MON ELDER SERVICES INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MON ELDER SERVICES INC (EIN 31-1520863)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-11
- IRS object ID
- 202301319349302200
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-11T09:09:40-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 STANWIX STREET | AddressLine1Txt |
| City | PITTSBURGH | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15222 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311520863 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MON ELDER SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MONE | BusinessNameControlTxt |
| Phone | 3045981242 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 JD ANDERSON DRIVE | AddressLine1Txt |
| City | MORGANTOWN | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26505 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFF SANDENE | PersonNm |
| Person Title | EXECUTIVE VP AND CFO | PersonTitleTxt |
| Phone | 3045981242 | PhoneNum |
| Signature | 2023-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JEFF | PersonFirstNm |
| Person Last | SANDENE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY J PETRELL | PreparerPersonNm |
| PTIN | P00138808 | PTIN |
| Phone | 4126976400 | PhoneNum |
| Preparation | 2023-04-27 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID S GOLDBERG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 JD ANDERSON DRIVE | AddressLine1Txt |
| City | MORGANTOWN | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26505 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,415,154 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | TO BE THE SENIOR LIVING COMMUNITY OF CHOICE IN MONONGALIA COUNTY. THE RESPECT, TRUST AND FRIENDSHIP OF OUR RESIDENTS WILL BE EARNED EVERY DAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 79 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $561,916 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,187,830 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,838,091 | CYProgramServiceRevenueAmt |
| PY Investment Income | $613,062 | PYInvestmentIncomeAmt |
| CY Investment Income | $577,063 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $7,362,808 | PYTotalRevenueAmt |
| CY Total Revenue | $6,415,154 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,317,146 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,595,454 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,877,221 | PYOtherExpensesAmt |
| CY Other Expenses | $2,927,796 | CYOtherExpensesAmt |
| PY Total Expenses | $6,194,367 | PYTotalExpensesAmt |
| CY Total Expenses | $6,523,250 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,168,441 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$108,096 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $35,632,091 | TotalAssetsBOYAmt |
| Total Assets EOY | $32,374,549 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $23,775,657 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $24,024,288 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,856,434 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,350,261 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO BE THE SENIOR LIVING COMMUNITY OF CHOICE IN MONONGALIA COUNTY. THE RESPECT, TRUST, AND FRIENDSHIP OF OUR RESIDENTS WILL BE EARNED EVERY DAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,910,671 | ExpenseAmt |
| Revenue | $5,838,091 | RevenueAmt |
| Desc | CONTINUING CARE RETIREMENT VILLAGE CONSISTING OF 90 INDEPENDENT LIVING APARTMENTS, 40 ASSISTED LIVING UNITS, AND COMMON SUPPORT AREAS ON 11 ACRES. | Desc |
| Total Program Service Expenses | $4,910,671 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 79 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GENE TOWNSEND - CONTROLLER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3042853676 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 JD ANDERSON DRIVE | AddressLine1Txt |
| City | MORGANTOWN | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26505 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| DAVID GOLDBERG | |||||||
| PRESIDENT/CEO | 1.00 | 49.00 | Yes (X) | Yes (X) | $0 | $804,616 | $112,875 |
| LISA SIMON CPA | |||||||
| VP FINANCE/CFO | 1.00 | 49.00 | Yes (X) | $0 | $422,632 | $55,782 | |
| JEFF CRUDELE | |||||||
| INTERIM CFO | 1.00 | 49.00 | Yes (X) | $0 | $275,000 | $0 | |
| EDWARD P BOYLE II | |||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KATHY MCNEIL | |||||||
| VICE CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JOHN LAW | |||||||
