedBusinessRevenue |
| Exclusion | -$27,066 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 9757013 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 9714487 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 42526 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 42526 | TotalRevenueColumn |
| Exclusion | $42,526 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 8500 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 13500 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 7700 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 800 | TotalRevenueColumn |
| Exclusion | $800 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Cafeteria Sales | 722310 | 123309 | $123,309 |
| Vending Machines | 454210 | 67194 | $67,194 |
| Miscellaneous | 900099 | 34060 | $34,060 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 224563 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 40581794 | TotalRevenueColumn |
| Related Or Exempt Function Income | 39331770 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 5474 | UnrelatedBusinessRevenue |
| Exclusion | $1,187,684 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16400 | Total |
| Program Services | 16400 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19000 | Total |
| Program Services | 19000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 909436 | Total |
| Program Services | 599045 | ProgramServices |
| Management And General | 310391 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17982126 | Total |
| Program Services | 11844826 | ProgramServices |
| Management And General | 6137300 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 671498 | Total |
| Program Services | 442316 | ProgramServices |
| Management And General | 229182 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1012861 | Total |
| Program Services | 667172 | ProgramServices |
| Management And General | 345689 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1200206 | Total |
| Program Services | 790576 | ProgramServices |
| Management And General | 409630 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 184249 | Total |
| Management And General | 184249 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102166 | Total |
| Management And General | 102166 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43862 | Total |
| Management And General | 43862 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1503426 | Total |
| Program Services | 990307 | ProgramServices |
| Management And General | 513119 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150005 | Total |
| Program Services | 98808 | ProgramServices |
| Management And General | 51197 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7303349 | Total |
| Program Services | 4810716 | ProgramServices |
| Management And General | 2492633 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 550786 | Total |
| Program Services | 362803 | ProgramServices |
| Management And General | 187983 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74681 | Total |
| Program Services | 49192 | ProgramServices |
| Management And General | 25489 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72679 | Total |
| Program Services | 47874 | ProgramServices |
| Management And General | 24805 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1595684 | Total |
| Program Services | 1051077 | ProgramServices |
| Management And General | 544607 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 157521 | Total |
| Program Services | 103759 | ProgramServices |
| Management And General | 53762 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debts | 3066820 | 3066820 | |
| Repairs & Maintenance | 940607 | 619578 | 321029 |
| Medicaid Provider Tax | 400658 | 400658 | |
| Physician Recruitment | 155410 | 155410 | |
| Continuing Education | 148798 | 98013 | 50785 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 299434 | Total |
| Program Services | 205126 | ProgramServices |
| Management And General | 94308 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38561662 | Total |
| Program Services | 26439476 | ProgramServices |
| Management And General | 12122186 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 968885 | BOY |
| EOY | 162232 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1018682 | BOY |
| EOY | 23096 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6831102 | BOY |
| EOY | 6631588 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1105458 | BOY |
| EOY | 1068843 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 339410 | BOY |
| EOY | 342751 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 31012764 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 21148264 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9677642 | BOY |
| EOY | 9864500 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33592554 | BOY |
| EOY | 38342445 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75402 | BOY |
| EOY | 75402 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1280714 | BOY |
| EOY | 1364278 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54889849 | BOY |
| EOY | 57875135 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6899794 | BOY |
| EOY | 5962876 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26758 | BOY |
| EOY | 26758 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2018514 | BOY |
| EOY | 2209143 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8945066 | BOY |
| EOY | 8198777 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45944783 | BOY |
| EOY | 49676358 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45944783 | BOY |
| EOY | 49676358 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54889849 | BOY |
| EOY | 57875135 | 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 Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 48898 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 597116 | OtherCostOrOtherBasis |
| Book Value | 646014 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1544574 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 10086965 | OtherCostOrOtherBasis |
| Depreciation | 8614255 | Depreciation |
| Book Value | 3017284 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17870332 | OtherCostOrOtherBasis |
| Depreciation | 12534009 | Depreciation |
| Book Value | 5336323 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 864879 | OtherCostOrOtherBasis |
| Book Value | 864879 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 9864500 | TotalOfBookValueLandBuildings |
| Total Revenue | 40581794 | TotalRevenue |
| Total Expenses | 38561662 | TotalExpenses |
