SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
2020
Open to Public Inspection
Name of the organization
West Virginia University Hospitals Inc
 
Employer identification number

55-0643304
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: . . . . . . . .
3b
 
No
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
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? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (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) . . . 		    16,136,982   16,136,982 1.140 %
b Medicaid (from Worksheet 3, column a) . . . . .     367,779,834 206,880,204 160,899,630 11.340 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     3,910,162 2,620,504 1,289,658 0.090 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     387,826,978 209,500,708 178,326,270 12.570 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     796,433   796,433 0.060 %
f Health professions education (from Worksheet 5) . . .     38,700,338 18,069,034 20,631,304 1.450 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     1,493,711   1,493,711 0.110 %
j Total. Other Benefits . .     40,990,482 18,069,034 22,921,448 1.620 %
k Total. Add lines 7d and 7j .     428,817,460 227,569,742 201,247,718 14.190 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     658   658  
2 Economic development            
3 Community support     333   333  
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy     1,339,335   1,339,335 0.090 %
8 Workforce development            
9 Other            
10 Total     1,340,326   1,340,326 0.090 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
12,430,175
3
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. ......
3
3,008,748
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
354,135,660
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
554,485,713
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-200,350,053
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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 % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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?1Name, 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) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 West Virginia University Hospitals Inc
1 Medical Center Drive
Morgantown,WV26506
wvumedicine.org/ruby-memorial-hospital/
11 		X X X X     X     A
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
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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)
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): 		1
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 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 ................. 5 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.................................. 6a   No
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https//wvumedicine.org/wp-content/uploads/2020/11/JWRMH-2019-Community-Health-Implementation-Plan.pd
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2020
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Schedule H (Form 990) 2020
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Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https//wvumedicine.org/bill-pay/financial-assistance/
b
https//wvumedicine.org/wp-content/uploads/2020/03/Financial-Assistance-Application-Form-3-17-2020.pd
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
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Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
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Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
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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, 20a, 20b, 20c, 20d, 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
Group West Virginia University Hospitals Line Part V, Section B, Line 5 The Community Health Needs Assessment CHNA was prepared by Thomas Bias, Christiaan Abildso, and Emily Sarkees from the West Virginia University Health Research Center. The CHNA process began with a thorough review of the previous cycles needs assessment report and implementation plan. The CHNA also involved collecting both primary and secondary data. Primary data was comprised of a survey of community members perceptions of health issues followed by a community event focused on soliciting input on community health needs and sought to identify group and organizations already providing essential services. Survey data was also reviewed and strategies for improving health outcomes was discussed among the group. Secondary data included US Census Data and County Health Ranking Data. The CHNA can also be found here https//wvumedicine.org/wp-content/uploads/2020/11/JWRMH-2019-Community-Health-Needs-Assessment.pdf .
Group West Virginia University Hospitals Line Part V, Section B, Line 5 The public survey was collected both online and through hard copies from residents 18 years of age and older. Collection points included but were not limited to WVUH staff, social media outlets, city officials, the Shack Neighborhood house, Milan Puskar Health Right, Friendship House, Morgantown Health and Wellness Commission and Early Head Start. The public community event was hosted by West VIrginia University Hospitals leadership in an effort to solicit additional views and perceptions of community health needs in Monongalia County, WV. Organizations represented at the community event included Monongalia County Schools, Mountain Line Transit Authority, Monongalia County Starting Points, Morgantown City Council, United Way of Mon and Preston Counties, Mon River Trails Conservancy, The Shack Neighborhood House, St. Ursulas Food Pantry and Outreach and WVU Medicine staff and students.
Group West Virginia University Hospitals Line Part V, Section B, Line 11 In the proceeding months after the community event, the leadership team met to review the primary and secondary data collected in order to identify priority areas for developing implementation strategies. During this meeting, leadership utilized a prioritization matrix in order to guide their discussion. The group considered the degree to which the hospital can realistically affect health outcomes for each, endeavors already underway for each, as well as level of importance relative to the reach of their impact. The leadership team identified the following prioritized needs 1. Obesity and Related Chronic Disease 2. Substance Use and Mental Health Issues 3. Cancer. The prioritized needs identified in the CHNA are being addressed by West Virginia University Hospitals, Inc. WVUH leadership in the following ways. With respect to obesity and related chronic disease, WVUH believes that the hospital does already provide some programming to address this need identified by the stakeholders. Hospital officials also believe that WVUH has the outreach and capacity to positively affect residents living within the service area via existing and new strategies. Due to its high importance, WVUH is prioritizing this as one of their three implementation topics. WVUH is also addressing the growing issue of substance use/abuse and mental health issues not only within the service area but in the state of West Virginia as a whole. Hospital leadership sees various opportunities to address these issues with close collaboration with Chestnut Ridge Hospital. Lastly, WVUH leadership believes that they can further expand cancer prevention and treatment options to further reduce the rates of cancer in the community.
