TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) David L Ramsey...................................................................... President, CEO & Trustee	50.00 ................. 7.00	X	X	1,118,814	220,873
(2) John R Hoblitzell Esq...................................................................... Chairman	2.50 ................. 5.00	X	X	0	0
(3) William Rice Jr...................................................................... Vice Chairman	3.00 ................. 3.50	X	X	0	0
(4) Gina R Busch MD...................................................................... Trustee	2.50 ................. 2.50	X		0	0
(5) Charles L Capito Jr...................................................................... Trustee	2.50 ................. 2.50	X		0	0
(6) Mark A Chandler...................................................................... Trustee	2.50 ................. 2.50	X		0	0
(7) Fonda Elliot...................................................................... Trustee	2.50 ................. 2.50	X		0	0
(8) James P Griffith MD...................................................................... Trustee	2.50 ................. 2.50	X		0	0
(9) Wanda Hightower...................................................................... Trustee	2.50 ................. 5.00	X		0	0
(10) Melvin Jones...................................................................... Trustee	2.50 ................. 2.50	X		0	0
(11) Linda J Powers...................................................................... Trustee	2.50 ................. 2.50	X		0	0
(12) Karen S Price...................................................................... Trustee	2.50 ................. 2.50	X		0	0
(13) E Michael Robie DO...................................................................... Director (start 11/18)	50.00 ................. 3.00	X		319,863	23,629
(14) Seyed A Shams MD...................................................................... Trustee (end 10/18)	50.00 ................. 3.00	X		308,257	40,043
(15) Eric D Shouldis MD...................................................................... Trustee	50.00 ................. 0.50	X		365,221	46,304
(16) Steven L Smith...................................................................... Trustee	2.50 ................. 2.50	X		0	0
(17) Kenneth L Tackett...................................................................... Trustee	2.50 ................. 2.50	X		0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) Edwin H Welch Ph D........................................................................ Trustee	2.50 .......................3.50	X				0	0
(19) Robert D Whitler........................................................................ VP Gov't & Comm Affairs	50.00 .......................1.00		X			225,686	34,124
(20) Kristi Snyder........................................................................ VP Human Resources	50.00 .......................1.00		X			308,790	177,930
(21) Angela Fenton Hill........................................................................ Secretary & General Counsel	50.00 .......................5.00		X			332,461	190,775
(22) Thomas P Mcllwain MD........................................................................ VP Medical Affairs & CMO	50.00 .......................5.00		X			577,274	120,961
(23) Jeffrey L Oskin........................................................................ VP Administrator	50.00 .......................0.00		X			415,495	248,468
(24) Jeffrey H Goode........................................................................ VP Ambulatory Services	50.00 .......................0.00		X			370,759	282,098
(25) S Andrew Weber........................................................................ VP Administrator	50.00 .......................0.00		X			293,880	165,653
(26) Eileen Clark........................................................................ VP Info Services & CIO	50.00 .......................5.00		X			422,179	235,193
(27) Stephen Z Bell........................................................................ VP Finance	50.00 .......................0.00		X			280,616	110,861
(28) Robert B Danielson........................................................................ VP Corporate Compliance	50.00 .......................5.00		X			737,600	43,872
(29) Glenn Crotty Jr MD........................................................................ Executive VP & COO	50.00 .......................6.00		X			602,531	152,139
(30) Micheal D Williams........................................................................ VP Administrator	50.00 .......................0.00		X			989,106	298,377
(31) Randall H Hodges........................................................................ VP Administrator	50.00 .......................0.00		X			333,742	38,002
(32) Jeff Sandene........................................................................ Executive VP & CFO	50.00 .......................10.00		X			613,479	225,898
(33) Heidi Edwards........................................................................ VP Prof Prac & CNO	50.00 .......................1.00		X			219,403	58,305
(34) Dawn Coon........................................................................ President CHN	50.00 .......................0.00		X			113,161	27,826
(35) Elie Gharib........................................................................ Physician	40.00 .......................0.00			X		1,155,056	45,104
(36) Mitchell Rashid MD........................................................................ Physician	40.00 .......................0.00			X		1,149,617	44,014
(37) Robert B Shin MD........................................................................ Physician	40.00 .......................0.00			X		1,110,880	32,421
(38) Sangeeta Mandapaka........................................................................ Physician	40.00 .......................0.00			X		1,040,500	17,890
(39) Nathan Kister MD........................................................................ Physician	40.00 .......................0.00			X		1,037,779	45,104
(40) Ronald E Moore........................................................................ Former VP Prof Prac & CNO	50.00 .......................0.00				X	312,589	8,515
(41) Lillian Morris........................................................................ Former Interim CNO	40.00 .......................0.00				X	168,202	9,519
(42) Rocky Blake........................................................................ Former VP Info Services	50.00 .......................0.00				X	220,365	35,327

(A) Name and business address	(B) Description of services	(C) Compensation
WVU Physicians of Charleston 3110 MacCorkle Ave SE Charleston,WV25304	GME/Physician Services	20,118,894
MedAssets Supply Chain Systems PO Box 742081 Atlanta,GA303742081	Nursing Services	19,541,861
Charleston Area Radiation Therapy Center PO Box 19532 Irvine,CA92623	Radiation Services	10,126,123
Universal Physician Services 1414 Lancaster Drive Marietta,OH45750	Physician Services	6,260,961
Liberty Solutions Inc 3763 Abbott Road Orchard Park,NY14125	IT Consulting Services	4,177,424
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 140

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Charleston Area Medical Center Inc

Employer identification number

55-0526150

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. 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 ....................... right arrow

33 1/3% support test—2017. If the organization did not check a 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 ..................... right arrow

17a

10%-facts-and-circumstances test—2018. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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 ....... right arrow

33 1/3% support tests—2017. 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 .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

Charleston Area Medical Center Inc

Employer identification number

55-0526150

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization Charleston Area Medical Center Inc

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization Charleston Area Medical Center Inc		Employer identification number 55-0526150

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization Charleston Area Medical Center Inc			Employer identification number 55-0526150
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Charleston Area Medical Center Inc

Employer identification number

55-0526150

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................
c	Total lobbying expenditures (add lines 1a and 1b) ...................................................................
d	Other exempt purpose expenditures ........................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Yes

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Yes

3,582

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

93,603

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

78,510

Total. Add lines 1c through 1i ....................................................................................................

175,695

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part II-B, Line 1:	Occasionally, individuals are asked by legislators at both the state and national levels for opinions on certain issues and the process of health-related legislation. At such time, CAMC representatives may hold discussions with legislative officials to present their information and perspectives regarding various health care issues. Such interactions do not typically involve CAMC expressing whether or not they support a particular bill, but rather consist of general discussions related to the pertinent health issues. CAMC is a member of the West Virginia Hospital Association, Association of American Medical Colleges, and 340B Health for Pharmaceutical Access. A percentage of the membership dues paid are related to lobbying activities.

Return Reference

Explanation

Part II-B, Line 1:

Occasionally, individuals are asked by legislators at both the state and national levels for opinions on certain issues and the process of health-related legislation. At such time, CAMC representatives may hold discussions with legislative officials to present their information and perspectives regarding various health care issues. Such interactions do not typically involve CAMC expressing whether or not they support a particular bill, but rather consist of general discussions related to the pertinent health issues. CAMC is a member of the West Virginia Hospital Association, Association of American Medical Colleges, and 340B Health for Pharmaceutical Access. A percentage of the membership dues paid are related to lobbying activities.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Charleston Area Medical Center Inc

Employer identification number

55-0526150

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	47,735,117	41,042,263	37,936,483	36,907,460	36,316,561
b	Contributions ...	1,198,091	1,557,388	664,817	15,881,552	817,450
c	Net investment earnings, gains, and losses	-1,872,517	5,953,945	3,046,608	-1,263,368	1,272,837
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	2,661,530	818,479	605,645	12,972,453	1,496,226
f	Administrative expenses ....				616,708	3,162
g	End of year balance ......	44,399,161	47,735,117	41,042,263	37,936,483	36,907,460

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

31.000 %

Temporarily restricted endowment SchDMd Bullet

69.000 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	30,409,557		30,409,557
b	Buildings ....	512,075,535	272,532,260	239,543,275
c	Leasehold improvements	11,762,533	9,361,956	2,400,577
d	Equipment ....	528,526,835	445,922,691	82,604,144
e	Other .....	24,075,135	11,011,241	13,063,894
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				368,021,447

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Malpractice Fund	46,964,315	F
(2)Malpractice Fund	1,347,830	C
(3)Recruitment/Student Loan	1,858,432	C
(4)Investments Other	6,732,457	C
(5)2013 Note Project Fund	31,371,440	F
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	88,274,474

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) Interest in Net Assets - CAMC Foundation				44,399,162
(2) Bond Debt Reserve Fund				12,818,191
(3) Bond Collateral				11,460,000
(4) Trustee Funds				6,910,053
(5) Affiliate Receivable- CAMC Foundation				235,060
(6) Affiliate Receivable- CHERI				358,103
(7) Derivative Asset Value				5,093,850
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				81,274,419

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	42,409
Estimated Malpractice Claims	30,612,000
Estimated Workers Compensation Claims	1,455,158
Affiliate Payable- CAMC Foundation	49,287
Affiliate Payable- CHERI	2,972,228
Settlements due to 3rd Parties	13,736,014
Estimated Retiree Health	1,822,182
Umbrella Trust & SERP	12,625,302
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	63,314,580
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Part IV, Line 2b:	CAMC operates HealthCare Financial Services, which provides collections services to outside clients. Payments that are not recovered by the collection department include both the commission portion and the amount due to the outside client. The amount listed in Part X Line 21 reflects the amount CAMC needs transmitted to the client.
Part V, Line 4:	To further the mission of the organization.
Part X, Line 2:	CAMC's financial statements are audited as part of the financial statements of CAMC Health System, Inc. and Subsidiaries (collectively, the "System"). Language regarding ASC 740 (FIN 48) included in the consolidated footnotes is as follows: "The IRS has determined that CAMC, the Foundation, the Institute and the Health Network are exempt from income taxes under Section 501 (c)(3) of the Code and applicable state statutes. The System does not have any material uncertain tax positions as of December 31, 2018."