| Excess Or Deficit For Year | 2020132 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 1711443 | NetUnrealizedGLOnInvestments |
| Total Adjustments | 1711443 | TotalAdjustments |
| Excess Or Deficit Per FS | 3731575 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 42217632 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 1711443 | NetUnrealizedGainsInvestments |
| Other Revenues | 29992 | OtherRevenues |
| Revenue Not Rptd F990 | 1741435 | RevenueNotRptdF990 |
| Revenue Subtotal | 40476197 | RevenueSubtotal |
| Investment Expenses Not Included | 43862 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 61735 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 105597 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 40581794 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 38486057 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 29992 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 29992 | ExpensesNotRptdF990 |
| Expenses Subtotal | 38456065 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 43862 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 61735 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 105597 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 38561662 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X: | Description of Uncertain Tax Positions Under FIN 48: | The organization had no uncertain tax positions under Fin 48 as reported in the financial statements. |
| Part XII, Line 2d - Other Adjustments: | Rental loss: 27066. Van rent depreciation: 2926. | |
| Part XII, Line 4b - Other Adjustments: | Scholarships netted against donations in the financial statements: 19000. Grants: 16400. Misc Exp reclassed: 26335. | |
| Part XIII, Line 2d - Other Adjustments: | Rental loss: 27066. Van Rental Depreciation : 2926. | |
| Part XIII, Line 4b - Other Adjustments: | Scholarships: 19000. Grants: 16400. Misc Exp reclassed: 26335. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Charity Golf Tournament | NameOfEvent1 |
| Gross Receipts Event1 | 22000 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 13500 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 8500 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 1000 | CashPrizesEvent1 |
| Rent Facility Costs Event1 | 6000 | RentFacilityCostsEvent1 |
| Other Direct Expenses Event1 | 700 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 22000 | GrossReceiptsTotal |
| Charitable Contributions Total | 13500 | CharitableContributionsTotal |
| Gross Revenue Total Events | 8500 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 1000 | CashPrizesTotalEvents |
| Rent Facility Costs Total Events | 6000 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 700 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 7700 | DirectExpenseSummaryEvents |
| Net Income Summary | 800 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 421296 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 421296 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01190 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8451096 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4977993 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3473103 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09780 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 281355 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 162089 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 119266 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00340 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9153747 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5140082 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4013665 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11310 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 3000 | PersonsServed |
| Total Community Benefit Expense | 50650 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 34000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 16650 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 28 | PersonsServed |
| Total Community Benefit Expense | 25000 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9500 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5385 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5385 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 3028 | PersonsServed |
| Total Community Benefit Expense | 81035 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 49500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 31535 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 3028 | PersonsServed |
| Total Community Benefit Expense | 9234782 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5189582 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4045200 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.11410 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 155398 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 155398 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00440 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 155398 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 155398 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00440 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,650,256 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 8631573 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 8787930 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -156357 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stonewall Jackson Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1 |
| City | Weston | City |
| State | WV | State |
| ZIP Code | 26452 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: We review the patients income, assets, expenses and medical bills to determine the amount of free or discounted care to give to the patient. | IncomeBasedCriteria |
| Costing Method Used | 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. | CostingMethodUsed |
| Subsidized Health Services Expln | Part I, Line 7g: | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | Part I, Line 7f: | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | 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 | BadDebtFootnote |
| Debt Collection Policy | Part III, Line 9b: Our collections policy applies to all patients regardless of financial class or any other classification. During our collections process, if the patient indicates they do not have the ability to pay their bill, the credit staff offers exoneration. | DebtCollectionPolicy |
