2017-08-15T12:39:07-05:00 2016-09-30 550486667 Arnett Carbis Toothman LLP P O Box 2629 Charleston WV 25329 990 2015-10-01 550392395 Highland Hospital Association HIGH 3049261600 300 56th Street Charleston WV 25304 Chris Miller CFO 3049261600 2017-08-11 1 Dolores Rose P01286262 3043460441 2015 2017-02-10 21:41:12Z Cynthia Persily 300 56th Street Charleston WV 25304 22968874 0 X www.highlandhosp.com X 1955 WV To provide psychiatric care to adults and children. 13 9 429 0 0 0 473 11421 18724850 21947138 1329 3352 703570 1003033 19430222 22964944 500 3297 0 0 11792966 13887180 0 0 0 7535399 8797775 19328865 22688252 101357 276692 7929536 9932702 6874705 10191697 1054831 -258995 To provide psychiatric care to adults and children. 0 0 19392746 3297 22950171 The hospital provided 22,700 inpatient days of psychiatric care, including 8,555 inpatient routine service days, 13,933 sub-provider service days, and 212 sub-acute service days. 19392746 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 22 0 429 1 0 0 0 0 0 0 0 0 0 0 X 13 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X Chris Miller 3049261600 1418A MacCorkle Avenue SW Charleston WV 25303 James H Dissen Chairman 40.00 4.00 X X 40731 0 479 Mike Casdorph Vice-Chairman/Treasurer 1.00 2.00 X X 35187 0 185 Kiran S Devaraj MD Secretary 40.00 9.00 X X 343660 0 15036 Cynthia Persily PhD CEO 15.00 30.00 X X 194103 0 0 Nohl A Braun Jr MD Trustee 20.00 20.00 X 0 343574 11592 Allan McVey Trustee 1.00 2.00 X 0 0 0 Amy Lawson Booth Trustee 1.00 0.00 X 0 0 0 Brenda Isaac RN Trustee 1.00 0.00 X 0 0 0 Charlie Wilson Trustee 1.00 0.00 X 0 0 0 Erica Mani Trustee 2.00 1.00 X 0 0 0 Gary McCallister Trustee 1.00 0.00 X 0 0 0 Matt Coleman Trustee 1.00 6.00 X 0 0 0 Michelle Easton PharmD Trustee 1.00 2.00 X 0 0 0 R Terrance Rodgers Trustee 1.00 6.00 X 0 0 0 Christopher Miller CFO as of 10/26/2015 40.00 0.00 X 86003 0 6198 Jennifer Thacker Pharmacist 40.00 0.00 X 100472 0 10537 Diana Martin MD Physician 40.00 0.00 X 138014 0 4927 Daniel G Walker Pharmacist 40.00 0.00 X 131670 0 10150 1069840 343574 59104 5 0 1 0 Charleston Area Medical Center PO Box 388 Charleston WV 25323 Lab Services 407935 Netsmart Technologies 4950 College Boulevard Overland Park KS 66211 Electronic Medical Records Vendor 223305 Security America PO Box 4525 Charleston WV 25364 Contracted Security Services 137223 Rafael Gomez MD 737 Lower Donnally Road Charleston WV 25304 Contracted Physician 116420 4 11421 11421 11421 Inpatient Services 622110 21947138 21947138 21947138 7282 7282 3930 -3930 -3930 -3930 Management Services 541610 646836 646836 Pharmacy Service Revenue 446110 219025 219025 137172 137172 1003033 22964944 22950171 0 3352 3297 3297 686029 582507 103522 10465297 8886084 1579213 551516 468292 83224 1281956 1088508 193448 902382 766213 136169 82243 82243 171122 171122 707870 601052 106818 172256 146263 25993 557736 473574 84162 3484325 2958540 525785 27860 23656 4204 12038 10221 1817 17412 14785 2627 252556 214445 38111 306781 260488 46293 Bad debts 1287487 1287487 Medical supplies 494594 494594 Healthcare Provider Tax 491074 491074 Repairs & Maintenance 441734 375076 66658 290687 246590 44097 22688252 19392746 3295506 0 520316 438235 8012 8012 3337617 5451624 144211 190793 356223 293590 7071797 5487328 1593775 1584469 20042 24473 1949340 1941506 7929536 9932702 2742053 2972939 154024 172509 3978628 7046249 6874705 10191697 X 1054831 -258995 1054831 -258995 7929536 9932702 X 276692 -375345 -1215173 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 237363 237363 3935913 3462460 473453 155881 127375 28506 2650693 1824955 825738 91947 72538 19409 1584469 Receivable From HHC, Inc. 267757 Receivable From HBHS, Inc. 541194 Receivable From Clarksburg/Intercompany 1128637 Other Receivables 800 Receivable From WVHHS 3118 1941506 Payable to Highland Hospital Foundation, Inc. 172330 Accrued Pension Cost 4594447 Payable to HHA, Inc. 2263752 Payable to other 15720 7046249 X Part X, Line 2: HHA, Inc, and Subsidiaries are exempt from Federal and State income taxes under Section 501(c)(3) of the Internal Revenue Code and similar state statues relating to not-for-profit organizations. Accounting principles generally accepted in the United States of America require the management of the Association to evaluate tax positions taken by the Association. Management has evaluated the Association's tax positions and did not become aware of any course of action on services or events that might adversely affect the entities' tax status. Therefore, no provision or liability for income taxes has been included in the consolidated financial statements. The Association is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The management of the Association believes it is no longer subject to income tax examination for years prior to the fiscal year ended September 30, 2013. 