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Charleston Area Medical Center Inc

Employer identification number

55-0526150

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	18,289,254		18,289,254	1.650 %
b	Medicaid (from Worksheet 3, column a) . . . . .	263,226,393	185,621,000	77,605,393	7.000 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	2,808,371	1,827,606	980,765	0.090 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	284,324,018	187,448,606	96,875,412	8.740 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,562,762	0	1,562,762	0.140 %
f	Health professions education (from Worksheet 5) . . .	42,585,122	6,854,704	35,730,418	3.220 %
g	Subsidized health services (from Worksheet 6) . . . .	842,181	719,182	122,999	0.010 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	319,833		319,833	0.030 %
j	Total. Other Benefits . .	45,309,898	7,573,886	37,736,012	3.400 %
k	Total. Add lines 7d and 7j .	329,633,916	195,022,492	134,611,424	12.140 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	662		662	0 %
3	Community support	202,962		202,962	0.020 %
4	Environmental improvements		0
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	42,703		42,703	0 %
9	Other	147,735	33,684	114,051	0.010 %
10	Total	394,062	33,684	360,378	0.030 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

44,326,663

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

14,361,839

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

330,388,829

Enter Medicare allowable costs of care relating to payments on line 5.....

502,599,701

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-172,210,872

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 General Division Medical Office Building LLC	Medical Office Space Rental	79.930 %	20.070 %
22 Charleston Area Radiation Therapy Centers LLC	Radiation Therapy	20.000 %	30.000 %
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?4Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Facility reporting group
1	CAMC Memorial Hospital 3200 MacCorkle Avenue Charleston,WV25304 www.camc.org 20	X	X	X	X	A
2	CAMC General Hospital 501 Morris Street Charleston,WV25301 www.camc.org 20	X	X	X	X	A
3	CAMC Women and Children's Hospital 800 Pennsylvania Avenue Charleston,WV253025302 www.camc.org 20	X	X	X	X	A
4	CAMC Teays Valley Hospital 1400 Hospital Drive Hurricane,WV25526 www.camc.org 20	X	X	X	X	B

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 17

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): See Part V, Section C.

Other website (list url): www.healthykanawha.org

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): See Part V, Section C.

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000% and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

http://www.camc.org/charity-uninsured-plan

The FAP application form was widely available on a website (list url):

http://www.camc.org/charity-uninsured-plan

A plain language summary of the FAP was widely available on a website (list url):
http://www.camc.org/charity-uninsured-plan

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Facility Reporting Group - B
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): See Part V, Section C.

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): See Part V, Section C.

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Facility Reporting Group - B
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000% and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

http://www.camc.org/charity-uninsured-plan

The FAP application form was widely available on a website (list url):

http://www.camc.org/charity-uninsured-plan

A plain language summary of the FAP was widely available on a website (list url):
http://www.camc.org/charity-uninsured-plan