| Patient Education Assistance | Part VI, Line 3: Information about our charity program is posted in the Emergency department and at the Registration windows. We also offer the applications to uninsured inpatients and have the applicatons available in all of our hospital-based physicians' offices. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: Stonewall Jackson Memorial Hospital serves a relatively large rural population of about 65,000 people with an average household income of $32,000. 30% of the population is disabled. Approximately 30% are Medicaid Eligible or are uninsured. We are the largest hospital in our service area, which includes two other hospitals, one being a Critical Access Hospital. We are located in a federally-designated medically underserved area. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: We recruit physicians to this area based entirely on what services the patients need. For example, our population has a high rate of COPD and other pulmonary diseases. We recruited a Pulmonologist who can address these needs in the community. Also, based on the high population of elderly patients, we have the need for Orthopedists and have recruited two in the past year. We also added an OB-Gyn to our Obstetrics/Gynechology clinic because of the high volume of patients needing care. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: Stonewall Jackson Memorial Hospital (SJMH) is a 70 bed rural acute hospital located in Lewis county West Virginia. SJMH is the only hospital located in the county as such it is solely responsible for the healthcare of this rural community. SJMH provides 24 hours Emergency Room and Obstetrics services and provides care regardless of the patients ability to pay. The majority of the governing body is comprised of community members. Medical privileges are offered to all qualified physicians in the community and SJMH has worked diligently to provide other physician services by expanding the services they provide.SJMH continues to make capital improvement to the facility and expand patient care services to meet the needs of the community. | OtherInformation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rotary Club of Weston | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 222 | AddressLine1 |
| City | Weston | City |
| State | WV | State |
| ZIP Code | 26452 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 550371556 | EINOfRecipient |
| IRC Section | 501(c) (4) | IRCSection |
| Amount Of Cash Grant | 16400 | AmountOfCashGrant |
| Purpose Of Grant | The purpose of the donation is to promote charitable services. | PurposeOfGrant |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | Nursing School Scholarships for recent high school graduates. | TypeOfGrant |
| Number Of Recipients | 19 | NumberOfRecipients |
| Amount Of Cash Grant | 19000 | AmountOfCashGrant |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| 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 | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J A Snead | |||||||||||||
| 237984 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 26302 | 0 | 264286 | 0 | 0 | 0 |
| David Shaffer | |||||||||||||
| 271374 | 0 | 0 | 0 | 0 | 0 | 13707 | 0 | 14453 | 0 | 299534 | 0 | 0 | 0 |
| Avah Stalnaker | |||||||||||||
| 135182 | 0 | 25000 | 0 | 0 | 0 | 8070 | 0 | 6652 | 0 | 174904 | 0 | 0 | 0 |
| Peter Edgerton | |||||||||||||
| 421485 | 0 | 0 | 0 | 0 | 0 | 21262 | 0 | 14453 | 0 | 457200 | 0 | 0 | 0 |
| John Wyllie | |||||||||||||
| 381455 | 0 | 0 | 0 | 0 | 0 | 19154 | 0 | 7693 | 0 | 408302 | 0 | 0 | 0 |
| Mario Estolano | |||||||||||||
| 285282 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2148 | 0 | 287430 | 0 | 0 | 0 |
| Salvatore Lanasa | |||||||||||||
| 326301 | 0 | 0 | 0 | 0 | 0 | 16503 | 0 | 14453 | 0 | 357257 | 0 | 0 | 0 |
| Jack Marcum | |||||||||||||
| 274996 | 0 | 0 | 0 | 0 | 0 | 13938 | 0 | 13718 | 0 | 302652 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 3 | Management duties customarily are performed under the direct supervision of officers, directors, trustees or key employees, but the Hospital has contracted their Dietary Management. The owner of the dietary company is considered a department head. She employs only one dietician. The remainder of the dietary department is employed by the Hospital. The Hospital contracts out the management duties of the Maintenance department. The manager of the Maintenance department (also considered a department head) is employed by the Maintenance company. All other Maintenance staff are employees of the Hospital. The Hospital contracts out the management duties of the Pharmacy department. The manager of the Pharmacy department (also considered a department head) is employed by the Pharmacy company. All other Pharmacy staff are employees of the Hospital. | |
| Form 990, Part VI, Section B, line 11 | The process the Hospital uses to review their 990 before filing with the IRS is the CFO is responsible for reviewing the form 990 for completeness and accuracy. A completed copy is provided for the board. It is then signed and submitted to the IRS. | |
| Form 990, Part VI, Section B, line 12c | All board members disclose possible conflicts of interest prior to appointment and periodically throughout their terms as trustees. | |
| Form 990, Part VI, Section B, line 15 | The Hospital obtains salary survey data. Performance Evaluations are done on each of these personnel & financial conditions are considered. | |
| Form 990, Part VI, Section C, line 19 | The Hospital places a publication in the local newspaper stating the governing documents, conflicts of interest policy and financial statements are available upon request. The policies and procedures are on the Stonewall Jackson website. | |
| Part XI Line 2c | The Finance committee shall review audits of the company's financial actions and status, and such audits shall take place at least on an annual basis. This committee shall meet at least monthly. | Committee That Assumes Audit Responsibility |
Schedule R IRS990ScheduleR
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stonewall Home Oxygen Therapy Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 Market Place Mall Suite 8 | AddressLine1 |
| City | Weston | City |
| State | WV | State |
| ZIP Code | 26452 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550754278 | EIN |
| Primary Activity | Oxygen Therapy Services | PrimaryActivity |
| Legal Domicile State | WV | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 40848 | ShareOfTotalIncome |
| Share Of EOY Assets | 253617 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | 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 | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| Stonewall Home Oxygen Therapy Inc | |