1 1 X 1 X 1 X 1 1 0 0 4145 4145 0.00020 8820486 8820486 8824631 8820486 4145 0.00020 458280 458280 0.02140 33906 33906 0.00160 492186 492186 0.02300 9316817 8820486 496331 0.02320 0 1287487 1029990 999477 999477 X 1 1 1 1 Highland Hospital Association 300 56th Street SE Charleston WV 25304 X Psych hospital Highland Hospital Association 1 0 0 1 X X X X X X X X 15 1 0 0 1 X See Part V, Section C for complete URL X 1 15 1 See Part V, Section C for complete URL 0 0 1 X 100.000000000000 200.000000000000 X X X X 1 1 X X X 1 X http://www.highlandhosp.com/charleston/our-organization X http://www.highlandhosp.com/charleston/our-organization X http://www.highlandhosp.com/charleston/our-organization/charity-care/ X X X X 1 X 0 X X X X 0 X X 0 0 Highland Hospital Association Part V, Section B, Line 5: For this needs assessment, Highland Hospital included feedback from the community and experts in the public health, mental health, and clinical care field. The assessment also took into account the health needs of vulnerable populations, including minorities, those with chronic illness, low-income and medically underserved. Highland Hospital Association Part V, Section B, Line 11: Cost limitations prevent the Hospital from addressing every need identified in the CHNA. Schedule H, Part V, Section B, Line 7a https://drive.google.com/file/d/0B1ikhcmrwaHFS095RTg2U1FOWjg/view? usp=sharing Schedule H, Part V, Section B, Line 10a https://drive.google.com/file/d/0B1ikhcmrwaHFZ1A2Uzl1UE5MLUk/view? usp=sharing Part I, Line 7: The amount of cash and in-kind contributions to community groups was obtained from the hospital's accounting records. 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 $ 1,287,487. Part III, Line 2: The cost of bad debts was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions. Part III, Line 3: Approximately 80% of those who are eligible do not provide proof of income or don't apply for charity care. Line 3 equals 80% of bad debt expense on Line 2. Part III, Line 4: Financial footnote that describes bad debt expense: Patient accounts receivable are reported at estimated net realizable amounts from patients and responsible third-party payors. Amounts owed to the Association are reported net of allowances for uncollectible accounts. Specific patient balances are written off at the time they are determined to be uncollectible. The process for estimating the ultimate collection of receivables involves significant assumptions and judgments. In this regard, the Association has implemented a standardized approach to estimate and review the collectability of its receivables based on patient accounts receivable aging trends. Historical collection and payor reimbursement experience is an integral part of the estimation process related to determining an allowance for contractual and uncollectible accounts. In addition, the Association assesses the current state of its billing functions in order to identify any known collection or reimbursement issues to determine the impact, if any on its reserve estimates, which involve judgment. Revisions in reserve estimates are recorded as an adjustment to net patient service revenue or the provision for uncollectible accounts. The Association believes that its collection and reserve process, along with the monitoring of its billing processes, help to reduce the risk associated with material revisions to reserve estimates resulting from adverse changes in collection, reimbursement experience and billing functions. Part III, Line 8: Medicare costs were obtained from the hospital's Medicare cost report. Part III, Line 9b: Patients and former patients with delinquent private pay accounts will be notified and given the option of paying in full or participating in a predefined monthly payment plan. Patients will be notified of their financial obligation for services rendered by receiving monthly billing statements. The Hospital offers a charity application and sliding-scale discount application to each patient at time of admission. If the patient does not qualify for charity, does not return the application, or returns it and does not qualify for charity assistance, the patient is contacted to make payment arrangements. Then, the hospital sends out four invoices and three collection notices over a period of time, after which the patient is turned over to a collection agency. In essence, the patient has 120 days to either apply for charity care or make payment. Part VI, Line 2: This CHNA focuses on the primary service area of Kanawha County, West Virginia. The study considered services offered by hospitals in the area, population trends, socio-economic demographics and the region's overall sufficiency of healthcare providers in the community. The study included data obtained from numerous health organizations as well as interviews with community leaders, hospital staff and the Hospital's Board of Directors. This information is being used to determine the community's future health needs. Part VI, Line 3: Uninsured patients are notified of the charity care and sliding fee scale discount policies at admission and again during the collection process if they have not already taken advantage of the available programs. Part VI, Line 4: Our primary service area is defined as the geographic area within which the majority of our patients reside. After reviewing our 2015 Summary of Discharges by County, we determined our Primary Service Area to be Kanawha County, WV with 47% of our total