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	Facility Reporting Group - B
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Facility Reporting Group - B
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B. Facility Reporting Group A	Part V, Section B, line 7a: https://www.camc.org/documents/Community/2017-2019%20Community%20Health%20Needs%20Assessment%20and%202017%20-%202019%20Implementation% 20Strategy.pdfSchedule H, Part V, Section B. Facility Reporting Group APart V, Section B, Line 10a:https://www.camc.org/documents/Community/2017-2019%20Community%20Health%20Needs%20Assessment%20and%202017%20-%202019%20Implementation%20Strategy.pdf
Part VI:	Part V, Section B, line 7a: https://www.camc.org/documents/Community/2018%20CAMC%20Teays%20Community%20Benefit%20Needs%20Assessment%20and%20Implementation%20Strategies.pdfSchedule H, Part V, Section B. Facility Reporting Group BPart V, Section B, line 10a: https://www.camc.org/documents/Community/2018%20CAMC%20Teays%20Community%20Benefit%20Needs%20Assessment%20and%20Implementation%20Strategies.pdf
Part V, Section B	Facility Reporting Group A
Facility Reporting Group A consists of:	- Facility 1: CAMC Memorial Hospital, - Facility 2: CAMC General Hospital, - Facility 3: CAMC Women and Children's Hospital
Facility Reporting Group - A Part V, Section B, line 5:	Household Telephone Survey: The household surveys were conducted using appropriate quality controls which included involving research experts in the design of the survey instrument, thorough and consistent training of interviewers, and the use of reputable survey-analysis software. The principal investigator provided oversight to the surveying process including data collection and entry. Data was collected and entered using a web-based survey. This report was compiled and verified for accuracy by members of the Kanawha Coalition for Community Health Improvement. This survey sample size results in a statistically significant 95% confidence interval with an error margin of plus or minus 5.73%. Not all respondents answered every question; therefore the margin of error was adjusted and reported for each question, based on the number of respondents. Numbers too small to be statistically significant were noted as such. An independent sampling firm randomly selected landline telephone numbers for Kanawha County households. The random landline sample consisted of 8,600 numbers which was screened for disconnects and businesses, resulting in a list of 4,568 numbers. A total of 26 nursing students received training and administered the phone survey. After learning that the number of American homes with only wireless telephones continues to grow and 47.4% of American homes had only wireless telephones (January - June 2015 National Center for Health Statistics Survey), the Kanawha Coalition attempted to increase the number of responses among younger residents and lower income residents, by doubling the acquired address based sample of households with only wireless phones. The wireless sample of 5,600 households received postcards in the mail directing them to the online survey or to call the Kanawha Coalition to arrange a convenient time to take the survey by telephone. The Kanawha Coalition process works to ensure that the survey sample size is valid, and that the sample is randomly selected. It also ensured that the fourth-year nursing students with the University of Charleston's School of Nursing were adequately trained in how to administer the phone survey. As with any telephone survey, there are certain limitations. The result of the survey depends on the accuracy of the responses given by the persons interviewed. Self-reported behavior must be interpreted with caution. To assure proper sampling distribution, the demographics of the survey respondents were compared to county demographics based on 2010-2015 U.S. Census Quickfacts data. This comparison reveals an over-representation of respondents who were female, over 55 years of age, widowed, had no children in the home and were Caucasian. There was an under-representation of African Americans, people with lower-educational attainment (high school or less), those with children in the home, and those who had never been married. Focus Groups:To understand community needs, focus groups were held throughout Kanawha County in November 2016. As one component of the Coalition's five-part assessment, focus groups offer insight into the needs, concerns and experiences of people whose voice is not often heard. Typically, focus groups are comprised of a small group of individuals, usually a vulnerable or target population. In this case focus groups were organized in communities located in different geographical locations in the county. It is important to note that the results reflect the perceptions of some community members, but may not necessarily represent all community members in Kanawha County. A series of six focus groups were convened. Participants received gift cards for their completion of the focus group. The purpose of the discussion was to obtain input on issues that could impact the health of the residents of their communities. A total of 51 community members participated in focus groups in the following communities: Cross Lanes, Elkview, Kanawha City, Marmet, Miami and London. The Kanawha Coalition provided training to fourth year University of Charleston-School of Health Science's nursing students with the University of Charleston-School of Health Sciences to enable them to facilitate the groups. The students also compiled the results and prepared reports of the findings for the Kanawha Coalition.Steering Committee: Steering Committee Members are from the CAMC, Thomas Health System,Highland Hospital, Charleston Area Alliance, Kanawha County Schools, WV Bureau for Public Health, Partnership of African American Churches and the Kanawha Coalition for Community Health Improvement and they serve in an advisory capacity for the Coalition. The Steering Committee follows a set of Guiding Principles as it promotes and safeguards the integrity of the collaborative process as each assumes the role of an equal partner in the process. They make tangible commitments of resources to the Coalition and believe that the process is the product and serves as the vehicle to putpeople together to explore and address challenges and opportunities toimprove the health of the people of Kanawha County. The SteeringCommittee is committed to including all members of the community in thecommunity health needs assessment process as it cultivates acommunity-wide sense of ownership, not organizational ownership. Itprovides encouragement and support to keep Coalition volunteers engagedand motivated while remaining flexible in its approach to meetingcommunity needs. It believes in continuous quality improvement andsupports an ongoing process to evaluate and improve outcomes and itcelebrates successes along the way.Members of the Kanawha Coalition Steering Committee actively participatein the survey planning process to provide public health insight and ensuredata integrity. Additionally, epidemiologists from the West VirginiaDepartment of Health and Human Services work with the Coalition for question design for consistency with other surveys to allow benchmarks andcomparisons. In addition, Key Informant Interviews provide in-depthinformation on the community. The Steering Committee also providescontact information for key informants in the community.Key Informant Interviews:The 87 key informants representing 20 different sectors or areas ofexpertise in the community were given both standardized questions and openended questions designed to elicit a full range of responses. They wereasked to identify the top three populations in Kanawha County with unmetneeds and to share their biggest concerns in terms of health riskbehaviors, clinical care, social and economic factors and the physicalenvironment. They were also asked to share the challenges and barriersthey believed exist and how best to overcome them. Finally, they wereasked to identify the top three overall issues in Kanawha County and whatthey believed to be the top three health related strengths and assets forthe community.
Facility Reporting Group - A Part V, Section B, line 6a:	Thomas Health System (Thomas Memorial Hospital and St. Francis Hospital); Highland Hospital
Facility Reporting Group - A Part V, Section B, line 6b:	United Way of Central West Virginia; FamilyCare Health Center; Kanawha-Charleston Health Department; Kanawha County Schools; Spilman Thomas & Battle, PLLC; Kanawha Coalition for Community Health Improvement; Charleston Area Alliance, Partnership of African American Churches, WV Department of Health and Human Services.
Facility Reporting Group - A Part V, Section B, line 11:	The following community health need issues were identified as community priorities and funded as part of operational planning by the CAMC Board of Trustees: Drugs, Diabetes, Obesity, Heart Disease/Hypertension/Heart Attack/Stroke, Limited Access to Healthy Foods, Tobacco Use, Lack of Access to Mental Health and Addiction Services, and Cancer.1.) One of the community need issues identified is Drugs (all typesillicit and prescription, does not include alcohol). We addressed thiscommunity need issue through the CAMC Ryan White Program. In 2018, therewere 366 participants and we provided $71,795 in unreimbursed care. Wealso addressed this issue with the Drug Addicted Mother Baby Program. In2018, 627 mothers were identified and participated in the program at CAMCWomen and Children's Hospital.2.) Another community need issue identified is Diabetes. We addressed thiscommunity need issue with our Outpatient Diabetes Education Program andInformation available through our Health Information Center. We alsoprovided community screenings via our annual Healthfest and Teddy Bear health fairs.3.) Obesity was addressed via our continued provision of Play Patch, a 940square feet children's play area that includes fruit and vegetable themedplay equipment along with a family restroom at the local shopping mall.4.) Heart Disease/Hypertension/Heart Attack/Stroke was addressed viacommunity education provided via the CAMC Mall Walkers, BLS Training forthe Community, CAMC Healthfest, and Physician Guest Lecture Programs.Health Screenings for heart disease were also provided at the CAMCHealthfest. In all, over 2,000 residents of the community were impactedby CAMC's outreach efforts.5.) Limited Access to Healthy Foods is addressed through our Local WealthCreation "Value Chain program and our continued efforts to work with TheGreater Kanawha Foundation to create and sustain a wealth creation valuechain. This approach bridges conventional approaches to community andeconomic development by using a systems framework, working with wealthcreation value chains. CAMC's 5 county primary service area is comprisedof 356,000 people with a small increases in the size of the workingpopulation since 1990. 18% of people and 25% of children live in povertywith little improvement over the past 10 years. The health connection isthat improvements in health care are associated with higher productivityin the workforce and for the economy overall. The value chain premisesare that we need to be intentionally inclusive of local people and placesas economic contributors to have a positive impact on wealth in ourcommunities. This program's focus is on working with local growers to develop their capability to sell their produce to CAMC at a guaranteedquantity and price and once the process is established to roll it out toother "buyers" . In 2018, we worked with over 140 individuals tocoordinate the number of growers providing fresh produce purchased by CAMCand to maintain and expand GAP certification.6.) Tobacco Use was addressed through "Tobacco Free for Baby and Me",the Tobacco Free Day at the West Virginia Legislature, the ALA Bike Trekand Great Smoke Out. The Tobacco Free for Baby and Me program identifiedover 200 women who were tobacco users through the CAMC Women's MedicineCenter in 2018.7.) Lack of Access to Mental Health and Addiction Services was addressed through the Outpatient Mental Health Program offered through the CAMC Family Resource Center. The program is for low income residents and served 122 individuals in 2018.8.) Cancer was addressed through Breast Cancer Awareness Activities, Community Cancer Screenings, and our Healthy Steps Program, Look Good/Feel Better Program, Breast Cancer Survivorship Group, Lung Bridge Program and participation in various community events such as Relay for Life and Run for Your Life.
Facility Reporting Group - A Part V, Section B, line 13h:	Other criteria considered for financial assistance eligibility: A financial assistance estimation tool that utilizes public records; and whether or not a patient receives assistance from certain state agencies.
Part V, Section B	Facility Reporting Group B
Facility Reporting Group B consists of:	- Facility 4: CAMC Teays Valley Hospital
Facility Reporting Group - B Part V, Section B, line 5:	Putnam County Health Improvement Advisory Committee completed a community survey in May 2018 to identify top issues in Putnam County in the following categories: quality of life, health behaviors, issues affecting quality of life, existing health conditions, and access to care. There were 150 responses collected with 144 of those responses from Putnam County (76% female, 23% male). Towns represented include Bancroft, Buffalo, Culloden, Eleanor, Frazier's Bottom, Hometown, Hurricane, Liberty, Poca, Red House, Scott Depot, Teays and Winfield. Putnam County Health Improvement Key Informant/Partner Survey (May 2018). 47 respondents from a variety of professional sectors including Governmental (21.3%), Health care provider (10.6%), Health care organization (8.5%), Law enforcement (8.5%), Business (6.4%), Mental/Behavioral health (6.4%) and Public safety (6.4%). The findings follow: o Target Populations with Greatest Unmet Need: addictions, mental health, and low income. o Youth Health Risks/Risky Behaviors: drug use (illicit drugs & prescription medications), child abuse/neglect, and unsafe driving habits.o Adult Health Risks/Risky Behaviors: drug use (illicit drugs), obesity, and affordable health care. o Older Adult Health Risks/Risky Behaviors: social isolation, affordable prescriptions, and affordable health care. o Community and Environmental Factors: lack of access to community recreation, lack of access to health foods, and public safety (unsafe neighborhoods).o Clinical Care Barriers to Healthcare. At least 50% of respondents identified the following health care services as having a significant or highly significant barrier to access- Addiction, Mental Health, Dental, Long Term Care, Healthcare Specialists, Primary Care, Vision, and Prescription Drug services.EnAct Community Needs Assessment Putnam County. In May 2018, EnAct Community Action Agency conducted a needs assessment in Boone, Clay, Fayette, Kanawha and Putnam Counties. The project included planning sessions with an interagency team, surveys of key community stakeholders and clients, community discussions with stakeholder groups, researching and compiling various available secondary data sets that inform the assessment and development of the community needs assessment report with key findings. 49 key informants familiar with local services and community conditions 16 completed the community survey in Putnam County. The information presented was prepared and presented by EnAct and EPIC Mission and Collective Impact, LLC. The top issues identified in the following priority areas of need for low income people in Putnam county include: o Healthcare: access to affordable health insurance, assistance with dental procedures, more affordable prescription drugs, and additional substance abuse treatment services.o Nutrition: transporation to grocery store, food pantry, or other food resources; increased availability of food programs such as senior center meals, Meals on Wheels or food pantries, and additional outlets (grocery store) for purchase of healthy food or Education about healthy food choices o Children's Needs: safe, drug free recreation programs for teens; summer activities including day camps for kids; safe homes and neighborhoods.o Senior Needs: meal delivery services, home modifications to accomodate handicaps or limited mobility, and information about internet or phone fraud targeted at Seniors. Key leaders from these groups in Putnam County identified and prioritized community health needs. Through CAMC Teays Valley Hospital's strategic planning process, the community health needs assessment and prioritized community health needs are used to set community health implementation strategies for CAMC Teays Valley Hospital. The Putnam County needs assessment was coordinated using input from the following individuals: Bill O'Dell, Program Director, Putnam County Wellness Coalition Cindy Farley, Chairwoman of the Putnam County Board of Health, John D. Law, Putnam County Health Department Information Officer, Randy Hodges, Vice President/Administrator, CAMC Teays Valley Hospital, Wanda Marks, CAMC Teays Valley Hospital Representative, E. Michael Robie, D.O., CAMC Teays Valley Hospital Representative.
Facility Reporting Group - B Part V, Section B, line 6b:	Putnam County Health Improvement Advisory Committee, Putnam County Health Improvement Key Informant Partner Survey, Putnam Wellness Coalition Survey, EnAct Community Needs Assessment
Facility Reporting Group - B Part V, Section B, line 11:	The following health issues are identified as community priorities in 2018 for 2018-2020: Overweight/Obesity, Access to Specialty Health Care, Substance Abuse (Prevention, Treatment, and Recovery Resources), High Blood Pressure/High Cholesterol, Access to Affordable Health Care, Managing Weight/Exercising/Physical Fitness, Low Income/Poverty, Abuse/Neglect in Children, Access to Affordable Healthy Foods, Adequate Health and Wellness Activities/Adequate Sidewalks, Sufficient Public Transportation, Depression/Anxiety, and Parenting Skills. Implementation strategies for 2018-2020 with 2018 progress updates include:1.) One community need priority addressed is Overweight/Obesity and we addressed it via the provision of free sports physicals, orthopedic coverage for area sporting events, donations for sporting equipment, transportation, and sponsorships for area schools. We supported community activities such as Heart Walk and Go Red. We also provided support for Camp Kno Koma.2.) Another community need priority addressed is Access to Specialty Health Care. We are providing surgery, neurology, urology, orthopedics, oncology, vascular, Level III Cardiac Rehab and Pain Management to the community.3.) Another community need priority addressed is Substance Abuse (Prevention, Treatment and Recovery resources). We provide sponsorship and board direction for the Putnam County Juvenile Drug Court, the 911 Advisory Committee, and the Putnam County Health Improvement Advisory Committee.4.) Another community need priority addressed is High Blood Pressure/High Cholesterol. We provide screenings during the Putnam County Homecoming Health Fair, Winfield Fair, sports physicals, and through our Level III Cardiac Rehab Services. We also provide education materials via the Backpack Buddy program and at various community fairs and festivals.5.) Another community need priority addressed is Access to Affordable Health Care. We provide reduced cost lab work, free sports physicals, charity care, and enrollment assistance for patients and families for health coverage.6.) Another community need priority addressed is Managing Weight/Exercising/Physical Fitness. We supported Camp Kno Koma, provided sports physicals, orthopedic coverage for sporting events and donations for sporting equipment and transportation. We also supported Heart Walk and Go Red.7.) Another community need priority addressed is Low Income/Poverty. We provide charity care and enrollment assistance for patients and families for health coverage. We also provide support for the Putnam County Schools Health Services Cluster Career Conference, the Health Occupations Students Association, the Backpack Buddy Program, and the Putnam Wellness Coalition.8.) Another community need priority addressed is Abuse/Neglect in Children. We provide support for the Putnam Wellness Coalition, the Officer Phil Program, Mandatory reports to the Department of Health and Human Services for Child Abuse and provide trained nurses for the Sexual Assault Nurse Examiner (SANE) program.9.) Another community need priority addressed is Access to Affordable Healthy Foods. We provide support for the Backpack Buddy Program and Putnam Aging Agency.10.) Another community need priority addressed is Adequate Health and Wellness Activities/Adequate Sidewalks. We support the Putnam Wellness Coalition, the Medical Response Team at Bible Center Church, Stop the Bleed Program, Sports Physicals, Orthopedic Coverage for area sporting events, donations of sporting equipment, transportation and sponsorships for area schools. We also support area Heart Walk, Fairs and Festivals.CAMC is unable to address certain community health needs:1.) Sufficient Public Transportation: CAMC Teays does not have the capability or funding to address this issue. 2.) Depression/Anxiety: This issue is addressed by CAMC General Hospital in Charleston. 3.) Parenting Skills: This issue is supported through the Family Resource Center at Women and Children's Hospital in Charleston. 4.) Adequate Sidewalks: CAMC Teays does not have the capability or funding to address this issue.
Facility Reporting Group - B Part V, Section B, line 13h:	Other criteria considered for financial assistance eligibility: A financial assistance estimation tool that utilizes public records; and whether or not a patient receives assistance from certain state agencies.