| SECRETARY/TREASURER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BOBBIE CONKLIN | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID RAMSEY | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| GREGORY CUNNINGHAM | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MARK JOHNSON MD | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MIKE MORRIS | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| NATALIE STONE | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| RAY THOMPSON | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| RODNEY BEAN | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| RON STOVASH | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TERRY SHAFFER | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,502,248 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $168,657 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| VERITAS CONTRACTING LLC | |||||
| 246 BUSINESS PARK DR | FAIRMONT | WV | 26554 | CONSTRUCTION | $468,788 |
| MICHAEL J CALLEN CONSTRUCTION | |||||
| 182 GREENVILLE SCHOOL ROAD | BRUCETON MILLS | WV | 26525 | CONSTRUCTION | $267,611 |
| US FOOD SERVICE | |||||
| PO BOX 643190 | PITTSBURGH | PA | 15264 | FOOD SERVICE | $228,816 |
| CDW | |||||
| 75 REMITTANCE DRIVE STE 1515 | CHICAGO | IL | 60675 | IT SERVICES | $224,190 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| ROOM AND BOARD | 623000 | $5,726,386 | $5,726,386 |
| RESIDENT SERVICES | 623000 | $111,705 | $111,705 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,838,091 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $435,218 | TotalRevenueColumnAmt |
| Exclusion | $435,218 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $141,345 | SecuritiesAmt |
| Other | $500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $141,345 | SecuritiesAmt |
| Other | $500 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $141,845 | TotalRevenueColumnAmt |
| Exclusion | $141,845 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,415,154 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,838,091 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $577,063 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,676,736 | TotalAmt |
| Program Services | $2,207,265 | ProgramServicesAmt |
| Management And General | $469,471 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,332 | TotalAmt |
| Program Services | $51,400 | ProgramServicesAmt |
| Management And General | $10,932 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $661,758 | TotalAmt |
| Program Services | $545,693 | ProgramServicesAmt |
| Management And General | $116,065 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,628 | TotalAmt |
| Program Services | $160,492 | ProgramServicesAmt |
| Management And General | $34,136 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,618 | TotalAmt |
| Management And General | $278,618 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,487 | TotalAmt |
| Management And General | $37,487 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,466 | TotalAmt |
| Program Services | $158,420 | ProgramServicesAmt |
| Management And General | $14,046 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,231 | TotalAmt |
| Program Services | $62 | ProgramServicesAmt |
| Management And General | $51,169 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,255 | TotalAmt |
| Program Services | $3,577 | ProgramServicesAmt |
| Management And General | $26,678 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $306,268 | TotalAmt |
| Program Services | $303,285 | ProgramServicesAmt |
| Management And General | $2,983 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,657 | TotalAmt |
| Program Services | $9,498 | ProgramServicesAmt |
| Management And General | $1,159 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $557,229 | TotalAmt |
| Management And General | $557,229 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $983,878 | TotalAmt |
| Program Services | $983,878 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,349 | TotalAmt |
| Program Services | $29,349 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DIETARY RELATED EXPENSE | $360,308 | $360,308 | |
| MISCELLANEOUS EXPENSE | $51,426 | $49,444 | $1,982 |
| REPAIRS AND MAINTENANCE | $29,010 | $27,392 | $1,618 |
| RECREATIONAL EVENTS | $15,449 | $10,884 | $4,565 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,165 | TotalAmt |
| Program Services | $9,724 | ProgramServicesAmt |
| Management And General | $4,441 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,523,250 | TotalAmt |
| Program Services | $4,910,671 | ProgramServicesAmt |
| Management And General | $1,612,579 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $206,946 | BOYAmt |
| EOY | $342,546 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,446,054 | BOYAmt |
| EOY | $854,816 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,999 | BOYAmt |
| EOY | $69,721 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,302 | BOYAmt |