Group West Virginia University Hospitals, Inc Line Part V, Section B, Line 13b West Virginia University Hospitals, Inc. offers discounted care only to individuals who qualify for free care. WVUH offers a Prompt - Pay Discount Program - patients who have no third party coverage uninsured or uninsurable may be eligible for a 50 self-pay discount while patients who have a guarantor balance may be eligible for a 20 discount. To be eligible for either prompt pay discount, the patient/guarantor must meed certain requirements.
Group West Virginia University Hospitals, Inc Line Part V, Section B, Line 24 All patients are charged an amount equal to gross charges regardless of payment method. Once FAP eligibility is confirmed, charge amounts are moved to Charity Care and no longer charged to the patient.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
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?10
Name and address Type of Facility (describe)
1 Chestnut Ridge Center
930 Chestnut Ridge Road
Morgantown,WV26505 		Behavioral Health Facility
2 Cheat Lake Physicians
608 Cheat Road
Morgantown,WV26508 		General Medical, Physician Offices
3 WVU Suncrest Towne Center
600 Suncrest Towne Centre
Morgantown,WV26506 		General Medical, Physician Offices
4 WVU Sleep Evaluation Center
205 Bakers Ridge Road
Morgantown,WV26508 		Sleep Evaluation
5 WVU Sports Medicine
943 Maple Drive
Morgantown,WV26505 		Sports Medicine
6 WVU Pain Management Center
1075 Van Voorhis Road
Morgantown,WV26505 		Pain Management
7 Wound Management Center
608 Cheat Road
Morgantown,WV26505 		Wound Care
8 Fairmont Regional Cancer Center
1325 Locust Ave
Fairmont,WV26554 		Cancer Treatment Center
9 University Town Centre
6040 University Town Centre Drive
Morgantown,WV26501 		General Medical, Physician Offices
10 Pediatric Neurodevelopment Center
201 Bakers Ridge Road
Morgantown,WV26508 		Pediatric Nuero Development
Schedule H (Form 990) 2020
Page 10
Schedule H (Form 990) 2020
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 WVU Hospital WVUH uses 200 Federal Poverty Guideline FPG to determine free care eligibility. However, WVUH does not offer discounted care to individuals who fail the 200 FPG test.
Part I Line 6a WVUH community benefit numbers are reported in total with the other hospitals within West Virginia United Health System. The most recent amounts can be found on WVU Medicines website here https//wvumedicine.org/about/leadership-and-more/community-benefit/.
Part I Line 7 Total community benefit expense for 2020 is 428,817,460 and is 30.23 of total net expenses. To calculate net expense, bad debt of 32,608,014 was deducted from total expenses of 1,451,058,051 as shown in Part IX line 25 of the core Form 990, for a net expense of 1,418,450,037.
Part I Line 7 Worksheet 2 from the IRS Schedule H instructions was used to derive the Cost-to-Charge ratio, which was used to calculate Charity Care, Unreimbursed Medicaid and other means-tested government programs at cost.
Part II Physical improvements and housing - Annually WVUH employees spend a weekday afternoon - on work time - volunteering at a social service agency to do repairs and maintenance on homes for residents of Monongalia and Preston Counties. For 2020 the volunteer opportunities were fewer however employeees volunteered for other United Way opportunities.
Part II Community Support - During the 2020 COVID pandemic WVUH Emergency Management Coordinator focused on addressing the needs of WVUH, the Health System and the community we serve in the following ways. WVU Medicine established a COVID-19 hotline for community members to contact with questions regarding the virus. This hotline was staffed 7 days a week. WVU Medicine established free COVID-19 testing sites at each hospital location, starting in March 2020, which are currently still running. WVUH held Incident Command meetings twice a day, 7 days a week for several months with hospital leadership, clinical leadership, and other key personnel, including the local health department and WVU. A System Incident Command Center was established to triage system level issues and was staffed 5 days a week for a few months. The RNI began conducting a research study with the goal of being able to predict individuals who would get COVID. WVU Medicine waived telemedicine co-pays for their patients for a period of time. WVUH Partnered with WVU to conduct a monoclonal antibody trial. WVU Medicine produced multiple media campaigns, including interviews, to promote community education.