Schedule H (Form 990) 2018

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?17
Name and address		Type of Facility (describe)
1	1 - CAMC Imaging Center 60 RHL Boulevard South Charleston,WV25309	Outpatient Imaging Center
2	2 - CAMC Urgent Care Center 314 Goff Mountain Road Suite 3 Cross Lanes,WV25313	Urgent Care Facility
3	3 - CAMC Physical Therapy and Sports Med 200 Tracy Way Charleston,WV253111258	Rehabilitation Facility
4	4 - CAMC Solutions 2568 Pennsylvania Avenue Charleston,WV253024907	Pharmacy Compounding Center
5	5 - CAMC Rheumatology 4610 Kanawha Ave SW South Charleston,WV25309	Rheumatology
6	6 - St Mary's Laboratory Services 2900 First Ave Suite 607 Huntington,WV25702	Laboratory Services
7	7 - CAMC Weight Loss Center 600 Tracy Way Suite 2 Charleston,WV25311	Weight Loss Center
8	8 - CAMC Primary Care-Nitro 4111 First Avenue 3 Nitro,WV25143	Family Practice
9	9 - CAMC Primary Care-Winfield 3456 Winfield Road Winfield,WV25526	Family Practice
10	10 - Plastic Surgery Center 210 Brooks Street Suite 200 Charleston,WV25301	Plastic Surgery
11	11 - Teays Valley Orthopedics 3703 Teays Valley Road Hurricane,WV25526	Orthopedic Center
12	12 - Urologic Surgical Center 11 Courtney Drive Charleston,WV25304	Urological Center
13	13 - Cardiology-South Charleston 4610 Kanawha Ave SW South Charleston,WV25309	Cardiology
14	14 - Cardiology-Summersville 400 Fairview Heights Road Summersville,WV26651	Cardiology
15	15 - Orthopedics - Madison 467 Main Street Suite 1 Madison,WV25310	Orthopedic Center
16	16 - CAMC EP Cardiology 3100 MacCorkle Avenue SE Suite 205 Charleston,WV25304	Cardiology
17	17 - CAMC Primary Care-Teays Valley 1204 Hospital Drive Hurricane,WV25526	Family Practice

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Part I, Line 3c:	CAMC may screen private pay balances for pre-qualified eligibility byusing financial assistance estimation tools that access public records.Using a proprietary algorithm (looking at tax records, bankruptcies,etc), the tool returns whether the patient is likely to qualify for theFinancial Assistance Policy. In cases where pre-qualified eligibilitydoes not qualify a patient for financial assistance, the patient maycomplete a financial assistance application where application materialis evaluated to determine if the patient can qualify based on incomeand assets. If the patient meets income criteria for eligibility an inventory of available assets is evaluated. If the patients availableassets fall below $50,000 excluding the patients primary residence andprimary vehicle, the patient will qualify for financial assistance.If a patient is found to be receiving certain State agency assistance(i.e. WIC, SNAP, etc), such patient will be presumed eligible for CAMCfinancial assistance, and an application for assistance needed todetermine income and asset eligibility criteria will be unnecessary.
Part I, Line 7:	Utilized worksheet 2 to determine cost-to-charge ratio.
Part I, Line 7, Column (f):	The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 44,326,663.
Part II, Community Building Activities:	CAMC Memorial, General and Women and Children's Hospitals community building activities improve the community's health and safety by addressing the root causes of health problems. CAMC is a member of the Partners in Health Network, Inc. (Partners), which is comprised of a network of mostly small and rural hospitals, clinics and health departments who work together to address quality and educational needs for improving care management, assistance with NCQA accreditation for patient centered medical homes and improved quality through addressing sepsis and other health issues. Access to health care for 5,000 working uninsured individuals in central and southern West Virginia is provided through Partners Community Access Program. Additionally, CAMC provides students enrolled in post-secondary education with related on-the-job training that is required for their graduation. Health Fairs for the community focusing on adults and children provide screening and health information to identify and address health issues. CAMC also partners with the Greater Kanawha Valley to create a value chain food system to support wealth creation for local growers.Kanawha Coalition for Community Health Improvement (KCCHI) Drugs:o Funding secured for Too Good For Drugs curriculum for all grades K-8. o Provided Too Good For Drugs instructor training for elementary and middle school personnel. o Too Good For Drugs implemented in grades K-8, School Year 2018-2019 (Pre/Post Survey Results pending)o Partnered with Kanawha County Schools on Generation Rx program delivered by University of Charleston School of Pharmacy students for all third grade class rooms in Kanawha County, funded by Cardinal Health.o KCCHI serves on the Board of the Kanawha Communities That Care Substance Abuse Prevention Partnership.Diabetes:o Established first ever Kanawha Diabetes Coalition (KDC). It has met monthly since May 2017.o KDC has 140 individual members, representing 60 organizations.o Completed inventory of Kanawha County diabetes and pre-diabetes programs.o Worked with WVU School of Public Health on Health Connect to populate Kanawha County resources based on our inventory. This searchable, mappable online inventory is available at https://www.healthconnection.com/kanwha-diabetes-coalitionresource.o Surveyed Kanawha County clinics regarding their usage of the CDC Prediabetes Screening Test.o Convened major payer to discuss return on investment for Prediabetes programs.o Conducted community assessment, including an environmental scan, of pre-diabetes resources, access to healthy foods, and physical activity opportunities for residents in the flood ravaged Clendenin, WV area. Presented findings and recommendations to Mayor of Clendenin and members of Clendenin City Council.o Developed Internship opportunities for KCCHI KCD work.o Developed written goals and objectives for KDC 2019-2020.o Developed Committee and Leadership structure for the KDC.o Partnered with Quality Insights to develop a Toolkit on How to Start a Diabetes Coalition.o Presented on the Diabetes Coalition Toolkit at the 2019 Try This WV Conference.Obesity:o Included Kanawha County physical activity opportunities in the Health Connection database.o Recruited community-based (non-profit and for profit) physical activity services to the Kanawha Diabetes Coalition. Fitness instructors at local businesses have become certified in the National Pre-Diabetes Prevention Program. o KCCHI continues to serve as a member of the KEYS 4 HealthyKids Steering Committee to address childhood obesity.Communities of Excellence Update:o The Kanawha Coalition is a Cohort One Community for the Communities of Excellence Program, made possible through support of CAMC. This cohort of communities from throughout the nation is working to apply the Baldrige principles for Performance Excellence at the community level.o As a result of our Communities of Excellence work, KCCHI has changed its community assessment model to include Community Health and Social Factors, Community Safety and Infrastructure, Education, Employment, and Local Attractions (arts, entertainment, sports, recreation).CAMC Teays Valley Hospital's community building activities improve the community's health and safety by addressing the root causes of health problems. CAMC Teays Valley supports Medical Explorers, a program designed to introduce youth in Putnam County who have designated health care as their health cluster to the health care environment. This helps to address a lack of parental oversight. Teays also supports the Putnam County Career Fair, Health Services Career Conference, and Portfolio Expositions where area high school students and adults are provided information on the educational requirement for health care careers.
Part III, Line 2:	This is the bad debt expense from the audited financial statements. Bad Debt is the net of discounts, payments and recoveries.
Part III, Line 3:	The estimated amount of bad debt expense attributable to patients eligible under the organization's financial assistance policy would be 14,361,839 for 2018.
Part III, Line 4:	The footnote for Allowance for Uncollectible Accounts is on page 12 of CAMC Health System's audited financial statements. In summary, private pay accounts and amounts for deductibles and co-insurance that are deemed uncollectible that do not appear to meet the charity care guidelines are written off as bad debt expense and appear as a deduction from patient service revenue in the audited financial statements.
Part III, Line 8:	CAMC treats any government reimbursement that is insufficient to cover allocated costs as being a community benefit. CAMC chooses to serve the community by participating in the Medicare program and accepting Medicare reimbursement.
Part III, Line 8:	Cost to charge ratio from the Medicare costs report is used.
Part III, Line 9b:	CAMC's collection policy makes provisions for patients who qualify for financial assistance. Patients who receive financial assistance must have income at 300% or less of Federal Poverty Guidelines, insufficient assets to pay for the care, and may not be eligible for any public programs. Patients who qualify for financial assistance with income under 200% FPG are given a 100% discount. Patients who qualify for financial assistance with income between 201-300% FPG receive a 50% discount. All uninsured patient responsibility debt not approved for financial assistance is reviewed with a financial assistance calculator. This financial assistance estimator process is only used to approve assistance. It is not used to deny assistance. Accounts are only reviewed for Financial Assistance at the 100% discount category. This process is performed before extraordinary collection efforts. Patients without third-party coverage who do not qualify for charity are given a 55% discount from charges (which is greater than any commercial discount). In addition to charity and uninsured discounts, CAMC provides assistance with payment plans, government programs, and an Employee Assistance Program.
Part VI, Line 2:	CAMC supports and strengthens its key communities through a systematic approach that begins with our mission, vision and values. Annually during our strategic planning process we review the community health needs assessment findings and priorities to develop our community strategy. This strategy is based on issues identified through the needs assessment process and supplemented with findings from our internal Environmental Analysis. Communities are identified, strategies are identified and plans are funded, implemented, tracked and measure. Our Board approves the plan and reviews plan progress annually. Because of the size and scope of our services, the approach we use to identify our key communities is based on the strategy, key stakeholders needs, and our capacity. Our community for the KCCHI work groups is Kanawha County as determined by the KCCHI mission. For our CAMC community strategy, community is based on the need identified and population to be addressed. We develop Health Indicator Data Sheets for each of our service area counties and identify key issues to address for all or part of our service area. For example, our Perinatal Telemedicine Project includes 14 rural counties and our Child Advocacy Center and HIV program serve our entire service area. Each strategy is deployed through a planning process that addresses key stakeholder needs and is evaluated based on predetermined criteria for outcomes expected. Cycles of learning have ensured the Civic Affairs Council monetary contributions support community organizations in the service area that are clearly aligned with our community strategy. In addition to addressing community needs and contributing financially, our leadership team serves in key leadership roles for community activities, programs and organizations as well as supports the workforce in participating in many community benefit activities such as Day of Caring and HealthFest. CAMC Teays Valley Hospital supports and strengthens the Putnam County community through its annual planning process where the needs assessmentfindings and priorities are reviewed to develop its community strategy and the community(ies) within Putnam County that are impacted. This strategy is based on issues identified through the needs assessment process and supplemented with findings from review of internal data. Strategies areidentified and plans are funded, implemented, tracked and measured. The CAMC Board Planning and Public Policy Committee and the CAMC Board of Trustees approve the plan and review plan progress annually. In additionto addressing community needs and contributing financially, CAMC Teays' Vice President and Associate Administrator serve in key leadership roles for community activities, programs and organizations as well as supportthe workforce in participating in many community benefit activities. As part of the strategic planning process, CAMC Teays determines if there are additional areas of support that can be provided to address the identified community health needs assessment issues.
Part VI, Line 3:	CAMC informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under CAMC's Financial Assistance Policy during the registration process. Information is available through signage and a plain language summary of the policy is given to each patient. In addition, Financial Assistance applications are available at each registration location. CAMC Financial Counselors are located in each Emergency Department and Admitting area. During registration, if a patient is uninsured, they may be referred to a Financial Counselor who provides education about Charity Care, Medicaid Eligibility and Federal Disability. WV State employees are also on site at each hospital to accept and process Medicaid applications and notify patients if they qualify.
Part VI, Line 4:	CAMC's community area of focus includes our Primary and Secondary Service area. Our primary service area (PSA) includes: Kanawha, Putnam, Fayette, Boone, and Logan Counties. Our secondary service area (SSA) is Clay, Jackson, Lincoln, Mercer, Nicholas, Raleigh, and Roane Counties. Kanawha County constitutes a population of 180,258 with a median age of 43.3 and a household income of $46,865. The PSA/SSA population is 562,808 with a median age of 43.4 and a household income of $44,594. Teays community and primary area of focus is Putnam County. Putnam County has a population of 56,924 with a median age of 42.6 and a household income of $59,732. Demographic, health and socioeconomic information is provided in detail in the 2018 Community Benefit Reports found on www.camc.org.
Part VI, Line 5:	CAMC's governing board is its Board of Trustees, a 17 member community board that meets WV State law requirements for nonprofit boardmembership including community representation. Admission to the medicalstaff is open to all qualified physicians in the area, consistent with thesize and nature of the facility. Each CAMC hospital operates a full-timeemergency room open to everyone, regardless of ability to pay. CAMCserves a broad cross-section of the community through research and charitycare. CAMC applies any surplus funds toward improving facilities, equipment, patient care, medical training, research and education. CAMC'sCommunity Health Improvement Services, Health Professions Education,Financial and In-kind Contributions, Community and Building Activities aredetailed in the Community Benefit Report on our website at www.camc.org.
Part VI, Line 6:	CAMC Health Education and Research Institute serves as the education and research arm of the CAMC Health System. The Institute promotes the health of the community by sponsoring health professional training programs training the region's health professionals in the community, region and state sponsoring management and leadership development programs, sponsoring community health education and prevention education programs for the community, conducting clinical and health services research targeted to improve health and health services delivery of our patients and community, pursuing special program funding and grants to support education and research programs, promoting economic development through its employment of approximately 80 full-time education, research and support staff and through its extramural and externally funded sponsored programs, promoting telehealth opportunities that link providers for health consultation and that improves access to health services to patients, creating linkages to education affiliates allowing approximately 800 learners to receive clinical training experiences at CAMC, sponsoring simulation training experiences for regional education affiliates, and promoting and sustaining networks and partnerships that improve access to clinical trials and research funding opportunities. The CAMC Foundations' mission is to support and promote CAMC's delivery of excellent and compassionate health services and CAMC's contribution to the quality of life and economic vitality of the region. This is accomplished through support of many services to CAMC patients and employees. Each year, the Foundation supports the Prevention First Program at CAMC Women and Children's Hospital. The Prevention First Program seeks to reduce medical costs, facilitate all aspects of health care, including support of the medical plan established by the primary care physician, while meeting the special needs of low-income children and families in the home environment. Specifically, the Prevention First Program promotes healthy outcomes that will decrease pre-term labor, infant mortality, unplanned C-Section rate, NICU/PICU length of stay and increase infant birth weight while promoting well-child care and immunizations. The Foundation also helps keep physicians and allied health care employees up-to-date by providing funding for many continuing education programs.
Part VI, Line 7, Reports Filed With States	WV
Part VI:	The following disclosure is in accordance with Rev. Proc 2015-21 Section 7 in regards to Schedule H, Part V, Section B, Line 13:During part of the tax year, CAMC's financial assistance policy did not reflect a complete list of the providers delivering emergency or other medically necessary care in the hospital facilities. CAMC's financial assistance policy did include a provider list, however the provider list had not been updated since January 2016. This was discovered in April 2018 as CAMC worked with tax consultants on Schedule H for the 2017 Form 990. CAMC updated the provider list on June 29, 2018 and posted the updated provider list on the CAMC website. CAMC has also implemented procedures to ensure compliance with this requirement in the future. CAMC will utilize a 501(r) compliance checklist to ensure compliance with the provider list requirement. CAMC plans to update the provider list and post the updated list to the CAMC website quarterly.
Part VI:	The following disclosure is in accordance with Rev. Proc 2015-21 Section 7 in regards to Schedule H, Part V, Section B, Line 22:During 2017, CAMC did not timely update the calculation of Amounts Generally Billed ("AGB" ). CAMC's financial assistance policy describes that CAMC intended to calculate AGB using the look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period. However, CAMC had not been correctly calculating AGB using the method described in their financial assistance policy ("FAP"). CAMC did complete an analysis in which they believed they were complying with the 501(r) regulations and asserted at that time that no individual that qualified for financial assistance under the FAP was charged more than AGB. CAMC also did not list the percentage for AGB or provide a link to where the AGB percentage can be found on its website. This was discovered in April 2018 as CAMC worked with tax consultants on Schedule H for the 2017 Form 990. In April of 2018, CAMC calculated the AGB percentage based on calendar year 2017 data and implemented the new AGB% and discount offered for those who qualify for financial assistance in their systems within the 120-day period allotted in the regulations. However, during part of the tax year the AGB % was not made available for people to view on CAMC's website, nor within the FAP. CAMC updated the financial assistance policy for the new AGB % and made the FAP widely available on its website and in paper format in September 2018. CAMC has also implemented procedures to ensure compliance with this requirement in the future. CAMC will utilize a 501(r) compliance checklist to ensure compliance with the AGB requirement. CAMC plans to complete the AGB calculation and update the FAP as required annually.

