2023-05-11T09:11:16-05:00 2022-06-30 390859910 BAKER TILLY US LLP 20 STANWIX STREET PITTSBURGH PA 15222 990 2021-07-01 550621551 MONONGALIA HEALTH SYSTEM INC MONO 3045981242 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 JEFF SANDENE EXECUTIVE VP AND CFO 3045981242 2023-05-09 1 JEFF SANDENE 999009999 JEFFREY J PETRELL P00138808 4126976400 2023-04-27 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DAVID S GOLDBERG 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 48994564 0 X WWW.MONGENERAL.COM X 1983 WV TO PROVIDE MANAGEMENT, PLANNING, DEVELOPMENT, COORDINATION, AND OTHER ACTIVITIES RELATED TO THE PROMOTION OF HEALTH CARE WITHIN THE SYSTEM'S SERVICE AREA. 14 13 201 13 -161330 0 7015 0 29207792 45871298 2483502 1302006 2256837 883750 33955146 48057054 0 0 0 0 15732535 20386696 0 0 0 20155055 31768854 35887590 52155550 -1932444 -4098496 96464249 86123608 53244507 48766501 43219742 37357107 TO ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. 0 0 35404029 45871298 MONONGALIA HEALTH SYSTEM, INC. IS A NOT-FOR-PROFIT ORGANIZATION INCORPORATED FOR THE PURPOSE OF PROVIDING MANAGEMENT, PLANNING, DEVELOPMENT, COORDINATION, AND OTHER ACTIVITIES RELATED TO THE PROMOTION OF HEALTH CARE WITHIN THE SYSTEM'S SERVICE AREA. 35404029 1 0 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 82 0 201 1 1 1 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 WV X GENE TOWNSEND - CONTROLLER 3042853676 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 DAVID GOLDBERG PRESIDENT/CEO 1.00 49.00 X X 804616 0 112875 EDWARD P BOYLE II CHAIR 1.00 1.00 X X 0 0 0 KATHY MCNEIL VICE CHAIR 1.00 1.00 X X 0 0 0 JOHN LAW SECRETARY/TREASURER 1.00 1.00 X X 0 0 0 RODNEY BEAN DIRECTOR 1.00 1.00 X 0 0 0 DAVID RAMSEY DIRECTOR 1.00 1.00 X 0 0 0 BOBBIE CONKLIN DIRECTOR 1.00 1.00 X 0 0 0 GREGORY CUNNINGHAM DIRECTOR 1.00 1.00 X 0 0 0 MARK JOHNSON MD DIRECTOR 1.00 1.00 X 0 0 0 RON STOVASH DIRECTOR 1.00 1.00 X 0 0 0 MIKE MORRIS DIRECTOR 1.00 1.00 X 0 0 0 TERRY SHAFFER DIRECTOR 1.00 1.00 X 0 0 0 NATALIE STONE DIRECTOR 1.00 1.00 X 0 0 0 RAY THOMPSON DIRECTOR 1.00 1.00 X 0 0 0 LISA SIMON CPA VP FINANCE/CFO 1.00 49.00 X 422632 0 55782 JEFF CRUDELE INTERIM CFO 1.00 49.00 X 275000 0 0 MELISSA LOCKWOOD CEO - PRESTON MEMORIAL HOSPITAL 20.00 20.00 X 261084 0 9841 EDWARD PHILLIPS CHIEF LEGAL OFFICER 20.00 20.00 X 334428 0 11808 MARK GILLIAM CHIEF ADMINISTRATIVE OFFICER 20.00 20.00 X 411308 0 14967 AVAH STALNAKER CEO STONEWALL JACKSON MEMORIAL 1.00 39.00 X 291370 0 0 BRADFORD WARDEN MD PHYSICIAN 20.00 20.00 X 492246 0 4481 3292684 0 209754 46 0 1 0 MARCH WESTIN 360 FRONTIER STREET MORGANTOWN WV 26505 CONSTRUCTION 7549768 CERNER PO BOX 959156 ST LOUIS MO 63195 IT SERVICES 3381785 MAPLE OFFICE COMPLEX 6200 MID ATLANTIC DRIVE MORGANTOWN WV 26508 RENTAL 2859484 USI PO BOX 61007 VIRGINIA BEACH VA 23466 INSURANCE SERVICES 1517161 CDW 75 REMITTANCE DRIVE STE 1515 CHICAGO IL 60675 IT SERVICES 1405210 42 MANAGEMENT FEE & RELATED INCOME 541610 45871298 45871298 45871298 