Part II Coalition building - WVUH employees participate in various community coalitions and other organizations that focus on addressing community health and safety issues. In 2020, employees participated in the Preston County Stakeholders Group, Marion County Stakeholders Group, Monongalia County Stakeholders Group, Monongalia County Family Resource Network Collaborative, Harrison County Family Resource Network Collaborative, Preston County Family Resource Network Collaborative, North Central Community Collaborative, InterMountain Collaborative, Senior Health Advocacy Group and regional youth stakeholder groups.
Part II Community Health Improvement Advocacy - WVUH is committed to improving the health and quality of life to West Virginians in the healthcare setting and in the communities served. In 2020, WVUH continued to support BOPARCs Play for All playground effort. WVUH also organizes and provides space for a weekly farmers market. WVUH does not charge a fee to vendors that wish to come to the farmers market. This famers market is attended by WVUH employees as well as employees of neighboring businesses and community members. In 2019 WVUH also launched a Pharmacy Assistance Program that is easing the burden for uninsured and underinsured patients who need lifesaving medications but not the stress of worrying about how they will afford them. WVUH has a full time employee dedicated to this program.
Part II Community Events - WVUH employees organized several community events throughout 2020. These included Community Day at the recently opened Waynesburg Outpatient Clinic and WVU Medicines Childrens Kids Fair.
Part II Workforce Development The Talent Acquisition team, a subset of the Human Resources Department at WVUH, is committed to workforce development in and around our community. Throughout 2020, the Talent Acquisition team attended 30 events in an effort to better train and recruit healthcare professionals. Our events included attendance at many virtual school/educational events, partnerships with the unemployment office Workforce WV, Jobs and Hope placement program, veteran events, and technical programs.
Part III Line 2 Bad Debt Expense at cost was calculated by multiplying bad debt expense of 32,608,014 by our cost to charge ratio of 38.12 for a total of 12,430,175.
Part III Line 3 Estimated bad debt attributable to patients eligible for charity care was calculated by running a report within our patient revenue software of all bad debt account balances greater than 50,000. The total of that report was 7,892,832 which we then multiplied by our cost to charge ratio of 38.12 for a total of 3,008,748.
Part III Line 3 The estimated bad debt attributable to patients eligible for charity care of 3,008,748 should be considered community benefit due to the fact that anyone with outstanding balances of 50,000 or greater usually qualifies as catastrophic if the patient completes the application process.
Part III Line 3 In our charity care policy, we define catastrophic care as any illness or injury that will likely require continuous or frequent treatment for more than one year. Regardless, that bad debt should be considered community benefit as we provide services to those in need regardless of their ability to pay.
Part III Line 4 WVUHs financial statements are prepared on a consolidated basis as a member of the WV United Health System. The footnote for Accounts Receivable is as follows Patient accounts receivable are reported at net realizable value. For accounts receivable associated with services provided to patients who have third-party coverage, the System estimates net realizable value based on the estimated contractual reimbursement percentage, which in turn is based on current contract provisions and historical paid claims by payor. For self-pay accounts, including uninsured and patient responsibility accounts, the net realizable value is determined using historical collection experience, adjusted for estimated conversions of patient responsibility portions, expected recoveries and changes in trends to estimate implicit price concessions. Management continually reviews the estimated net realizable value of accounts receivable by monitoring cash collections, economic conditions and trends, changes in payor mix, changes in federal or state healthcare coverage and other matters. The System grants credit without collateral to its patients, most of whom are local residents and are insured under third-party payor agreements, primarily with Medicare, Medicaid and various commercial insurance companies. The System records accounts receivable net of estimated price concessions and such amounts have historically been within managements expectations. The mix of accounts receivable at December 31, 2020 from patients and third-party payors is as follows Medicare - 29, Medicaid - 17, Blue Cross - 21, Commercial, managed care and other - 28, Patients - 5, totaling 100.
Part III Line 4 For receivables associated with self-pay patients, which includes both patients without insurance and insured patients with deductible and copayment balances, the System records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the billed rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.
Part III Line 8 The amount reported in Part III Line 6 554,485,713 was calculated using the total Medicare allowable cost from the Medicare cost report, less Medicare reimbursement of direct GME.
Part III Line 8 WVUHs shortfall, 200,350,053 of Medicare program reimbursement should be considered a community benefit because we are relieving a government burden by providing care in excess of our costs to these patients. WVUH has the only Level 1 Trauma Center in the area, and we serve an aging population that relies on WVUH to provide the most state-of-the-art care available in the area.
Part III Line 9b WVUH does have a debt collection policy. When a patient has been approved for financial assistance under our charity care policy, they will not be sent to bad debt. Additionally, if a patient is being evaluated for charity, the patient will not be sent to bad debt agency pending charity guarantor status until the pending status has been finalized approved/denied. All other patients with outstanding balances will be processed through billing and collections pursuant to our Financial Policy.
Part VI Line 2 West Virginia University Hospitals, Inc. WVUH considers several components in assessing how the organization determines the need of the community it serves. For the 2019 CHNA, individuals from the West Virginia University Health Research Center Thomas Bias, Christiaan Abildso, and Emily Sarkees assisted the WVUH leadership team with defining the community served as all of Monongalia County. Data collection was structured so that the leadership team could analyze three different areas of the county based on respondents proximities to each of the three high schools, acknowledging that reported needs of those living in or close to city limits Morgantown differ significantly from those living in more rural areas of the county. Residents were classified into the following categories Morgantown High School area downtown/city limits, University High School area north/east outskirts of town, and Clay-Battelle High School area western end of the county. These classifications were also used for the stakeholder community health concerns survey.
Part VI Line 3 WVUH employs 5.84 financial counselors to meet with patients and discuss eligibility to qualify for charity care. WVUH provides brochures discussing charity care and the qualifications for receiving charity care. These brochures are available at each registration area in the facility. WVUH provides financial assistance to patients who do not qualify for any state or federal programs.
Part VI Line 3 Our charity care eligibility guidelines are also listed on our website at www.wvumedicine.com under the Billing and Insurance - Online Bill Pay section of the Patient and Visitor page. WVUH also has contracted a third party organization to be on-site to help patients, that qualify for charity care, Medicaid, or other types of financial assistance, complete the required applications and provide the correct documentation to receive these benefits.
Part VI Line 4 WVUH serves residents in the entire state of West Virginia and portions of the neighboring states of Maryland, Pennsylvania and Ohio. However, WVUH considers its Primary Service Area PSA to include Monongalia County, WV. The 2019 market share for our PSA is 47.8 with 24.2 of WVUH patients covered by Medicaid. The largest non-profit competitor within our PSA include Monongalia General Hospital. Other non-profit competitors within areas WVUH serves residents include Charleston Area Medical Center CAMC and University of Pittsburgh Medical Center UPMC.
Part VI Line 4 Monongalia County has a population of 105,822, a median household income of 55,940, an employment rate of 60.7 and a poverty rate of 22.3. 4.4 of Monongalia County residents also report that they do not have healthcare coverage. This population and demographic information was obtain from the United State Census Bureau https//data.census.gov/cedsci/.
Part VI Line 4 WVUH offers a comprehensive range of healthcare, from well-child visits with a pediatrician to life-saving surgery. While our central mission is to provide state-of-the-art care to the people of West Virginia and the surrounding areas, the excellence of our services brings people from every U.S. state, and our international program serves patients from countries around the world. WVUH also provides support throughout the entire state of West Virginia by making sure that health care is available to all, regardless of income or health insurance by supporting important educational and social welfare activities within our immediate community and to the entire state of West Virginia and surrounding areas and by providing financial support to the health professions education programs of West Virginia University.
Part VI Line 4 39.7 of West Virginias adult residents suffered from obesity, according to a study by the Center for Disease Control and Prevention. Obesity is defined as a body mass index BMI of 30 or greater. Obesity is a major risk factor for cardiovascular disease, certain types of cancer, and Type 2 Diabetes. WVUH participates in many different programs that address obesity throughout West Virginia The Coronary Artery Risk Detection in Appalachian Communities CARDIAC, Healthy Hearts A Web-based Instructional Module for Children on Cardiovascular Health, Choosy Kids, Helping Educators Attack CVD Risk Factors Together HEART, Walk 100 Miles in 100 days, which is the states largest sustained exercise program, and the WV Healthy Lifestyles Act on Education Practices and Childhood Obesity. WVUH physicians also participate in day camps that promote healthy activities to children in our community.
Part VI Line 4 West Virginia is also faced with high rates of deaths due to cancer and cardiovascular disease. WVUH operates the Mary Babb Randolph Cancer Center MBRCC, this center is West Virginias premier cancer facility with a national reputation of excellence in cancer treatment, prevention and research. MBRCC is recognized by the American College of Surgeons Commission on Cancer for providing the best in cancer care.
Part VI Line 4 In 2017, the new WVU Heart and Vascular Institute HVI opened. The new clinic treats adult patients who need services related to cardiology, cardiothoracic surgery, vascular surgery, thoracic surgery, and cardiac rehabilitation. The HVI provides a comprehensive cardiac care program using the most current diagnostic procedures to detect and evaluate mild to life-threatening heart problems. Our board-certified cardiac experts include medical and interventional cardiologists, surgeons, cardiac electro-physiologists and others who treat people with all types of heart problems-from congenital heart issues to heart attacks.
Part VI Line 4 We offer both traditional and the latest, minimally invasive interventions, followed by cardiac rehabilitation and heart disease management programs. After surgery or other procedures, we work with the primary care doctor to facilitate patient rehabilitation.
Part VI Line 5 WVUHs board of directors is a diverse board, with eight of the fifteen members living in or around Morgantown, WV. The remaining board members live outside the PSA for WVUH, but still live within our overall service area. Having members living outside our PSA allows us to be more aware of the healthcare needs in other areas of West Virginia. Fourteen of the fifteen board members are neither employees nor independent contractors of WVUH, nor family members thereof.
Part VI Line 5 As a university medical center, WVUH only extends medical privileges to faculty of the West Virginia University School of Medicine.
Part VI Line 5 WVUH allocates available funding to capital purchases and expanded services to improve patient care, support of medical education at West Virginia University, and research through support of the Mary Babb Randolph Cancer Center.
Part VI Line 5 WVU Hospital is responsible for providing educational and clinical facilities primarily for the Universitys Schools of Health, Science, Dentistry and Medicine.
Part VI Line 5 WVUH is one of 260 hospitals in the U.S. participating in the first national pay-for-performance demonstration of its kind, designed to determine if economic incentives are effective at improving the quality of inpatient care.
Part VI Line 5 Many WVU Medicine providers and students volunteer their time at Milan Puskar Health Right, a community health clinic, which provides care at no cost to uninsured or underinsured low-income residents. In addition, WVUH organizes Kids Health Fairs, Women Love Your Heart screenings, along with offering free screenings at clinical open houses.
Part VI Line 6 West Virginia University Hospitals, Inc. is a part of the WV United Health System WVUHS. WVUHS is a not-for-profit corporation formed to serve as part of an integrated health science and healthcare delivery team. WVUHS serves as the parent corporation to an affiliated group of healthcare providing entities. The strategic plan of the System states intent to build a regional health care delivery system in its service areas, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves.
Part VI Line 6 System management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. Other hospitals in the System include United Hospital Center in Bridgeport, WV, Camden-Clark Memorial Hospital in Parkersburg, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Potomac Valley Hospital in Keyser, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, Reynolds Memorial Hospital, in Glen Dale, WV, West Virginia Health Care Cooperative, doing business as, Summersville Regional Medical Center in Summersville, WV, Braxton County Memorial Hospital in Gassaway, WV, Community Health Association, doing business as, Jackson General Hospital in Ripley, WV, and Wetzel County Hospital in New Martinsville, WV.
Part VI Line 6 In addition to the above mentioned hospitals, the System includes physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp that operate in conjunction with the System hospitals along with United Summit Center, Inc. a behavioral health center located in Clarksburg, WV. The System also includes, WVUH-East, Inc. and Camden-Clark Health Services, Inc. which operate as management companies for their respective hospitals. University Healthcare Foundation, Inc. in Martinsburg, WV, United Health Foundation, Inc. in Bridgeport, WV, Camden-Clark Foundation, Inc. in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation, Inc. in Glen Dale, WV, which perform various fundraising activities for their respective hospitals. In 2020, the System formed WVUHS Home Care, LLC to provide Home Health and Hospice services to our service areas, supporting System hospitals by providing continuous care to our patients.
Schedule H (Form 990) 2020
Additional Data


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