Schedule H (Form 990) 2018

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Charleston Area Medical Center Inc

Employer identification number
55-0526150

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) University of Charleston 2300 MacCorkle Charleston,WV253041099	55-0357039	501(c)(3)	285,000	Nursing, Pharmacy and General Program support
(2) WV Health Right Inc 1520 Washington Street Charleston,WV25311	31-1066881	501(c)(3)	167,300	General Program Support
(3) Braxton County Memorial Hospital 100 Hoylman Drive Gassaway,WV26624	55-0611919	501(c)(3)	75,915	General Program Support
(4) WV Medical Professionals-Health Program 4013 Buckhannon Pike Mount Clare,WV26408	74-3226821	501(c)(3)	30,000	General Program Support
(5) Ronald McDonald House Charities of Southern West Virginia Inc 910 Pennsylvania Avenue Charleston,WV25302	55-0631080	501(c)(3)	26,000	General Program Support
(6) WomenHeart-The National Coalition for Women with Heart Disease 1100 17th Street Suite 500 Washington,DC20036	52-2148006	501(c)(3)	15,000	General Program Support
(7) American Heart Association 7272 Greenville Ave Dallas,TX752314596	13-5613797	501(c)(3)	7,500	General Program Support

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) Nursing Scholarships	47	66,575
(2) Allied Health Scholarships	35	32,500
(3) Medical Scholarships	49	100,150
(4) Employee Dependent Scholarships	22	43,750
(5) Employee Scholarships	175	243,900
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Part I, Line 2:

CAMC provides nursing, allied health and medical student scholarships funded by the CAMC Foundation. An application portfolio is submitted by the candidate and reviewed and scored anonymously by the CAMC Foundation's Nursing Allied Health and Medical Student Scholarship committee co-chairs for subsequent scholarship award by the committee. CAMC provides employee and employee dependent scholarships. Candidates submit an application and required materials and a committee reviews applications based on scholarship guidelines and criteria and awards scholarships. Scholarship payments are submitted directly to the college or university on behalf of the recipient. CAMC provides support to the University of Charleston ("UC") nursing program and pharmacy school program. UC is a nonprofit, tax exempt organization. UC provided CAMC with an acknowledgement letter along with a giving history report. CAMC provides assistance to various community programs which are reviewed by the Civic Affairs Council for award or at the discretion of the Chief Executive Officer.