1302006 1302006 3376984 937510 2439474 2439474 2439474 PARTNERSHIP INCOME 900099 -161330 -161330 NET GAIN (LOSS) FROM EQUITY AFFIL 900099 -1394394 -1394394 -1555724 48057054 45871298 -161330 2347086 16442461 14798215 1644246 395868 356281 39587 2439870 2195883 243987 1108497 997647 110850 446291 401662 44629 3568624 2854899 713725 1095851 547926 547925 481237 240619 240618 83220 41610 41610 70431 56345 14086 82514 66011 16503 957853 766282 191571 3275706 2620565 655141 4644936 928987 3715949 REPAIRS & MAINTENANCE 13499902 6749951 6749951 MISCELLANEOUS 1505318 752659 752659 SALES TAX 804281 402141 402140 RECRUITING 604331 302166 302165 648359 324180 324179 52155550 35404029 16751521 0 3091757 794071 2428989 2896941 1899367 3339389 75155994 17965667 64704334 57190327 19453975 17657065 4885827 4245815 96464249 86123608 3856654 4934866 811790 786428 32651644 31761110 15924419 11284097 53244507 48766501 X 43219742 37357107 43219742 37357107 96464249 86123608 X -4098496 312779 -2076918 X X 0 1 X 1 0 X X 2 MONONGALIA COUNTY GENERAL HOSPITAL CO 237441353 3 1 0 0 MON ELDER SERVICES INC 311520863 10 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 PART IV, SECTION D, LINE 3 MONONGALIA HEALTH SYSTEM IS THE CONTROLLING ORGANIZATION OF THE SUPPORTED ORGANIZATIONS LISTED IN PART I. THE HEALTH SYSTEM AND ITS SUPPORTED ORGANIZATIONS SHARE AN INVESTMENT POLICY. PART IV, SECTION E, LINE 3A MONONGALIA HEALTH SYSTEM IS THE CONTROLLING ORGANIZATION OF THE SUPPORTED ORGANIZATIONS LISTED IN PART I. THE HEALTH SYSTEM APPOINTS THE BOARD OF DIRECTORS FOR ITS SUPPORTED ORGANIZATIONS. PART IV, SECTION E, LINE 3B MONONGALIA HEALTH SYSTEM IS THE CONTROLLING ORGANIZATION OF THE SUPPORTED ORGANIZATIONS LISTED IN PART I. THE HEALTH SYSTEM HAS RESERVED POWERS THAT ALLOWS FOR A SUBSTANTIAL DEGREE OF DIRECTION OVER POLICIES, PROGRAMS, AND ACTIVITIES OF EACH OF ITS SUPPORTED ORGANIZATIONS. 12819408 12819408 57514211 17402394 40111817 4593086 563273 4029813 229289 229289 57190327 CARE PARTNERS 428314 C EMS 1617791 C INTERMED LABS 437500 C MON HEALTH CARE, INC. 2431337 C MORGANTOWN ACCOMODATIONS LLC 1240069 C MORGANTOWN PHYSICAL THERAPY (HEALTHWORKS) 2986284 C MOUNTAIN STATE 175000 C MOUNTAINTOP LP & MTOP, LLC 382545 C MOUNTAINVIEW REHAB HOSPITAL (HEALTHSOUTH) 257696 C PREMIER, INC. 5008081 C RABBI TRUST 2692448 C 17657065 LIABILITY - RABBI TRUST 2692448 DUE TO AFFILIATES 6235266 OPERATING LEASE 1931383 PROFESSIONAL AND GENERAL LIABILITY 425000 11284097 X 49307343 312779 937510 1250289 48057054 0 48057054 53093060 937510 937510 52155550 0 52155550 PART X, LINE 2: THE HEALTH SYSTEM IS GENERALLY EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC), WITH THE EXCEPTION OF MHC WHICH IS A CORPORATION SUBJECT TO INCOME TAX. ADDITIONALLY, THE HEALTH SYSTEM QUALIFIES FOR CHARITABLE CONTRIBUTIONS DEDUCTIONS UNDER SECTION 170(B)(1)(A)(VI) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(1). INCOME WHICH IS NOT RELATED TO EXEMPT PURPOSES, LESS APPLICABLE DEDUCTIONS, IS SUBJECT TO FEDERAL AND STATE CORPORATE INCOME TAXES. THE HEALTH SYSTEM HAD NO SIGNIFICANT UNRELATED BUSINESS INCOME FOR THE YEARS ENDED JUNE 30, 2022 OR 2021. INTEREST AND PENALTIES RELATED TO INCOME TAX ASSESSMENTS, IF ANY, ARE REFLECTED IN INCOME TAX EXPENSE ON THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. THE HEALTH SYSTEM FOLLOWS THE FASB'S AUTHORITATIVE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR THE RECOGNITION AND MEASUREMENT OF THE BENEFITS OF INDIVIDUAL TAX POSITIONS IN THE CONSOLIDATED FINANCIAL STATEMENTS. TAX POSITIONS MUST MEET A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT IN ORDER FOR THE BENEFIT OF THOSE TAX POSITIONS TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE HEALTH SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS EXIST. GENERALLY, TAX RETURNS FOR YEARS ENDED JUNE 30, 2018, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED WITH REVENUE 937,510. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED WITH REVENUE 937,510. 1 X X X X 1 1 0 0 0 0 0 0 0 DAVID GOLDBERG PRESIDENT/CEO 565581 0 115644 0 123391 0 112875 0 0 0 917491 0 0 0 BRADFORD WARDEN MD PHYSICIAN 389916 0 100000 0 2330 0 3905 0 576 0 496727 0 0 0 LISA SIMON CPA VP FINANCE/CFO 367856 0 53534 0 1242 0 48897 0 6885 0 478414 0 0 0 MARK GILLIAM CHIEF ADMINISTRATIVE OFFICER 355838 0 53148 0 2322 0 9044 0 5923 0 426275 0 0 0 EDWARD PHILLIPS CHIEF LEGAL OFFICER 289807 0 42299 0 2322 0 5525 0 6283 0 346236 0 0 0 AVAH STALNAKER CEO STONEWALL JACKSON MEMORIAL 0 0 5099 0 286271 0 0 0 0 0 291370 0 0 0 JEFF CRUDELE INTERIM CFO 275000 0 0 0 0 0 0 0 0 0 275000 0 0 0 MELISSA LOCKWOOD CEO - PRESTON MEMORIAL HOSPITAL 227090 0 32860 0 1134 0 6908 0 2933 0 270925 0 0 0 PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS DEFERRED THE FOLLOWING AMOUNTS UNDER A 457(F) PLAN - DAVID GOLDBERG ($104,418) AND LISA SIMON ($39,945). THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT - AVAH STALNAKER ($286,271). FORM 990, PART VI, SECTION B, LINE 11B THE GOVERNING BODY IS PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW PRIOR TO SUBMISSION. THE MEMBERS ARE ASKED TO INFORM MANAGEMENT OF ANY QUESTIONS OR REVISIONS THEY MAY HAVE. IF CHANGES ARE MADE, BASED ON MEMBER'S REVISIONS, MANAGEMENT REDISTRIBUTES A FINAL VERSION TO ALL MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, A CONFLICT OF INTEREST QUESTIONNAIRE IS SENT OUT TO ALL BOARD MEMBERS. THE BOARD REVIEWS ALL RESPONSES FOR POSSIBLE CONFLICTS OF INTEREST AND DETERMINES WHAT TYPES OF DECISIONS THAT A MEMBER IS PROHIBITED FROM PARTICIPATING. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY, A CONSULTANT COMPILES A MARKET DATA REPORT ON CEO COMPENSATION; THIS REPORT IS THEN REVIEWED BY THE EXECUTIVE COMMITTEE TO DETERMINE COMPENSATION FOR THE INDIVIDUAL. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES IT FORMS 990 AND 990-T AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. FINANCIAL STATEMENTS ARE MADE AVAILABLE THROUGH PUBLIC DISCLOSURE WITH THE WV HEALTH CARE AUTHORITY. FORM 990, PART XI, LINE 9: TRANSFER FROM FOUNDATION -601,761. CHANGE IN NET ASSETS FROM MON HEALTH CARE, INC. -1,475,157. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S FINANCE COMMITTEE OF THE BOARD OF DIRECTORS SELECTS THE INDEPENDENT ACCOUNTANT. THIS PROCESS REMAINS UNCHANGED FROM PRIOR YEARS. MONONGALIA COUNTY GENERAL HOSPITAL COMPANY 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 237441353 HOSPITAL WV 501(C)(3) LINE 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) LINE 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) LINE 7 MONONGALIA COUNTY GENERAL HOSPITAL COMPANY 0 PRESTON MEMORIAL HOSPITAL 300 SOUTH PRICE STREET KINGWOOD WV 26537 311097818 HOSPITAL WV 501(C)(3) LINE 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) LINE 3 PRESTON MEMORIAL HOSPITAL 0 PRESTON MEMORIAL HEALTH FOUNDATION 300 SOUTH PRICE STREET KINGWOOD WV 26537 550740121 RAISE FUNDS FOR PRESTON HOSPITAL WV 501(C)(3) LINE 12B, II PRESTON MEMORIAL HOSPITAL 0 AUXILIARY OF MONONGALIA GENERAL HOSPITAL 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550362965 RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL WV 501(C)(3) LINE 12A, I MONONGALIA COUNTY GENERAL HOSPITAL CO 0 LIABILITY INSURANCE TRUST FOR MONONGALIA HEALTH SYSTEM 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550689535 LIABILITY INSURANCE TRUST WV 501(C)(3) LINE 12A, I MONONGALIA HEALTH SYSTEM INC 1 STONEWALL JACKSON MEMORIAL HOSPITAL 230 HOSPITAL PLAZA WESTON WV 26452 550422958 HOSPITAL WV 501(C)(3) LINE 3 MONONGALIA HEALTH SYSTEM INC 1 MON HEALTH MARION NEIGHBORHOOD HOSPITAL 140 MIDDLETOWN LOOP WHITEHALL WV 26554 853994078 HOSPITAL WV 501(C)(3) LINE 3 MONONGALIA HEALTH SYSTEM INC 1 MGH SURGERY LLC 2000 MON HEALTH MEDICAL PARK DR MORGANTOWN WV 26505 472736896 SURGERY CENTER WV N/A 0 0 MON HEALTH CARE INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550654973 MEDICAL EQUIPMENT WV MONONGALIA HEALTH SYSTEM INC C -1379434 2683764 1.00000 1 STONEWALL HOME OXYGEN THERAPY INC 100 MARKET PLACE MALL SUITE 8 WESTON WV 26452 550754278 OXYGEN THERAPY SERVICES WV N/A C 0 FAIRMONT HOME EQUIPMENT AND SUPPLY 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550763259 EQUIPMENT RENT & SVC WV N/A C 0 MORGANTOWN PHYSICAL THERAPY ASSOC INC 943 MAPLE DRIVE MORGANTOWN WV 26505 550614636 REHABILITATION SERVICES WV MONONGALIA HEALTH SYSTEM INC C -1166842 7040725 1.00000 1 CARE PARTNER'S INC 511 BURROUGHS STREET SUITE 102 MORGANTOWN WV 26505 550754326 HOME HEALTH WV MONONGALIA HEALTH SYSTEM INC C 231065 437102 1.00000 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 MON GENERAL HOSPITAL O 35595505 CASH PRESTON MEMORIAL HOSPITAL O 4024372 CASH MON HEALTH CARE INC A 103413 CASH MON ELDER SERVICES INC O 278618 CASH MON HEALTH CARE INC O 91171 CASH STONEWALL JACKSON MEMORIAL HOSPITAL O 4656898 CASH FOUNDATION OF MONONGALIA GENERAL HOSPITAL INC O 158344 CASH MON HEALTH MARION NEIGHBORHOOD HOSPITAL O 205971 CASH