| EOY | $25,782 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,032 | BOYAmt |
| EOY | $92,555 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $25,670,864 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,983,231 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,750,934 | BOYAmt |
| EOY | $12,687,633 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,055,159 | BOYAmt |
| EOY | $18,280,872 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,665 | BOYAmt |
| EOY | $20,624 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,632,091 | BOYAmt |
| EOY | $32,374,549 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $732,303 | BOYAmt |
| EOY | $713,122 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $795,173 | BOYAmt |
| EOY | $1,007,983 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,524,786 | BOYAmt |
| EOY | $8,721,350 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,723,395 | BOYAmt |
| EOY | $13,581,833 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,775,657 | BOYAmt |
| EOY | $24,024,288 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,856,434 | BOYAmt |
| EOY | $8,350,261 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,856,434 | BOYAmt |
| EOY | $8,350,261 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,632,091 | BOYAmt |
| EOY | $32,374,549 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$108,096 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$3,398,077 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $136 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus1 Year | $561,916 | CurrentTaxYearMinus1YearAmt |
| Total | $562,052 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,859,124 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,994,987 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,089,165 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,187,830 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,838,091 | CurrentTaxYearAmt |
| Total | $29,969,197 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,859,260 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,994,987 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,089,165 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,749,746 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,838,091 | CurrentTaxYearAmt |
| Total | $30,531,249 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $30,531,249 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24,786 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,731 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $314,329 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $385,073 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $435,218 | CurrentTaxYearAmt |
| Total | $1,180,137 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24,786 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,731 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $314,329 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $385,073 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $435,218 | CurrentTaxYearAmt |
| Total | $1,180,137 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,884,046 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,015,718 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,403,494 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,134,819 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,273,309 | CurrentTaxYearAmt |
| Total | $31,711,386 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.96280 | PublicSupportCY509Pct |
| Public Support PY509 | 0.97570 | PublicSupportPY509Pct |
| Investment Income CY | 0.03720 | InvestmentIncomeCYPct |
| Investment Income PY | 0.02430 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,993,736 | OtherCostOrOtherBasisAmt |
| Book Value | $3,993,736 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,806,135 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,534,888 | DepreciationAmt |
| Book Value | $5,271,247 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,898,094 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,244,437 | DepreciationAmt |
| Book Value | $653,657 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,972,899 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,203,906 | DepreciationAmt |
| Book Value | $2,768,993 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,687,633 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| REFUNDABLE FEES | $13,217,609 |
| SECURITY DEPOSITS | $128,088 |
| ESTIMATED LIABILITY OBLIGATIONS | $103,605 |
| DUE TO AFFILIATES | $132,531 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $13,581,833 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID GOLDBERG | ||||||||||||||
