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Nonprofiteer
← DAVIS MEMORIAL HOSPITAL

Form 990 for tax year 2022

Filed by DAVIS MEMORIAL HOSPITAL.

Totals

Total revenue
$116,156,825
Total expenses
$138,191,455
Contributions and grants received
$956,495
Grants paid
$64,305
Program service revenue
$116,357,826
Investment income
-$1,560,117
Other revenue
$402,621
Total assets, end of year
$85,218,888
Total liabilities, end of year
$50,299,505
Net assets or fund balances, end of year
$34,919,383
Program services expenses (Part IX)
$107,888,496
Management and general expenses
$30,302,959
Fundraising expenses
$0
Program service expenses (Part III)
$107,888,496

Program services were 78.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • BRIDGETTE WILSON

    CHAIRMAN

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • ASHTON CURTIS DPM

    VICE CHAIRMAN

    Total calculated
    $93,940
    From this org
    $72,181
    From related orgs
    $0
    Other
    $21,759
    Hours/week
    39 + 1 related

  • HUGH HITCHCOCK

    TREASURER

    Total calculated
    $0
    Hours/week
    3 + 3 related

  • JOHN KABLER

    SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • JAMES TRIPLETT

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • TOM FELTON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • DANNY FRANKE

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 2.5 related

  • CONNIE TENNEY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25 + 0.25 related

  • AMANDA PENNINGTON

    BOARD MEMBER

    Total calculated
    $393,561
    From this org
    $365,307
    From related orgs
    $0
    Other
    $28,254
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $365,205
    Bonus
    $102
    Other
    $0
    Deferred
    $3,676
    Nontaxable benefits
    $24,578
    Filer's total
    $393,561

  • DREW PINGLEYMSN RN

    BOARD MEMBER

    Total calculated
    $116,376
    From this org
    $92,618
    From related orgs
    $0
    Other
    $23,758
    Hours/week
    39 + 1 related

  • JOHANNA BIOLA MD

    BOARD MEMBER

    Total calculated
    $299,471
    From this org
    $272,515
    From related orgs
    $0
    Other
    $26,956
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $272,413
    Bonus
    $102
    Other
    $0
    Deferred
    $2,749
    Nontaxable benefits
    $24,207
    Filer's total
    $299,471

  • VANCE JACKSON

    CEO

    Total calculated
    $386,465
    From this org
    $358,038
    From related orgs
    $0
    Other
    $28,427
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $357,936
    Bonus
    $102
    Other
    $0
    Deferred
    $3,565
    Nontaxable benefits
    $24,862
    Filer's total
    $386,465

  • WILLAM KOCH

    VP OF FINANCE AND CFO

    Total calculated
    $131,592
    From this org
    $129,285
    From related orgs
    $0
    Other
    $2,307
    Hours/week
    1

  • THOMAS BENZ MD

    PHYSICIAN

    Total calculated
    $839,452
    From this org
    $805,882
    From related orgs
    $0
    Other
    $33,570
    Hours/week
    40 + 1.5 related

    Schedule J breakdown matched by us

    Base
    $789,113
    Bonus
    $102
    Other
    $16,667
    Deferred
    $7,712
    Nontaxable benefits
    $25,858
    Filer's total
    $839,452

  • MOHAMED FAHIM MD

    PHYSICIAN

    Total calculated
    $670,118
    From this org
    $659,328
    From related orgs
    $0
    Other
    $10,790
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $659,226
    Bonus
    $102
    Other
    $0
    Deferred
    $6,556
    Nontaxable benefits
    $4,234
    Filer's total
    $670,118

  • WALTER BOARDWINE DO

    PHYSICIAN

    Total calculated
    $593,629
    From this org
    $573,204
    From related orgs
    $0
    Other
    $20,425
    Hours/week
    40 + 11 related

    Schedule J breakdown matched by us

    Base
    $573,102
    Bonus
    $102
    Other
    $0
    Deferred
    $5,696
    Nontaxable benefits
    $14,729
    Filer's total
    $593,629

  • DAVID DAVIS MD

    PHYSICIAN

    Total calculated
    $628,775
    From this org
    $598,304
    From related orgs
    $0
    Other
    $30,471
    Hours/week
    40 + 4 related

    Schedule J breakdown matched by us

    Base
    $583,202
    Bonus
    $102
    Other
    $15,000
    Deferred
    $5,851
    Nontaxable benefits
    $24,620
    Filer's total
    $628,775

  • NIRVA DUBE MD

    PHYSICIAN

    Total calculated
    $540,032
    From this org
    $521,702
    From related orgs
    $0
    Other
    $18,330
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $438,991
    Bonus
    $82,711
    Other
    $0
    Deferred
    $5,221
    Nontaxable benefits
    $13,109
    Filer's total
    $540,032

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Travel for companions
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 1A
THE HOSPITAL WILL REIMBURSE FOR ALL OF THE REASONABLE TRAVEL, LODGING AND MEAL EXPENSES INCURRED BY THE CEO'S SPOUSE FOR TWO BUSINESS-RELATED MEETINGS OR CONFERENCES PER YEAR.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

  • MOUNTAIN STATE FOREST FESTIVAL

    $16,000

    ASSIST IN PRODUCTION OF COUNTY FAIR, PARADES, AND EVENTS.

  • WEST VIRGINIA MEDICAL FOUNDATION

    $12,500

    GENERAL PURPOSES

  • RANDOLPH COUNTY

    $10,135

    GENERAL PURPOSES

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

  • WVUH-DAVIS MOB LLC

    RENTAL OF MEDICAL FACILITIES AND EQUIPMENT · WV · income -$57,556 · assets $7,491,060

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • HEALTH FACILITIES INC

    C · HEALTH CARE · WV · 100% owned · share of income -$1,552,479 · share of assets $9,904,827 · controlled entity

    Directly controlled by DAVIS MEMORIAL HOSPITAL

  • CENTRAL WV MEDCORP INC

    C · PHYSICIAN OFFICES · WV · 100% owned · share of income -$6,653 · share of assets $37,879 · controlled entity

    Directly controlled by DAVIS MEMORIAL HOSPITAL

  • DAVIS REGIONAL HEALTH PARTNERS INC

    C · HOSPITAL ORGANIZATION · WV · 50% owned · controlled entity

    Directly controlled by DAVIS MEMORIAL HOSPITAL

Provenance

Return type
form_990
Tax year
2022
Filed
15 November 2023
IRS schema version
2022v5.0
Source object
202303199349318255

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