2025-11-17T17:35:17-06:00 2024-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 46204 990 2024-01-01 320185772 DAVIS HEALTH SYSTEM FOUNDATION INC DAVI 3046373155 PO BOX 1188 ELKINS WV 26241 JEFF SANDENE EVP AND CFO 3046373155 2025-11-17 1 0 ANGELA M MOORE P00244342 3174648600 2025-11-15 2024 2025-03-06 01:10:19Z RON ANDRO PO BOX 1188 ELKINS WV 26241 829076 0 X WWW.DHSFOUNDATION.COM X 2006 WV DAVIS HEALTH SYSTEM FOUNDATION PROVIDES OPPORTUNITIES FOR OUR COMMUNITY TO ADVANCE HEALTHCARE THROUGH GIVING. FOUNDATION INITIATIVES SUPPORT DAVIS HEALTH SYSTEM'S COMMITMENT TO BRINGING BETTER HEALTH TO LIFE. CONTRIBUTIONS PROVIDE EXPERT STAFF, STATE-OF-THE-ART TREATMENTS, AND CUTTING-EDGE TECHNOLOGIES THROUGHOUT THE POTOMAC HIGHLANDS OF NORTH CENTRAL WEST VIRGINIA SO THAT OUR NEIGHBORS, FRIENDS, AND FAMILIES CAN GO BEYOND ROUTINE CARE WITHOUT GOING FAR FROM HOME. 15 13 0 14 0 0 463426 782615 0 0 31140 -339 14912 -10625 509478 771651 234016 283221 0 0 0 92455 0 0 128786 147984 251717 382000 627393 127478 144258 946065 1160134 55847 80915 890218 1079219 WE CARE FOR LIFE. 0 0 287471 283221 THE DAVIS HOUSE FUND OFFERS CANCER PATIENTS AND THEIR FAMILY MEMBERS A "HOME AWAY FROM HOME" WHEN IT IS NECESSARY TO TRAVEL TO THE DMC CANCER CARE CENTER FOR TREATMENT. NOT HAVING TO WORRY ABOUT WHERE TO STAY OR HOW TO PAY FOR LODGING ALLOWS DAVIS HOUSE GUESTS TO FOCUS ON THE MOST IMPORTANT THING: GETTING WELL. THE DHS FOUNDATION PATIENT ASSISTANCE FUNDS, INCLUDING THE DMC CANCER CARE CENTER PATIENT ASSISTANCE FUND, GUARDIAN ANGEL GENERAL PATIENT ASSISTANCE FUND, AND NORONHA BENEVOLENT CARE FUND, PROVIDE FINANCIAL SUPPORT TO PATIENTS FOR MEDICALLY NECESSARY ITEMS AND SERVICES (INCLUDING A FREE MAMMOGRAM PROGRAM) THAT CONTRIBUTE DIRECTLY TO THE OVERALL HEALTH, WELLNESS, AND QUALITY OF LIFE OF THE INDIVIDUAL. 287471 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WV X RICK SCHERICH 3046373196 812 GORMAN AVE ELKINS WV 26241 MISHA PHILLIPS-LEE DIRECTOR 2.00 40.00 X 0 242415 30075 SHELLY AUGUST DIRECTOR 2.00 0.00 X 0 38449 12513 CHRISTY TRIBBLE TREASURER 2.00 0.00 X X 0 0 0 CINDEE CAMPBELL VICE PRESIDENT 2.00 0.00 X X 0 0 0 JEFFREY S ZURBUCH SECRETARY 2.00 0.00 X X 0 0 0 JUDY SCHOONOVER RITCHIE DIRECTOR/SECRETARY 2.00 0.00 X X 0 0 0 MICHAEL CVECHKO PRESIDENT 2.00 0.00 X X 0 0 0 CHERI STURM DIRECTOR (END 06/24) 2.00 0.00 X 0 0 0 CRYSTAL WARNER GIBSON DIRECTOR 2.00 0.00 X 0 0 0 DAVID CUTLIP DIRECTOR 2.00 0.00 X 0 0 0 DIANNA VANNOY DIRECTOR 2.00 0.00 X 0 0 0 HUGH HITCHCOCK DIRECTOR 2.00 3.00 X 0 0 0 MELANIE DEMPSEY DIRECTOR 2.00 0.00 X 0 0 0 PATRICIA MAYES DIRECTOR (END 06/24) 2.00 0.00 X 0 0 0 PENNY GRAHAM DIRECTOR 2.00 0.00 X 0 0 0 STERL DEAN DIRECTOR 2.00 0.00 X 0 0 0 WHITNEY MORRIS DIRECTOR 2.00 0.00 X 0 0 0 MICHAEL BELL EXECUTIVE DIRECTOR 40.00 0.00 X 0 150382 29802 0 431246 72390 0 0 1 0 0 57660 174000 550955 782615 -339 -339 46800 57660 57425 -10625 -10625 771651 0 0 -10964 275098 275098 8123 8123 85153 25546 59607 7302 2191 5111 4250 4250 154548 154548 2550 2550 2676 803 1873 7506 7506 FUNDRAISING/DONOR RECOG 62195 