| PRESIDENT/CEO | $0 | $565,581 | $0 | $115,644 | $0 | $123,391 | $0 | $112,875 | $0 | $0 | $0 | $917,491 | $0 | $0 |
| LISA SIMON CPA | ||||||||||||||
| VP FINANCE/CFO | $0 | $367,856 | $0 | $53,534 | $0 | $1,242 | $0 | $48,897 | $0 | $6,885 | $0 | $478,414 | $0 | $0 |
| JEFF CRUDELE | ||||||||||||||
| INTERIM CFO | $0 | $275,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $275,000 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE CEO'S COMPENSATION IS PAID BY MONONGALIA HEALTH SYSTEM. MONONGALIA HEALTH SYSTEM USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 4B | THE FOLLOWING INDIVIDUALS DEFERRED THE FOLLOWING AMOUNTS UNDER A 457(F) PLAN - DAVID GOLDBERG ($104,418) AND LISA SIMON ($39,945). |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONONGALIA COUNTY BUILDING COMMISSION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 311520863 | BondIssuerEIN |
| CUSIP | 610208CK4 | CUSIPNum |
| Bond Issued | 2011-04-20 | BondIssuedDt |
| Issue Price | $12,454,808 | IssuePriceAmt |
| Purpose | TO REFINANCE ORIGINAL CONSTRUCTION ISSUANCE | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | Yes (1) | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $4,153,731 | RetiredAmt |
| Total Proceeds | $12,454,808 | TotalProceedsAmt |
| Refunding Escrow | $12,205,712 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $249,096 | IssuanceCostsFromProceedsAmt |
| Substantial Completion | 2011 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | Yes (1) | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE GOVERNING BODY IS PROVIDED A COPY, PRIOR TO SUBMISSION, FOR THEIR REVIEW AND TO ANSWER QUESTIONS OR REVISE. IF CHANGES ARE MADE, BASED ON MEMBER'S REVISIONS, MANAGEMENT REDISTRIBUTES A FINAL VERSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, A CONFLICT OF INTEREST QUESTIONNAIRE IS SENT OUT TO ALL BOARD MEMBERS. THE BOARD THEN REVIEWS ALL RESPONSES FOR POSSIBLE CONFLICTS OF INTEREST. THE BOARD THEN DETERMINES WHAT TYPES OF DECISIONS THAT MEMBER IS PROHIBITED FROM PARTICIPATING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO'S COMPENSATION IS PAID BY MONONGALIA HEALTH SYSTEM. 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. ANNUALLY, A CONSULTANT COMPILES A MARKET DATA REPORT ON CFO AND COO 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 FORM 990 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|
| MONONGALIA HEALTH SYSTEM | ||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550621551 | PARENT/MANAGEMENT COMPANY | WV | 501(C)(3) | LINE 12C, III-FI | 0 | |
| MONONGALIA COUNTY GENERAL HOSPITAL CO | ||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 237441353 | HOSPITAL | WV | 501(C)(3) | LINE 3 | 0 | MONONGALIA HEALTH SYSTEM INC |
| 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 | 0 | MONONGALIA COUNTY GENERAL HOSPITAL CO |
| PRESTON MEMORIAL HOSPITAL | ||||||||||
| 300 SOUTH PRICE STREET | KINGWOOD | WV | 26537 | 311097818 | HOSPITAL | WV | 501(C)(3) | LINE 3 | 0 | MONONGALIA HEALTH SYSTEM INC |
| PRESTON MEMORIAL MEDICAL GROUP | ||||||||||
| 300 SOUTH PRICE STREET | KINGWOOD | WV | 26537 | 550717988 | PRIMARY AND URGENT CARE | WV | 501(C)(3) | LINE 3 | 0 | PRESTON MEMORIAL HOSPITAL |
| PRESTON MEMORIAL HEALTH FOUNDATION | ||||||||||
| 300 SOUTH PRICE STREET | KINGWOOD | WV | 26537 | 550740121 | RAISE FUNDS FOR PRESTON HOSPITAL | WV | 501(C)(3) | LINE 12B, II | 0 | PRESTON MEMORIAL HOSPITAL |
| 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 | 0 | MONONGALIA COUNTY GENERAL HOSPITAL CO |
| 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 | 0 | MONONGALIA HEALTH SYSTEM INC |
| STONEWALL JACKSON MEMORIAL HOSPITAL | ||||||||||
| 230 HOSPITAL PLAZA | WESTON | WV | 26452 | 550422958 | HOSPITAL | WV | 501(C)(3) | LINE 3 | 0 | MONONGALIA HEALTH SYSTEM INC |
| MON HEALTH MARION NEIGHBORHOOD HOSPITAL | ||||||||||
| 140 MIDDLETOWN LOOP | WHITEHALL | WV | 26554 | 853994078 | HOSPITAL | WV | 501(C)(3) | LINE 3 | 0 | MONONGALIA HEALTH SYSTEM INC |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MGH SURGERY LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 MON HEALTH MEDICAL PARK DR | AddressLine1Txt |
| City | MORGANTOWN | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26505 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 472736896 | EIN |
| Primary Activities | SURGERY CENTER | PrimaryActivitiesTxt |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| MON HEALTH CARE INC | |||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26508 | 550654973 | HOME MEDICAL EQUIPMENT PROVIDER | WV | N/A | C | 0 |
| 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 | N/A | C | 0 |
| CARE PARTNER'S INC | |||||||||
| 511 BURROUGHS STREET SUITE 102 | MORGANTOWN | WV | 26505 | 550754326 | HOME HEALTH | WV | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |