Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
West Virginia University Hospitals Inc
Employer identification number
55-0643304
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
0 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
0 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
0 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
10000149
Software Version:
2010.2.15
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
West Virginia University Hospitals Inc
Employer identification number
55-0643304
Identifier
Return Reference
Explanation
Form 990 Part VI
3
WVUH has contracted out the oversight duties of quality control, medical infomation, and medical staff affairs. The companys employees assigned to these duties by the company are licensed physicians and have the proper training and skills to perform these duties. These positions as well as the associated costs are Board approved.
Form 990 Part VI
11b
The Form 990 is prepared by the accounting department and then reviewed by the accounting manager. Upon approval, it is then reviewed by the non-profit tax manager of our independent auditing firm. Once all review notes are cleared, it is presented to the CFO. Once approved at that level, it is then reviewed by the Audit Committee. After being approved by the audit committee, it is provided to all Board members for comments before being signed and submitted to the IRS.
Form 990 Part VI
12c
Annually, all Board Members, Vice Presidents, officers, and managers are required to disclose any relationships which may give rise to a conflict of interest. The responses are then input into spreadsheet format and given to the audit committee which is responsible for the ongoing monitoring of these responses. Any identified conflicts are reviewed by the Ethics Committee, the Ethics Committee makes a recommendation related to resolution or disciplinary actions. The recommendations are then provided to the President and/or Board of WVUH to accept, adopt, or institute. Nothing of concern has been brought to the Ethics Committee for review in 2010.
Form 990 Part VI
15ab
The compensation of all executives is determined based upon a salary and benefit survey prepared by an independent company using data of comparable facilities. This data is then interpreted and provided to an independent compensation committee. The independent compensation committee then uses this data to determine a fair and reasonable compensation package. All relevant data as well as minutes from each meeting are retained.
Form 990 Part VI
19
The WV Healthcare Authority publishes the annual financial statements of WVUH in the local newspapers. All other financial and governing documents are available upon request at the WVUH Administration Office during normal business hours.
Form 990 Part VI
4
West Virginia University Hospitals, Inc, WVUH West Virginia University Medical Corporation d/b/a University Health Associates UHA, WV United Health System WVUHS, and WVU Board of Governors on behalf of West Virginia University and its School of Medicine WVUSM have entered into a Joint Operating Agreement in order to strengthen their support of the WVUSM and its faculty in their pursuit of educating and training the next generation of physicians and of conducting research that advances the science of medicine and its benefits to patients, the state of West Virginia, and the nation. UHA and WVUH therefore entered into a Joint Operating Agreement in order to further integrate their mission and purpose, management, clinical activities, economic and financial activities, and identities, so as to function as a single strategic and economic unit.
Form 990 Part VI
4
UHA and WVUH believe that greater integration will lead to a more complete and timely consideration of the best interest of the patients, students, and education programs in the decision-making process and provide comprehensive understanding of the financial impact of decision making across all departments and activities associated with Healthcare provided by WVUH and UHA.
Form 990 Part VII
1a
WV United Health System WVUHS reimburses WVUH for a portion of Richard King and Robert Brandfass salaries and benefits as part of a shared employee agreement. WVUHS reimbursed WVUH 146,264 in 2010. The average numbers of hours per week reported for WVUH are only the hours for WVUH, average hours for WVUHS are reported on their Form 990.
Form 990 Part XI
5
The Amount shown on line 5, 5,022,118 is made up of Unrealized Gains on Investments of 11,194,218 less related organization capitalization transfers of 1,628,483 and obligation to the West Virginia University School of Medicine of 4,543,617 under the Joint Operating Agreement.
Form 990
Schedule K - For purposes of reporting bond issuance allocations on Schedule K to the Internal Revenue Service, WVUH, as parent company to City Hospital, Jefferson Memorial Hospital and City Hospital Foundation, is reporting bond issuances allocated to WVUH and its subsidiaries on a consolidated basis on Schedule K attached to this tax return.
Form 990
Schedule K - United Hospital Center is reporting bond allocations issued to it on the return filed by such taxpayer. Several bond issuances were issued in series and each series is reported in this tax return separately. For each series identified in Schedule K, Part I, the taxpayer will reconcile the series amount reported in this tax return and the tax return filed by United Hospital Center to the applicable 8038 filed with the IRS for each bond issuance. Each bond series is reported on the appropriate Form 990, Schedule K, only once in this matter.
Form 990
Schedule K, Part I, Line D, Column e - The 2008 Series D Bonds issue price 27,115,000, CUSIP number 956622YG3 were issued collectively with 2008 Series A Bonds issue price 46,420,000, CUSIP 956622YE8, 2008 Series B Bonds issue price 46,765,000, CUSIP number 956622YD0 and 2008 Series C Bonds issue price 60,725,000, CUSIP number 956622YF5 totaling 181,025,000 total issue price for all four reported on Form 8038 for August 29, 2008 issuance. 2008 Series A Bonds and 2008 Series B Bonds were allocated to United Health Center and will be reported on their Schedule K. 2008 Series C Bonds were refunded on December 19, 2009 by the 2009 Series C Bonds, which are reported on Schedule K 2nd Schedule K Part I, Line D, column e of this tax return.
Form 990
Schedule K, Part 1, Line D, Column e 2nd Schedule K - The 2009 C Series Bonds were issued as one series but were allocated within the Obligated Group to WVUH and City Hospital issue price - 31,894,128 and United Hospital Center issue price - 69,402,501. The total issue price for the 2009 Series C Bonds was 101,296,629 consistent with total issue price reported on Form 8038 for December 17, 2009 issuance, CUSIP 956622D27. The consolidated portion of the 2009 Series C Bonds allocated to WVUH is reported on Schedule K 2nd Schedule, Part I, Line D of this return. The United Hospital Center allocated portion of the 2009 Series C Bonds is reported on the tax return filed by such taxpayer.
Form 990
Schedule K, Part III, Line 3c All columns - Prior to each bond issuance the West Virginia United Health System engages bond council to review all managment and service contracts, leases and reserach agreements for all hospitals involved in the issunace.
Form 990
Schedule K, Part III, Line 7 All columns - While no policy was put in place during 2010, management is in the process of working with bond council to impliment a post-issuance complinace policy for the year 2012.
Form 990
Schedule K, Part I, Line D, Column f 2nd Schedule K -The purpose of the 2009 Series C Bonds was to a refund 2008 Series C Bonds and b fund capital renovations and improvements for hospital facilities owned by City Hospital and WVUH. The portion of the 2009 C Bonds used to refund the 2008 Series C Bonds was allocated to United Health Center and is reported on the tax return of such taxpayer.
Form 990
Schedule K, Part II, Line 7, Column A, B, C - Bond issuance costs reported on Form 8038 for the September 4, 2003 issuance equal 961,817, of which a 178,527 was allocated to 2003 Series A Bonds, b 195,743 was allocated to 2003 Series B Bonds, c 290,199 was allocated to 2003 Series C Bonds and d 297,348 was allocated to 2003 Series D Bonds.
Form 990
Schedule K, Part II, Line 8, Column A, B, C - Total credit enhancement costs reported on Form 8038 for the September 4, 2003 issuance equal 4,681,150, of which a 533,198 was allocated to 2003 Series A Bonds, b 584,618 was allocated to 2003 Series B Bonds, c 1,581,201 was allocated to 2003 Series C Bonds and d 1,982,133 was allocated to 2003 Series D Bonds.
Form 990
Schedule K, Part II, Line 7, Column D - Bond issuance costs reported on Form 8038 for the August 29, 2008 issuance equal 1,040,256, of which a 535,000 was allocated to the 2008 Series A Bonds and the 2008 Series B Bonds, which are reported by United Hospital Center, b 350,000 was allocated to 2003 Series C Bonds, which were refunded by the 2009 Series C Bonds and c 155,265 was allocated to 2008 Series D Bonds.
Form 990
Schedule K, Part II, Line 8, Column D - Credit enhancement costs reported on Form 8038 for the August 29, 2008 issuance equals 27,427, all of which was allocated to 2008 Series D Bonds, consistent with the amount identified above.
Form 990
Schedule K, Part II, Line 7, Column B C 2nd Schedule K - Bond issuance costs reported for the February 26, 2009 issuance equal 738,882, of which a 496,524 was allocated to 2009 Series A Bonds and b 242,358 was allocated to 2009 Series B Bonds.
Form 990
Schedule K, Part II, Line 8, Column B C 2nd Schedule K - Credit enhancement costs reported on Form 8038 for the February 26, 2009 issuance equal 660,355, of which a 442,892 was allocated to 2009 Series A Bonds and b 217,463 was allocated to 2009 Series B Bonds.
Form 990
Schedule K, Part II, Line 7, Column D 2nd Schedule K - Bond issuance costs reported on Form 8038 for the December 17, 2009 issuance equal 1,237,133, of which a 663,475 was allocated to WVUH for the 2009 Series C Bonds and b 573,658 was allocated to United Hospital Center and is reported on the tax return of such taxpayer.
Form 990
Schedule K, Part II, Line 10, Column A 2nd Schedule K - The difference between the total issue price reported on Line 3 for the 2008 E Bonds of 34,350,881 varies from the total of Lines 4 through 12 by 18,876. This variance consists of investment proceeds from debt service reserve fund equal to 18,876.
Form 990
Schedule K, Part II, Line 10, Column C 2nd Schedule K - The difference between the total issue price reported on line 3 for the 2009 B Bonds of 22,385,000 varies from the sum of Lines 4 through 12 by 58,558. This variance is due to a the transfer of 53,652 due to overfunding of costs of issuance fund, which was subsequently transferred to the project fund for capital expenditures that had not been expended as of the end of fiscal year 2009 and b 4,906 in investment proceeds received by WVUH in 2009.
Form 990
Schedule K, Part II, Line 10, Column D 2nd Schedule K - The difference between the total issue price reported on Line 3 for the 2009 C Bonds of 31,894,128 varies from the sum of Lines 4 through 12 by 137,455. This variance is due to overfunding of refunding escrow fund, which was subsequently transferred to the project fund for capital expenditures that had not been expended as of the end of fiscal year 2009.
Form 990
Schedule K, Part II, Line 13, Column B 2nd Schedule K - The 2009 Series B Bonds were issued on February 26, 2009 and the final allocation of the capital expenditures was not substantially complete as of the end of fiscal year 2010.
Form 990
Schedule K, Part II, Line 13, Column C 2nd Schedule K- The 2009 Series C Bonds were issued on December 17, 2009 and the final allocation of the capital expenditures was not substantially complete as of the end of fiscal year 2010.
Form 990
Schedule K Part III, Line 3c, All Columns - Prior to each bond issuance, WVUH, City Hospital, City Hospital Foundation and Jefferson Memorial Hospital engage bond counsel to review management and services contracts, leases and research agreements in anticipation of such bond issuance.
Form 990
Schedule K, Part III, Line 4, All Columns - Although the series of bonds are separately reported on Part I and Part II of this Schedule K, private use calculations were completed based on the total amount of the issuance, as reported to the IRS.
Form 990
Schedule K, Part III, LIne 7, All Columns - WV United Health System is in the process of creating and implimenting a post-issuance compliance policy for all System entities, this policy will be put in place during 2011.
Form 990 Part III Program Service Accomplishments
Line 4d Other Activities
Program Service Expenses 32,069,048, Grants and allocations 0, Revenue 50,045,537 Hematology/Oncology - The Hematology and Oncology Department of WVU Hospitals diagnose and treat all adult malignant disorders and diseases of the blood, including anemia, leukemia, lymphoma, and bleeding problems. Our doctors, nurses, and staff offer state-of-the-art care in a personalized and compassionate environment. Our services include evaluating and diagnosing cancer and blood disorders, cancer chemotherapy, targeted therapies, and immunotherapy.
Form 990 Part III Program Service Accomplishments
Line 4d Other Activities
Program Service Expenses 22,862,059, Grants and allocations 0, Revenue 42,882,293 Cardiology - The WVU Heart Institutes cardiac team uses the most current diagnostic procedures to detect and evaluate mild to life-threatening heart problems in our new, state-of-the-art facility. WVU Heart Institute uses a 64-Slice CT Scanner to provide detailed images of the hearts anatomy and coronary circulation. Our pediatric cardiologists offer world-class experience and compassionate care. We provide diagnostic and treatment services for all forms of congential heart defects, arrhythmias, acquired heart disease, hypercholesterolemia, and cardiomyopathies.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.