62195 DUES, SUBSCRIPTIONS 11186 11186 ADMINISTRATIVE EXPENSES 6806 6806 627393 287471 211136 128786 95595 0 818684 552478 4001 0 25235 3000 2550 0 563186 0 41470 946065 1160134 24269 20161 31578 60754 55847 80915 X 246064 -23685 644154 1102904 890218 1079219 946065 1160134 144258 44743 0 X 0 1 X 1 0 X 201525 410026 391317 463426 782615 2248909 56753 56753 258278 410026 391317 463426 782615 2305662 11221 11221 0 11221 11221 2294441 41152 41152 41152 41152 299430 410026 391317 463426 782615 2346814 0.97770 0.98000 0.01750 0.02000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 644154 566849 44749 152848 1102904 562572 523703 442121 644154 849581 -5957 281052 562572 1050143 47515 248077 849581 1051327 164795 165979 1050143 0.47000 0.53000 1 0 0 DUE TO AFFILIATES 60754 60754 X PART V, LINE 4: THE FOUNDATION'S ENDOWMENT FUNDS WILL BE USED FOR THE FOLLOWING: RENOVATE AND OPERATE DAVIS HOUSE WHICH PROVIDES FREE, TEMPORARY HOUSING TO THOSE RECEIVING TREATMENT FOR CANCER AND OTHER CRITICAL ILLNESSES AT DAVIS MEMORIAL HOSPITAL; NORONHA BENEVOLENT FUND-TO PROVIDE FINANCIAL ASSISTANCE FOR PATIENTS WITHOUT INSURANCE, HIGH DEDUCTIBLE PLANS, NOT ON STATE ASSISTANT; RENOVATE THE EMERGENCY DEPARTMENT; CANCER PATIENT ASSISTANCE; AND OTHER CHARITABLE ACTIVITIES. PART X, LINE 2: THE IRS HAS DETERMINED THAT THE SYSTEM ENTITIES ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE CODE AND APPLICABLE STATE STATUTES, EXCEPT FOR MHC, FHE, CMC, AND HFI, WHICH ARE CORPORATIONS SUBJECT TO INCOME TAX. THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2024 AND 2023. TAX RETURNS FOR THE YEAR ENDED JUNE 30, 2020, ARE OPEN FOR THE MHS ENTITIES AND TAX RETURNS FOR THE YEAR ENDED DECEMBER 31, 2021, ARE OPEN FOR CAMC ENTITIES. GOLF 50065 16465 33600 29390 400 2483 DERBY GALA 41430 32330 9100 952 11686 650 5725 1 12965 8865 4100 3996 1587 556 104460 57660 46800 34338 13673 650 8764 57425 -10625 1 DAVIS MEMORIAL HOSPITAL PO BOX 1484 ELKINS WV 26241 550375433 501(C)(3) 214221 0 FMV GENERAL SUPPORT 1 0 CANCER PATIENT ASSISTANCE FUND 301 8123 0 0 0 0 0 0 0 0 0 MISHA PHILLIPS-LEE DIRECTOR 0 242415 0 0 0 0 0 7484 0 22591 0 272490 0 0 MICHAEL BELL EXECUTIVE DIRECTOR 0 143122 0 0 0 7260 0 4598 0 25204 0 180184 0 0 FORM 990, PART VI, SECTION A, LINE 6 DAVIS HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF THE FOUNDATION. THE FOUNDATION'S ARTICLES OF INCORPORATION AND BY-LAWS GRANT TO DAVIS HEALTH SYSTEM, INC. ALL RIGHTS GRANTED TO MEMBERS OF NONSTOCK, NONPROFIT CORPORATIONS BY THE LAWS OF THE STATE OF WEST VIRGINIA. FORM 990, PART VI, SECTION A, LINE 7A ALL DIRECTORS ARE ELECTED BY DAVIS HEALTH SYSTEM, INC., THE SOLE MEMBER OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B DAVIS HEALTH SYSTEM, INC., THE SOLE MEMBER OF THE ORGANIZATION, HAS THE SOLE AUTHORITY TO AMEND, ALTER, RESTATE, OR REPEAL THE ARTICLES OF INCORPORATION AND BY-LAWS; TO ELECT, APPOINT, OR REMOVE ANY DIRECTOR; TO ADOPT A PLAN OF MERGER OR CONSOLIDATION WITH ANOTHER ORGANIZATION; TO AUTHORIZE THE SALE, LEASE, EXCHANGE, OR MORTGAGE OF SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF THE ORGANIZATION; AND TO AUTHORIZE THE VOLUNTARY DISSOLUTION OF THE ORGANIZATION, REVOKE PROCEEDINGS THERE FOR, AND ADOPT A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF THE ORGANIZATION UPON DISSOLUTION. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 WILL BE DISTRIBUTED TO ALL BOARD MEMBERS. IT WILL BE PRESENTED AND DISCUSSED AT A BOARD MEETING OR FINANCE COMMITTEE MEETING, WHICHEVER OCCURS FIRST AFTER COMPLETION OF THE 990. IF THE FINANCE COMMITTEE MEETING IS THE FIRST TO OCCUR, ALL BOARD MEMBERS WILL BE ENCOURAGED TO ATTEND THE FINANCE COMMITTEE MEETING WHERE THE FORM 990 WILL BE DISCUSSED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ADHERES TO THE CONFLICT OF INTEREST POLICY OF DAVIS HEALTH SYSTEM, INC. THAT POLICY REQUIRES THAT EACH DIRECTOR, OFFICER AND COMMITTEE MEMBER WITH BOARD DESIGNATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THE PERSON HAS RECEIVED A COPY OF THE POLICY AND READS AND UNDERSTANDS THE POLICY. BOARD MEMBERS COMPLETE THE STATEMENT IN AUGUST OF EACH YEAR. THE STATEMENTS ARE THEN REVIEWED BY THE EXECUTIVE COMMITTEE. ADDITIONALLY, SENIOR STAFF IS REQUIRED TO ANNUALLY PREPARE A CONFLICT OF INTEREST STATEMENT. FORM 990, PART VI, SECTION B, LINE 15 THE FOUNDATION UTILIZES DAVIS MEDICAL CENTER'S MARKET SALARY STUDY TO EVALUATE AND ADJUST THE COMPENSATION OF THE DIRECTOR, OFFICERS, AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. VANDALIA HEALTH INC PO BOX 1547 CHARLESTON WV 253261547 550664138 PARENT COMPANY WV 501(C)(3) 12C, III-FI N/A 0 CAMC FOUNDATION INC PO BOX 1547 CHARLESTON WV 253261547 310887133 FUNDRAISING WV 501(C)(3) 12A, I CHARLESTON AREA MEDICAL CENTER INC 1 CHARLESTON AREA MEDICAL CENTER INC PO BOX 1547 CHARLESTON WV 253261547 550526150 HOSPITAL WV 501(C)(3) 3 VANDALIA HEALTH INC 0 MONONGALIA HEALTH SYSTEM INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550621551 PARENT COMPANY WV 501(C)(3) 12C, III-FI VANDALIA HEALTH INC 0 MONONGALIA COUNTY GENERAL HOSPITAL COMPANY 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 237441353 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 MON ELDER SERVICES INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 311520863 CONTINUING CARE RETIREMENT CENTER WV 501(C)(3) 10 MONONGALIA HEALTH SYSTEM INC 1 THE FOUNDATION OF MONONGALIA GENERAL HOSPITAL 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550570338 RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL WV 501(C)(3) 7 MONONGALIA COUNTY GENERAL HOSPITAL CO 1 PRESTON MEMORIAL HOSPITAL 150 MEMORIAL DRIVE KINGWOOD WV 26537 311097818 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 PRESTON MEMORIAL MEDICAL GROUP 300 SOUTH PRICE STREET KINGWOOD WV 26537 550717988 PRIMARY AND URGENT CARE WV 501(C)(3) 3 PRESTON MEMORIAL HOSPITAL CORPORATION 1 PRESTON MEMORIAL HOSPITAL FOUNDATION 300 SOUTH PRICE STREET KINGWOOD WV 26537 550740121 RAISE FUNDS FOR PRESTON HOSPITAL WV 501(C)(3) 12B, II PRESTON MEMORIAL HOSPITAL CORPORATION 1 LIABILITY INSURANCE TRUST FOR MONONGALIA HEALTH SYSTEM 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550689535 LIABILITY INSURANCE TRUST WV 501(C)(3) 12A, I MONONGALIA HEALTH SYSTEM INC 1 STONEWALL JACKSON MEMORIAL HOSPITAL 230 HOSPITAL PLAZA WESTON WV 26452 550422958 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC 140 MIDDLETOWN LOOP WHITEHALL WV 26554 853994078 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 CAMC GREENBRIER VALLEY MEDICAL CENTER INC 1320 MAPLEWOOD AVENUE RONCEVERTE WV 24970 884128022 HOSPITAL WV 501(C)(3) 3 CHARLESTON AREA MEDICAL CENTER INC 1 CAMC PLATEAU MEDICAL CENTER INC 430 MAIN STREET OAK HILL WV 25901 921715117 HOSPITAL WV 501(C)(3) 3 CHARLESTON AREA MEDICAL CENTER INC 1 CAMC HEALTH EDUCATION AND RESEARCH INSTITUTE INC PO BOX 1547 CHARLESTON WV 253261547 550753754 MEDICAL EDUCATIONAL RESEARCH WV 501(C)(3) 12A, I CHARLESTON AREA MEDICAL CENTER INC 1 DAVIS HEALTH SYSTEM INC PO BOX 1484 ELKINS WV 26241 550737655 HEALTH SYSTEM WV 501(C)(3) 12B, II MONONGALIA HEALTH SYSTEM INC 0 DAVIS MEMORIAL HOSPITAL INC PO BOX 1484 ELKINS WV 26241 550375433 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM INC 1 BROADDUS HOSPITAL ASSOCIATION INC PO BOX 930 PHILLIPI WV 26416 550379108 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM INC 1 WEBSTER MEMORIAL HOSPITAL 812 GORMAN AVENUE ELKINS WV 26241 871759588 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM INC 1 GENERAL DIVISION MEDICAL OFFICE BUILDING LLC PO BOX 1547 CHARLESTON WV 253261547 550623949 MEDICAL OFFICE BUILDING WV N/A 0 0 DASCO-CAMC HOME MEDICAL EQUIPMENT LLC 501 MORRIS STREET CHARLESTON WV 25301 844487189 HOME MEDICAL EQUIPMENT WV N/A 0 0 MGH SURGERY LLC 2000 MON HEALTH MEDICAL PARK DRIVE MORGANTOWN WV 26505 472736896 SURGERY CENTER WV N/A 0 0 MON HEALTH-DASCO HOME MEDICAL EQUIPMENT LLC 375 N WEST ST WESTERVILLE OH 43082 871577276 HOME MEDICAL EQUIPMENT OH N/A 0 0 CHARLESTON SURGICAL HOSPITAL LLC 1306 KANAWHA BLVD E CHARLESTON WV 25301 550526191 SURGERY CENTER WV N/A 0 0 VANDALIA INSURANCE COMPANY 76 ST PAUL STREET STE 500 BURLINGTON VT 05401 030308754 INSURANCE VT N/A C 1 MON HEALTH CARE INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550654973 MEDICAL EQUIPMENT WV N/A C 1 STONEWALL HOME OXYGEN THERAPY INC 100 MARKET PLACE MALL SUITE 8 WESTON WV 26452 550754278 OXYGEN THERAPY SERVICES WV N/A C 1 HEALTH FACILITIES INC 909 GORMAN AVENUE ELKINS WV 26241 550516937 HEALTH CARE WV N/A C 1 CENTRAL WV MEDCORP INC PO BOX 2630 ELKINS WV 26241 550739314 PHYSICIAN SERVICES WV N/A C 1 DAVIS REGIONAL HEALTH PARTNERS INC PO BOX 2632 ELKINS WV 26241 550746206 CONTRACT NEGOTIATIONS WV N/A C 1 XERCOR RE SEGREGATED PORTFOLIO #2 DAVIS 18 FORUM LANE 2ND FLOOR GRAND CAYMAN CAYMAN ISLANDS CJ KY1-1102 CAPTIVE INSURANCE CJ N/A C 1 FAIRMONT HOME EQUIPMENT AND SUPPLY 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550763259 EQUIPMENT RENT & SVC WV N/A C 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 DAVIS MEMORIAL HOSPITAL INC B 214221 FAIR MARKET VALUE WEBSTER MEMORIAL HOSPITAL C 69120 FAIR MARKET VALUE DAVIS MEMORIAL HOSPITAL INC C 90881 FAIR MARKET VALUE