| A | 47083 |
| Stonewall Home Oxygen Therapy Inc | |
| P | 267879 |
| Stonewall Home Oxygen Therapy Inc | |
| Q | 19207 |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | In a letter from the Internal Revenue Service dated June 13, 2011, the Service denied a second extension to file the Form 990 for the tax period ending September 30, 2010 because the second extension did not provide a statement explaining why additional time is needed to file the return. We understand that since our gross receipts are in excess of $1,000,000 your office will assess a penalty of $100 per day. We concede that second extension for the Form 990 was filed in error and that a penalty for late filing will be assessed but respectfully request full abatement of such penalty as we have reasonable cause for the error in filing the second extension Form 990. Reasonable cause exists as circumstances beyond our control were responsible as described below. Reasonable cause exists due to a clerical error on the part of our Accounting firm in which the explanation for a second extension was inadvertently omitted. The second extension was needed in order to gather the appropriate information necessary to file a complete and accurate return. The additional data requirements of Schedule H is the primary reason the second extension was requested. Fiscal Year 09/30/2010 is the first year we had to address all of the additional Schedule H reporting criteria. Reasonable cause also exists because we have a proven track record of filing our reports in a timely matter. Our prior Forms 990, payroll reports and other reports filed with the IRS have always been filed on time. Additionally, a penalty assessment would be an undue burden on our operations since we are a small rural hospital which serves a large volume of Medicare, Medicaid and Uncompensated care patients. Any of these reasons standing alone may not constitute reasonable cause, however, all of them together, would in anyones mind constitute reasonable cause especially since the return is being filed by the due date of a properly filed second extension. We understand your office may subject us to a penalty under Section 6652 (c) which imposes a penalty on an organization for failing to file a return required under Section 6033 (a)(1) of the Internal Revenue Code. Section 6652(c)(4) of the Internal Revenue Code provides that no penalty shall be imposed under this subsection with respect to any failure if it is shown that such failure is due to reasonable cause. Reasonable cause is not clearly defined in the Internal Revenue Code or the relevant Treasury Regulations. The Internal Revenue Code provides no guidance at all, and certain regulations applicable to other Sections of the Internal Revenue Code provide only minimal help. One regulation applicable to the failure to properly file certain information returns states that reasonable cause exists if there were significant mitigating factors or the failure arose from events beyond the taxpayers control. The Internal Revenue Service has issued limited guidance on what qualifies as reasonable cause. Various court decisions have also addressed the definition of reasonable cause. Many of the cases involved the taxpayers reliance on a tax expert or third party. In United States vs. Boyle, 55 AFTR 2d 85-1535 (105 S.Ct. 687), the United States Supreme Court established a bright line rule for when reliance on a tax advisor does not constitute reasonable cause. In this estate tax case in which the taxpayer owed significant taxes, the Supreme Court held that a taxpayer cannot avoid the penalties under Section 6651(a)(1) of the Internal Revenue Code by relying on an agent to file the return. Nonetheless, we do not believe this case is applicable to the case at hand. First, and foremost, potential penalties may be imposed under Section 6652(c) of the Internal Revenue Code whereas the Supreme Court case involved Section 6651(a)(1). Secondly, in our case, no taxes are due or will be paid late. In the Supreme Court case, the taxpayer owed and paid late several hundred thousand dollars in taxes. Third, the standard for escaping the tax under Section 6651(a)(1) is a higher standard than that under Section 6652(c). Under Section 6651(a)(1) the taxpayer must prove both that the failure did not result from willful neglect, and (emphasis added) that the failure was due to reasonable cause. Last but not least, we were not relying on the tax expert to file the return but to file an extension. Accordingly, we believe that United States vs. Boyle AFTR 2d 85-1535 (105 S.Ct. 687), is not applicable to the case at hand and that reasonable cause also exists as we relied upon a tax expert to file the extension. In summary, we respectfully request abatement of any potential late filing penalty as we have reasonable cause. Reasonable cause exists as circumstances beyond our control directly contributed to the late filing of the Form 990. It was our intention to file for an extension and hired a third-party tax expert to prepare and file such extension. Reliance on a third-party tax expert, our record of timely filing, and our unique position in providing care to a large volume of Medicare, Medicaid, and Uncompensated care patients in an underserved area combine to provide reasonable cause to abate any potential penalty. We also believe that our fact pattern can be differentiated from the Supreme Court decision in United States vs. Boyle AFTR 2d 85-1535 (105 S.Ct. 687), and that our reliance on a third party is also reasonable cause. The events described above in addition to the following provide additional support that reasonable cause existed and that the penalty should not be imposed:1. A timely extension was filed, but a description explaining why additional time was needed was inadvertently omitted resulting in rejection; otherwise the tax return would have been timely filed; 2. A lay person does not normally know the due date of a Form 990 especially when the accounting period is not a calendar year end;3. No harm was done as no taxes were due or payable;4. We acted in good faith;5. Late filing was not a conscious, intentional failure or reckless indifference, i.e. it was not due to willful neglect;6. We filed the tax return without being requested to by the Internal Revenue Service other than the request with the denial of the extension; and7. Based on our knowledge, we have never paid a penalty in a prior period for filing the Form 990 late. | Explanation |
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