Schedule I (Form 990) 2018

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Charleston Area Medical Center Inc

Employer identification number

55-0526150

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1David L Ramsey President, CEO & Trustee	(i) (ii)	829,721 ------------- 0	100 ------------- 0	288,993 ------------- 0	188,500 ------------- 0	32,373 ------------- 0	1,339,687 ------------- 0	85,785 ------------- 0
2E Michael Robie DO Director (start 11/18)	(i) (ii)	305,750 ------------- 0	0 ------------- 0	14,113 ------------- 0	11,000 ------------- 0	12,629 ------------- 0	343,492 ------------- 0	0 ------------- 0
3Seyed A Shams MD Trustee (end 10/18)	(i) (ii)	271,903 ------------- 0	0 ------------- 0	36,354 ------------- 0	11,000 ------------- 0	29,043 ------------- 0	348,300 ------------- 0	0 ------------- 0
4Eric D Shouldis MD Trustee	(i) (ii)	362,579 ------------- 0	100 ------------- 0	2,542 ------------- 0	11,000 ------------- 0	35,304 ------------- 0	411,525 ------------- 0	0 ------------- 0
5Robert D Whitler VP Gov't & Comm Affairs	(i) (ii)	194,428 ------------- 0	100 ------------- 0	31,158 ------------- 0	8,091 ------------- 0	26,033 ------------- 0	259,810 ------------- 0	0 ------------- 0
6Kristi Snyder VP Human Resources	(i) (ii)	274,251 ------------- 0	100 ------------- 0	34,439 ------------- 0	166,735 ------------- 0	11,195 ------------- 0	486,720 ------------- 0	23,042 ------------- 0
7Angela Fenton Hill Secretary & General Counsel	(i) (ii)	284,656 ------------- 0	100 ------------- 0	47,705 ------------- 0	161,530 ------------- 0	29,245 ------------- 0	523,236 ------------- 0	34,955 ------------- 0
8Thomas P Mcllwain MD VP Medical Affairs & CMO	(i) (ii)	398,476 ------------- 0	100 ------------- 0	178,698 ------------- 0	94,964 ------------- 0	25,997 ------------- 0	698,235 ------------- 0	40,000 ------------- 0
9Jeffrey L Oskin VP Administrator	(i) (ii)	369,307 ------------- 0	100 ------------- 0	46,088 ------------- 0	229,716 ------------- 0	18,752 ------------- 0	663,963 ------------- 0	33,533 ------------- 0
10Jeffrey H Goode VP Ambulatory Services	(i) (ii)	312,865 ------------- 0	100 ------------- 0	57,794 ------------- 0	241,986 ------------- 0	40,112 ------------- 0	652,857 ------------- 0	36,665 ------------- 0
11S Andrew Weber VP Administrator	(i) (ii)	251,730 ------------- 0	100 ------------- 0	42,050 ------------- 0	128,109 ------------- 0	37,544 ------------- 0	459,533 ------------- 0	31,178 ------------- 0
12Eileen Clark VP Info Services & CIO	(i) (ii)	315,810 ------------- 0	45,000 ------------- 0	61,369 ------------- 0	211,696 ------------- 0	23,497 ------------- 0	657,372 ------------- 0	32,675 ------------- 0
13Stephen Z Bell VP Finance	(i) (ii)	212,976 ------------- 0	100 ------------- 0	67,540 ------------- 0	96,338 ------------- 0	14,523 ------------- 0	391,477 ------------- 0	35,723 ------------- 0
14Robert B Danielson VP Corporate Compliance	(i) (ii)	183,589 ------------- 0	100 ------------- 0	553,911 ------------- 0	19,282 ------------- 0	24,590 ------------- 0	781,472 ------------- 0	279,270 ------------- 0
15Glenn Crotty Jr MD Executive VP & COO	(i) (ii)	521,028 ------------- 0	100 ------------- 0	81,403 ------------- 0	115,537 ------------- 0	36,602 ------------- 0	754,670 ------------- 0	25,440 ------------- 0
16Micheal D Williams VP Administrator	(i) (ii)	314,045 ------------- 0	100 ------------- 0	674,961 ------------- 0	263,286 ------------- 0	35,091 ------------- 0	1,287,483 ------------- 0	660,007 ------------- 0
17Randall H Hodges VP Administrator	(i) (ii)	218,739 ------------- 0	100 ------------- 0	114,903 ------------- 0	9,799 ------------- 0	28,203 ------------- 0	371,744 ------------- 0	0 ------------- 0
18Jeff Sandene Executive VP & CFO	(i) (ii)	473,618 ------------- 0	100,000 ------------- 0	39,861 ------------- 0	190,117 ------------- 0	35,781 ------------- 0	839,377 ------------- 0	0 ------------- 0
19Heidi Edwards VP Prof Prac & CNO	(i) (ii)	205,053 ------------- 0	100 ------------- 0	14,250 ------------- 0	32,324 ------------- 0	25,981 ------------- 0	277,708 ------------- 0	0 ------------- 0
20Elie Gharib Physician	(i) (ii)	1,126,832 ------------- 0	0 ------------- 0	28,224 ------------- 0	11,000 ------------- 0	34,104 ------------- 0	1,200,160 ------------- 0	0 ------------- 0
21Mitchell Rashid MD Physician	(i) (ii)	1,096,381 ------------- 0	0 ------------- 0	53,236 ------------- 0	11,000 ------------- 0	33,014 ------------- 0	1,193,631 ------------- 0	0 ------------- 0
22Robert B Shin MD Physician	(i) (ii)	1,110,855 ------------- 0	0 ------------- 0	25 ------------- 0	11,000 ------------- 0	21,421 ------------- 0	1,143,301 ------------- 0	0 ------------- 0
23Sangeeta Mandapaka Physician	(i) (ii)	1,022,000 ------------- 0	0 ------------- 0	18,500 ------------- 0	11,000 ------------- 0	6,890 ------------- 0	1,058,390 ------------- 0	0 ------------- 0
24Nathan Kister MD Physician	(i) (ii)	961,956 ------------- 0	0 ------------- 0	75,823 ------------- 0	11,000 ------------- 0	34,104 ------------- 0	1,082,883 ------------- 0	0 ------------- 0
25Ronald E Moore Former VP Prof Prac & CNO	(i) (ii)	0 ------------- 0	100 ------------- 0	312,489 ------------- 0	0 ------------- 0	8,515 ------------- 0	321,104 ------------- 0	0 ------------- 0
26Lillian Morris Former Interim CNO	(i) (ii)	147,493 ------------- 0	100 ------------- 0	20,609 ------------- 0	6,013 ------------- 0	3,506 ------------- 0	177,721 ------------- 0	0 ------------- 0
27Rocky Blake Former VP Info Services	(i) (ii)	199,773 ------------- 0	100 ------------- 0	20,492 ------------- 0	8,307 ------------- 0	27,020 ------------- 0	255,692 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Part I, Line 3	The CAMCHSI Board of Directors Compensation Committee selects and supervises an independent consultant who advises the Committee on compensation arrangements and transactions between CAMC Health System, Inc. subsidiaries (including CAMC) and executives (including CAMC's CEO). The Committee uses the data to determine the total compensation of CAMC's CEO and other executive officers. This data is reviewed every two years or when a new person comes into an executive role.
Part I, Lines 4a-b	Ronald Moore received $312,489 severance in 2018. Supplemental Executive Retirement Plan ("SERP"). Participants are key officers of CAMCHSI and subsidiaries. Participant Michael Williams was paid $635,000 in 2018 and participant Robert Danielson was paid $509,117 in 2018. Terms and Conditions of SERP plan: Defined Benefit. Vest at age 60, or later, if one time postponement is made prior to age 59. Deferred vesting date cannot be earlier than age 65 or later than age 68. Benefit at age 60 with 30 years of service is computed as the difference between 55% of Final Average Total compensation and sum of retirement benefits paid from: CAMC Health System, Inc. Qualified Retirement Plan, Non-Qualified Retirement Restoration Plan and 50% of projected age 62 Primary Social Security Benefit. Eligible to receive SERP benefits upon earliest of: normal retirement or date elected, if extended; death; disability; involuntary termination without cause. Early retirement at age 55 with at least 5 years of service reduced 1.83% for each year of service less 30 and 0.5% reduction for each month prior to Normal Retirement Date (age 60). Taxes due upon distribution. Subject to the Substantial Risk of Forfeiture. CEO Supplemental Executive Retirement Plan ("SERP"): Participant-CEO Terms and Conditions of CEO SERP Plan: Defined Contribution. Vest at age 65. Benefit at age 65 projected as the difference between 60% of Final 5 Year Average Total compensation and sum of retirement benefits paid from: CAMC Health System, Inc. Qualified Retirement Plan and 50% of projected age 65 Primary Social Security Benefit. Actual benefits will depend upon simulated investment results based on investment options selected by participant. Eligible to receive SERP benefits upon earliest of: deferred vesting date; death; disability; involuntary termination without cause. Taxes due upon vesting. Subject to the Substantial Risk of Forfeiture. Under the Execu-Flex Benefit Plan (409A), executives receive 11% of their salary in flex allowance. This flex allowance is used to elect executive benefits. Any remaining flex allowance is credited to a tax-deferred Capital Accumulation Account. The minimum vesting period is two years, maximum age is 68. A two year non-compete agreement (Substantial Risk of Forfeiture Agreement) applies if termination of employment occurs prior to the vesting date. Certain participants had amounts vested and included as reportable compensation this year, as detailed below: Stephen Z. Bell - $35,770 Eileen Clark - $46,782 Glenn Crotty Jr., M.D. - $53,825 Robert B. Danielson - $34,794 Jeffrey H. Goode - $36,713 Angela Fenton Hill - $34,999 Randall H. Hodges - $75,071 Thomas P. McIlwain - $50,147 Jeffrey L. Oskin - $33,577 David L. Ramsey - $228,835 Kristi Snyder - $23,072 S. Andrew Weber - $31,219 Robert D. Whitler - $18,080 Michael Williams - $25,039
Part I, Line 7	The organization provides incentive payments to certain employees after operating and performance goals are achieved. Incentive payment plans are reviewed and approved by the CAMC Health System, Inc. Board of Directors Compensation Committee.