discharges living in Kanawha County. Our secondary service area based on our 2015 Summary of Discharges by County is a 10-county area that includes: Putnam, Boone, Cabell, Wood, Jackson, Mercer, Logan, Fayette, Raleigh, and Lincoln with 33% of patients residing within these 10 counties in West Virginia.According to the United States 2010 census, Kanawha County, West Virginia has a population of 193,063 living in 92,618 housing units and has a population density of 214.1 persons per square mile. In Kanawha County 89.1% of persons self-identified as white and 7.3% self-identified as black. High school graduates comprise 85.9% of the population over 25 and 23.4% have a college degree. An estimated 13.7% of persons live below the poverty level in the county. The population is aging, with 45% of the population over the age of 45.We are a small rural state with pockets of some urbanization. We provide treatment to patients from all 55 counties of the state. The population of West Virginia is 1,852,994 according to the US Census report from 2010. This is up 2.5% from 2000. The 2009 average income in WV was $32,219, while the US average income was $39,130. The 2010 percentage of residents below the poverty level in WV was 17% while the percentage in the entire US is 13.2%. The percentage of Medicaid patients for 2010 was 36%. There are 2 other community psychiatric hospitals in our state and 2 state-operated inpatient facilities. Part VI, Line 5: 1) All of Highland's board members reside in our service area. 2) Highland extends medical staff privileges to all qualified physicians in our one department. 3) Highland reinvests all of our surplus back into our daily budget. We keep up with current trends on facility improvements and provide medical staff development opportunities to staff by encouraging and supporting participation in conferences and other related seminars. 4) Highland offers behavioral health treatment to children and adolescents, a service that is not offered elsewhere in the Charleston area. 5) The Highland Hospital Foundation raises money throughout the year through events, mail appeals, Neighborhood Investment Programs and donations. 6) Highland has a web site that discusses our community involvement. Part VI, Line 6: Highland's mission is to identify and respond to mental health needs, and promote physical, social, emotional and intellectual well-being. Our vision is to be a valued leader in psychiatric healthcare, recognized for providing innovative and patient-centered programming in a technologically advanced, financially secure and user-friendly environment. Our values include a genuine commitment to learning, continuous evaluation and improvement, data-based decision-making, and respecting and supporting the individual needs and differences of patients, staff and our community. X X 0 0 0 0 0 0 0 0 0 Kiran S Devaraj MD Secretary 343660 0 0 0 0 0 0 0 16782 0 360442 0 0 0 Cynthia Persily PhD CEO 194103 0 0 0 0 0 0 0 1498 0 195601 0 0 0 Nohl A Braun Jr MD Trustee 0 343574 0 0 0 0 0 0 0 12920 0 356494 0 0 Form 990, Part VI, Section B, line 11 The 990 is received from the accounting firm and reviewed by the CEO and CFO to make sure nothing is omitted. The CFO then signs the return and mails it to all regulatory and tax authorities. Form 990, Part VI, Section B, line 12c The Quality Management Director keeps a copy of the policy on file and secures the signatures of the board members every year. If situations arise, board members will excuse themselves from any vote in which they may have a conflict of interest. The conflict of interest policy is reviewed annually by the Risk Manager in a meeting with board members to ensure there are no conflicts at voting times. Form 990, Part VI, Section B, line 15 The organization reviews compensation levels on a comparative basis. The CEO must approve all salary increases whether by job type, or individually. The CEO's salary is negotiated with and approved by the Board of Directors. The Data Blue Market Watch Survey is used to compare and provide guidance in compensation decisions. Form 990, Part VI, Section C, line 19 The 990 is available through direct inquiry of the fiscal office of the organization. Form 990, Part XI, line 9: Pension Plan Adjustment -1,215,173. Form 990, Part XII, Line 2C Highland Hospital Association has a separate finance committee which oversees the audits of all of the members of Highland Health System. The Finance Committee reviews and makes a recommendation to the Board of Directors as to whether to accept the audit and point out any areas of discussion or concern with Board members. The process has not changed. Highland Behavioral Health Services Inc 300 56th St Charleston WV 25304 550777789 Psychiatric Treatment WV 501(c)(3) 9 HHA Inc 0 HHA Inc 300 56th St Charleston WV 25304 550705453 Parent Company WV 501(c)(3) 11, Type I N/A 0 Highland Health Center Inc 300 56th St Charleston WV 25304 205948175 Patient Treatment WV 501(c)(3) 3 HHA Inc 0 Highland Hospital Foundation Inc 300 56th St Charleston WV 25304 550705451 Foundation WV 501(c)(3) 11, Type I HHA Inc 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0