Schedule J (Form 990) 2018

Additional Data

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- TIN:

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Charleston Area Medical Center Inc

Employer identification number
55-0526150

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	West Virginia Hospital Finance Authority	62-1256910	956624AQ3	06-19-2008	127,355,000	See Part VI		X		X		X
B	West Virginia Hospital Finance Authority	62-1256910	956622ZV9	09-10-2009	177,519,271	See Part VI		X		X		X
C	West Virginia Hospital Finance Authority	62-1256910	956622F74	07-24-2014	50,641,160	See Part VI		X		X		X
D	West Virginia Hospital Finance Authority	62-1256910	000000000	09-30-2008	26,000,000	See Part VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	10,290,000		88,880,000				9,468,458
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	130,398,907		178,397,572		50,641,160		26,105,219
4 Gross proceeds in reserve funds .............			9,161,405		3,656,786
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	2,071,347		2,455,533		640,714		146,457
8 Credit enhancement from proceeds .............	773,024
9 Working capital expenditures from proceeds .............			17,301,803
10 Capital expenditures from proceeds .............	94,470,515		2,926,790				4,214,557
11 Other spent proceeds .............	33,084,021		146,196,700		50,000,446		21,744,205
12 Other unspent proceeds .............
13 Year of substantial completion .............	2015		2013				2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X		X		X		X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X	X			X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X			X	X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X			X		X	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X			X		X		X
b Name of provider ..........	Merrill Lynch Capital
c Term of hedge .........	2920.0000000000 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........		X

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X	X		X			X
b Name of provider ..........			Wachovia		Wachovia
c Term of GIC .........			2300.0000000000 %		2300.0000000000 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........			X		X
6 Were any gross proceeds invested beyond an available temporary period?	X		X			X	X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference

Explanation

Date Rebate Computation Performed

Issuer Name: West Virginia Hospital Finance Authority Date the Rebate Computation was Performed: 06/30/2013 Issuer Name: West Virginia Hospital Finance Authority Date the Rebate Computation was Performed: 06/30/2014 Issuer Name: West Virginia Hospital Finance Authority Date the Rebate Computation was Performed: 06/30/2013

Schedule K Supplental Information

Part I, Line A (F) Description of purpose: The proceeds for the 2008A Bonds were used to (i) currently refund the Series 1995A Bonds originally issued on 9/26/95, (ii) pay the costs of certain capital expenditures made, or to be made, by CAMC, refinance a bank loan, and (iii) pay the costs of issuing the Series 2008A Bonds, including certain fees of the bank. Part I Line B (F) Description of purpose: The proceeds for the 2009A Bonds were used to (i) currently refund the outstanding principal amount of the 2002 Series A and B Bonds originally issued on 9/24/02, (ii) pay a portion of a termination payment as a result of termination of hedge agreement in connection with the 2002 Bonds (an extraordinary working capital expenditure), (iii) fund a debt service reserve fund, and (iv) pay the costs of issuing the 2009 Bonds. Part I Line C (F) Description of purpose: The proceeds for the 2014A Bonds were used to (i) currently refund and extinguish a portion of the Series 2009A Bonds issued 9/10/2009 and (ii) pay the costs of issuing the 2014A Bonds. Part I Line D (F) Description of purpose: The proceeds of the 2008A Bonds were to refund a portion of a $30,000,000 temporary note used to finance the acquisition, construction and improvement of facility and to finance a project acquisition fund. Differences between the issue price (Part I) and total proceeds (Part II, line 3) are due to investment earnings. Working capital expenditures reported in Part II, Line 9, Column B consist of a swap termination payment. Part II, line 11, column B: Form 8038 reported that $148,894,025 of proceeds was to be used to retire the prior debt. The actual amount required for that purpose was $146,196,700. The remainder was deposited to a project fund and spent on capital expenditures eligible for tax-exempt financing. Part III has been completed for the column B bonds only with respect to the new money portion of the issue, as the refunding portion refunded pre-2003 debt. Part III has been completed for the column C bonds exactly the same as for the column B bonds, since the column C bonds current refunded a portion of the column B bonds. Part IV, Line 6, column A, B, and D: Such amounts were appropriately yield restricted.

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Charleston Area Medical Center Inc

Employer identification number

55-0526150

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance
(1) Haley Edwards	Family member of Heidi Edwards, Officer	5,000	Scholarship	Nursing Scholarship
(2) Audrey Goode	Family member of Jeffrey H. Goode, Officer	7,692	Scholarship	Nursing Scholarship

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2018

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Rick Crotty	Family Member of Glenn Crotty Jr., MD, Officer	66,869	Employed by Organization		No
(2) Barbara Covelli	Family member of Glenn Crotty Jr., MD, Officer	94,790	Employed by Organization		No
(3) Donna Bell	Family member of Stephen Z. Bell, Officer	177,260	Employed by Organization		No
(4) Matthew Griffith	Family member of James P. Griffith, MD, Trustee	25,591	Employed by Organization		No
(5) John Snyder	Family member of Kristi Snyder, Officer	105,234	Employed by Organization		No
(6) Christine Oskin	Family member of Jeffrey L. Oskin, Officer	122,408	Employed by Organization		No
(7) Erik Reeder	Family member of Glenn Crotty Jr., MD, Officer	46,439	Employed by Organization		No
(8) Kim Goode	Family member of Jeffrey H. Goode, Officer	42,405	Employed by Organization		No
(9) Alexis McCormick Whitler	Family member of Robert D. Whitler, Officer	51,767	Employed by Organization		No
(10) Kellie Teel	Family member of S. Andrew Weber, Officer	109,073	Employed by Organization		No
(11) Alan Summers	Family member of Wanda Hightower, Trustee	15,240	Employed by organization		No
(12) Janet Morris	Family member of Lilian Morris, Former Officer	69,135	Employed by organization		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Charleston Area Medical Center Inc

Employer identification number

55-0526150

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Med. Analyzer )	X	2	307,225	FMV
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which is not required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2018)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
Part I, Column (b):	Column (b) refers to the number of items contributed.

Schedule M (Form 990) (2018)

Additional Data

Software ID:
Software Version:

- 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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Charleston Area Medical Center Inc

Employer identification number

55-0526150

Return Reference	Explanation
Form 990, Part VI, Section A, line 4	CAMC's Articles of Incorporation and Bylaws were amended in November 2018, primarily to reflect CAMC's objectives and purposes as a clinical and scientific research and teaching institution and as an organization that promotes the physical and mental health and well-being of the community and discourages the use and/or abuse of addictive substances, including alcohol, drugs and tobacco products.
Form 990, Part VI, Section A, line 6	CAMC Health System, Inc. ("CAMCHSI") is CAMC's sole voting member.
Form 990, Part VI, Section A, line 7a	CAMC Health System, Inc. ("CAMCHSI") is CAMC's sole voting member and has authority to elect all voting trustees of CAMC other than ex-officio trustees named in CAMC's governing documents. The sole voting member has the sole authority to amend CAMC's governing documents.
Form 990, Part VI, Section A, line 7b	CAMCHSI is CAMC's sole voting member and has reserved powers under CAMC's governing documents, which provide that decisions of CAMC's governing body, such as election of officers, approval of annual budgets and borrowings, are subject to approval by the sole voting member. The sole voting member also has all approval powers provided to members of West Virginia nonprofit corporations under state law.
Form 990, Part VI, Section B, line 11b	CAMC compiles necessary information for Form 990 through the efforts of various officers and trustees of the organization and its affiliates. The return is then prepared and reviewed by an external consultant firm. This firm then reviews the completed Form 990 with the CAMC Board of Trustees and its Audit Committee.
Form 990, Part VI, Section B, line 12c	Corporate officers, including the President and Secretary, develop the agendas for board meetings and identify and resolve potential conflict of interest issues relative to action items. Annual disclosure procedures are implemented and the board chair and Nominating Committee periodically review conflict situations. The organization's conflict of interest policy requires all disclosed conflicts to be reported by the Chief Compliance Officer to the CAMC Health System Management Compliance Committee. The Compliance Officer will inform the Board of Trustees Audit Committee at their next scheduled meeting of all such activities approved by the CAMC Health System Management Compliance Committee. The Manager (the direct supervisor of a company representative) may concur with the Compliance Officer's decision or may ask that the Management Compliance Committee review the Conflict of Interest Form in question. The CAMC Health System Management Compliance Committee will then review the conflict of interest in question at the next meeting and their decision is final.
Form 990, Part VI, Section B, line 15	The CAMCHSI Board of Directors Compensation Committee selects and supervises an independent consultant who advises the Committee on compensation arrangements and transactions between CAMCHSI companies and executives. The Committee uses the data to determine the total compensation of CAMC's CEO and the other executives. The data is reviewed every two years or when a new person comes into an executive role.
Form 990, Part VI, Section C, line 19	The organization's audit is part of a consolidated financial audit for CAMC Health System, Inc. and Subsidiaries. Consolidated audited financial statements are available on-line at CAMC.org. They are also filed with the WV Health Care Authority where they are available online and in person. There is no formal method of making the organization's Bylaws and Conflict of Interest Policy publicly available, but they are available upon request. The organization's Articles of Incorporation are on file at and publicly available through the West Virginia Secretary of State's Office.
Form 990, Part XI, line 9:	Increase/Decrease in beneficial interest in CAMC Foundation -3,335,956. Change in Affiliate Receivable 945,536. Affiliate Transfers: CAMC Health System, Inc. and Subsidiaries 1,974,459. Change in Retirement Obligation -435,700. Change in Non-Controlling Interest -168,200.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Charleston Area Medical Center Inc

Employer identification number

55-0526150

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) CAMC Health Network PO Box 1547 Charleston,WV253261547 83-1560412	Integrator of Care	WV	0	0	Charleston Area Medical Center Inc

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)CAMC Health System Inc PO Box 1547 Charleston,WV253261547 55-0664138	Parent Company	WV	501(c)(3)	Line 12C	N/A		No
(2)CAMC Health Education and Research Institute Inc PO Box 1547 Charleston,WV253261547 55-0753754	Medical Educational Research	WV	501(c)(3)	Line 12B	CAMC Health System Inc	Yes
(3)CAMC Foundation Inc PO Box 1547 Charleston,WV253261547 31-0887133	Fundraising	WV	501(c)(3)	Line 12C	CAMC Health System Inc	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Women and Children's Medical Office Building LLC PO Box 1547 Charleston,WV253261547 55-0669065	Medical Office Building	WV	Charleston Area Medical Center Inc	Related	268,938	3,043,392		No		Yes		90.440 %
(2) General Division Medical Office Building LLC PO Box 1547 Charleston,WV253261547 55-0623949	Medical Office Building	WV	Charleston Area Medical Center Inc	Related	335,146	584,318		No		Yes		79.930 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) CAMC Foundation Inc	C	3,721,427	Fair Market Value
(2) Women and Children's Medical Office Building LLC	C	452,212	Fair Market Value
(3) General Division Medical Office Building LLC	C	479,588	Fair Market Value
(4) CAMC Health Education and Research Institute Inc	J	209,994	Contract
(5) CAMC Foundation Inc	K	591,447	Contract
(6) Women and Children's Medical Office Building LLC	K	1,198,171	Contract
(7) General Division Medical Office Building LLC	K	1,007,735	Contract
(8) CAMC Foundation Inc	L	254,912	Fair Market Value
(9) CAMC Health Education and Research Institute Inc	L	513,492	Fair Market Value
(10) Women and Children's Medical Office Building LLC	L	263,608	Fair Market Value
(11) General Division Medical Office Building LLC	L	202,154	Fair Market Value
(12) CAMC Health Education and Research Institute Inc	M	16,974,395	Fair Market Value
(13) CAMC Health Education and Research Institute Inc	P	462,794	Fair Market Value
(14) CAMC Foundation Inc	Q	193,650	Fair Market Value
(15) CAMC Health Education and Research Institute Inc	Q	3,551,178	Fair Market Value
(16) Women and Children's Medical Office Building LLC	Q	293,050	Fair Market Value
(17) General Division Medical Office Building LLC	Q	146,683	Fair Market Value
(18) CAMC Health Education and Research Institute Inc	R	6,022,177	Fair Market Value

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Striving to provide the best healthcare to every patient, every day.CAMC owns and operates four separately-licensed hospitals as a tertiary-care academic medical center designed to provide care for community residents through every stage of life. CAMC patients depend on CAMC to provide convenient and compassionate care delivered regardless of a patient's ability to pay.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	8,973
6	Total number of volunteers (estimate if necessary) .............	6	322
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	11,050,269
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	1,480,411

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,809,964	4,076,490
9	Program service revenue (Part VIII, line 2g) .........	1,095,188,793	1,164,983,303
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,612,561	13,963,443
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,816,522	1,860,179
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,104,427,840	1,184,883,415
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,714,748	1,125,582
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	546,521,430	569,211,300
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 413,354
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	574,434,785	582,147,053
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,122,670,963	1,152,483,935
19	Revenue less expenses. Subtract line 18 from line 12.......	-18,243,123	32,399,480
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	972,952,668	970,849,506
21	Total liabilities (Part X, line 26).............	592,753,399	575,311,355
22	Net assets or fund balances. Subtract line 21 from line 20.....	380,199,269	395,538,151

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	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 714,988,336 including grants of $ 160,407 ) (Revenue $ 1,166,737,450 )
	CAMC is one of West Virginia's largest medical centers with over 8,973 employees and 710 medical staff. CAMC is licensed for 956 beds at four campuses and our health care services delivery focuses on providing a full range of inpatient and outpatient services as a tertiary regional referral center, teaching and safety net hospital. As a regional referral center, CAMC has one of only two state Level 1 Trauma Centers, a Level III Neonatal ICU, a Pediatric ICU, a DNV-Certified Primary Stroke Center, and a Bariatric Center of Excellence. CAMC is the primary medical safety net provider of women and children's and trauma services in central and southern West Virginia and provides 20% of the charity care in the state. There were inpatient days of 218,601, outpatient visits of 616,948, emergency department visits of 102,357 and deliveries of 2,670 in 2018. CAMC gives back to the community because we understand the impact that high quality medical care, charity care, education, corporate contributions and community partnerships have on the lives of real people.

4b	(Code: ) (Expenses $ 38,472,304 including grants of $ 771,875 ) (Revenue $ )
	CAMC has established medical and allied health education excellence as a core competency. Provision and support for education include training for interns and residents, nurses, anesthetists and other personnel. 150 WVU/WVSOM medical students trained at CAMC hospitals and 179 medical residents were employed by CAMC. CAMC provided faculty support to the University of Charleston and BridgeValley Community and Technical College helping educate pharmacy students, nursing students and physician assistance program. CAMC assisted 19 employees through student loan forgiveness, and provided educational assistance to 328 individuals who intend to pursue a career in healthcare.

4c	(Code: ) (Expenses $ 111,503,627 including grants of $ 193,300 ) (Revenue $ 351,985 )
	CAMC does much more than just provide health care, being involved in nearly every aspect of the health and well being of the community. CAMC offered 67 outreach programs which served an estimated 86,066 people. CAMC provided acute inpatient and outpatient hospital services including unreimbursed charity care at cost of $18,289,254. Creative, state-of-the-art programs and services are provided to our community to serve our community - particularly the needs of the low income, elderly and other vulnerable persons. Community benefits are programs or activities that provide treatment or promote health and healing as a response to identified community needs and meet at least one of the following community benefit criteria: 1) Improves access to health care services; 2) Enhances health of the community; 3) Advances medical or health care knowledge; 4) Relieves or reduces the burden of government or other community efforts.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses864,964,267

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	15,143,305	0	2,979,225

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	3,721,427
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	355,063

g	Noncash contributions included in lines 1a - 1f:$ 307,225
h Total. Add lines 1a-1f.......		4,076,490

		Business Code
2a	Net Patient Revenue	621990	1,106,629,384	1,106,629,384
b	Pharmacy	446110	29,497,703		686,192	28,811,511
c	Lab Services	621500	10,304,374		10,304,374
d	Cafeteria/Vending	721000	7,291,041			7,291,041
e	Rental (Non Residentia	531120	5,720,576	890,477		4,830,099
f	All other program service revenue.		5,540,225	3,457,933	59,703	2,022,589
g	Total. Add lines 2a–2f ....		1,164,983,303

3 Investment income (including dividends, interest, and othersimilar amounts) ......			6,219,006	245,953		5,973,053
4 Income from investment of tax-exempt bond proceeds			206,208			206,208
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		114,521,734
b	Less: cost or other basis and sales expenses		106,983,505
c	Gain or (loss)		7,538,229
d	Net gain or (loss).....			7,538,229			7,538,229
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	Laundry		812300	1,195,758	1,195,758
b	Management Fees		541610	581,204	581,204
c	Medical Center Inn		721110	56,959	56,959
d	All other revenue ....			26,258	26,258
e	Total. Add lines 11a–11d ......			1,860,179
12	Total revenue. See Instructions......			1,184,883,415	1,113,083,926	11,050,269	56,672,730

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	638,707	638,707
2	Grants and other assistance to domestic individuals. See Part IV, line 22	486,875	486,875
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	11,748,826		11,748,826
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	1,650,896	1,297,044	353,852
7	Other salaries and wages	438,756,447	346,488,801	91,968,627	299,019
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	13,217,470	10,169,464	2,959,718	88,288
9	Other employee benefits .......	74,071,601	57,353,427	16,692,127	26,047
10	Payroll taxes ...........	29,766,060	21,437,665	8,328,395
11	Fees for services (non-employees):
a	Management ......	13,591,665	11,186,292	2,405,373
b	Legal .........	4,624,519		4,624,519
c	Accounting ...........	740,718		740,718
d	Lobbying ...........	107,136		107,136
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	1,267,642		1,267,642
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	104,500,162	73,385,397	31,114,765
12	Advertising and promotion ....	1,971,162	101,167	1,869,995
13	Office expenses .......	9,715,365	3,141,886	6,573,479
14	Information technology ......	20,997,902	381,413	20,616,489
15	Royalties ..
16	Occupancy ...........	19,889,314	11,838,113	8,051,201
17	Travel ............	2,349,171	848,402	1,500,769
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	60,665	83	60,582
20	Interest ...........	16,158,601		16,158,601
21	Payments to affiliates .......	6,507,272	6,507,272
22	Depreciation, depletion, and amortization ..	42,916,790	17,200,528	25,716,262
23	Insurance ...	12,893,420	68,730	12,824,690
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical Supplies	222,091,501	221,831,158	260,343
b	Provision for Uncollect	43,255,735	43,255,735
c	Provider Tax	30,323,687	30,323,687
d	Sales & Use Tax	11,767,883		11,767,883
e	All other expenses	16,416,743	7,022,421	9,394,322
25	Total functional expenses. Add lines 1 through 24e	1,152,483,935	864,964,267	287,106,314	413,354
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			40,220	1	77,250
2	Savings and temporary cash investments .........			96,191,021	2	149,372,000
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			248,297,908	4	220,305,399
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....			680,627	7	740
8	Inventories for sale or use ........			19,438,245	8	20,889,187
9	Prepaid expenses and deferred charges ......			4,753,299	9	8,129,335
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,106,849,595
b	Less: accumulated depreciation	10b	738,828,148	372,058,362	10c	368,021,447
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			8,948,379	12	8,991,442
13	Investments—program-related. See Part IV, line 11 ..			97,873,873	13	88,274,474
14	Intangible assets ...............			34,422,709	14	25,513,813
15	Other assets. See Part IV, line 11 ...........			90,248,025	15	81,274,419
16	Total assets. Add lines 1 through 15 (must equal line 34)...			972,952,668	16	970,849,506

17	Accounts payable and accrued expenses .....	153,620,119	17	152,827,230
18	Grants payable ...		18
19	Deferred revenue .........	13,240,028	19	6,019,642
20	Tax-exempt bond liabilities .........	279,670,233	20	269,999,232
21	Escrow or custodial account liability. Complete Part IV of Schedule D	59,885	21	69,107
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	82,075,544	23	78,803,365
24	Unsecured notes and loans payable to unrelated third parties ..	5,836,194	24	4,278,199
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	58,251,396	25	63,314,580
26	Total liabilities. Add lines 17 through 25..	592,753,399	26	575,311,355

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	332,464,151	27	351,138,989
28	Temporarily restricted net assets ...........	34,505,258	28	30,583,893
29	Permanently restricted net assets	13,229,860	29	13,815,269
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	380,199,269	33	395,538,151
34	Total liabilities and net assets/fund balances ........	972,952,668	34	970,849,506