PRESTON MEMORIAL HOSPITAL CORPORATION: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- PRESTON MEMORIAL HOSPITAL CORPORATION (EIN 31-1097818)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-10
- IRS object ID
- 202201309349303260
- Schema version
- 2020v4.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-10T12:36:34-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | 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 | 101 WASHINGTON STREET EAST | AddressLine1Txt |
| City | CHARLESTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25329 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311097818 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRESTON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PRES | BusinessNameControlTxt |
| Phone | 3043291400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 MEMORIAL DRIVE | AddressLine1Txt |
| City | KINGWOOD | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 265371442 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN GESSLER | PersonNm |
| Person Title | VP OF FINANCIAL SERVICES | PersonTitleTxt |
| Phone | 3043291400 | PhoneNum |
| Signature | 2022-05-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KEVIN | PersonFirstNm |
| Person Last | GESSLER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DOLORES ROSE | PreparerPersonNm |
| PTIN | P01286262 | PTIN |
| Phone | 3043460441 | PhoneNum |
| Preparation | 2022-05-05 | 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 | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID GOLDBERG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 MEMORIAL DRIVE | AddressLine1Txt |
| City | KINGWOOD | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 265371442 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $50,555,683 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PRESTONMEMORIAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1955 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | TO ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 432 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $500 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,710,177 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $43,245,271 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $45,349,746 | CYProgramServiceRevenueAmt |
| PY Investment Income | $197,463 | PYInvestmentIncomeAmt |
| CY Investment Income | $193,272 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,087,442 | PYOtherRevenueAmt |
| CY Other Revenue | $302,488 | CYOtherRevenueAmt |
| PY Total Revenue | $47,530,676 | PYTotalRevenueAmt |
| CY Total Revenue | $50,555,683 | 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 | $25,293,038 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,984,115 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $21,941,979 | PYOtherExpensesAmt |
| CY Other Expenses | $21,551,498 | CYOtherExpensesAmt |
| PY Total Expenses | $47,235,017 | PYTotalExpensesAmt |
| CY Total Expenses | $46,535,613 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $295,659 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,020,070 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $53,292,174 | TotalAssetsBOYAmt |
| Total Assets EOY | $60,807,644 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $47,983,883 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $48,677,780 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,308,291 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,129,864 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $32,464,204 | ExpenseAmt |
| Revenue | $45,620,313 | RevenueAmt |
| Desc | THE HOSPITAL HAD 3,403 INPATIENT DAYS, CARED FOR 9,090 EMERGENCY PATIENTS AND TREATED 67,785 PATIENTS IN ITS OUTPATIENT CLINICS. THE HOSPITAL PROVIDES CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. CHARGES FOREGONE FOR CHARITY CARE AMOUNTED TO $738,013.THE HOSPITAL PROMOTES AND PROVIDES ACTIVITIES SUCH AS HEALTH FAIRS, BLOOD DRIVES, AND A FITNESS CENTER TO IMPROVE THE HEALTH AND WELFARE OF ITS PATIENTS. THE HOSPITAL ALSO CONDUCTS COMMUNITY-WIDE SPEAKER BUREAUS TO HELP EDUCATE THE COMMUNITY ON SPECIFIC HEALTH AND WELLNESS MATTERS.THE HOSPITAL STRIVES TO PROVIDE AND PROMOTE NEEDED SERVICES IN THE COMMUNITY BY PARTNERING WITH LOCAL AGENCIES SUCH AS THE PRESTON COUNTY HEALTH DEPARTMENT, FAMILY RESOURCE NETWORK, PRESTON PREVENTION PARTNERSHIP, AND THE PRESTON COUNTY CHAMBER OF COMMERCE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $451,515 | ExpenseAmt |
| Revenue | $31,921 | RevenueAmt |
| Desc | THE ORGANIZATION SPONSORED HEALTH FAIRS, BLOOD DRIVES, CANCER SCREENINGS, CPR/FIRST AID CLASSES, CRISIS INTERVENTION, DIABETES INTERVENTION, FAMILY/PARENTING/SIBLING EDUCATION, FITNESS EDUCATION, FLU SHOTS, NUTRITION/WEIGHT MAINTENANCE, SCHOOL BASED PROGRAMS, SENIOR EDUCATION AND OUTREACH PROGRAMS, SPORTS INJURY PREVENTION, SUBSTANCE ABUSE AND TOBACCO/SMOKING CESSATION. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $32,915,719 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 56 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 432 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN GESSLER VP FINANCIAL SERVICE | PersonNm |
| Phone | 3043291400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 MEMORIAL DRIVE | AddressLine1Txt |
| City | KINGWOOD | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 265371442 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| MELISSA LOCKWOOD | |||||||||
| PMH CAO | 48.00 | 2.00 | Yes (X) | Yes (X) | $0 | $221,758 | $7,633 | ||
| NICK TAYLOR | |||||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RAY THOMPSON | |||||||||
| VICE CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TIM CALVERT | |||||||||
| SEC/TREAS, FINANCE CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BONNIE FORMAN MD | |||||||||
| CHIEF OF STAFF | 20.00 | 0.00 | Yes (X) | $146,957 | $0 | $23,570 | |||
| RON CRITES | |||||||||
| PMH BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RITA MCCROBIE | |||||||||
| PMH BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHY MCNEILL | |||||||||
| PMH BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TARRELL RIES | |||||||||
| PMH BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LARRY WILLIAMS | |||||||||
| PMH BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID GOLDBERG | |||||||||
| MHS PRESIDENT/CEO | 1.00 | 49.00 | Yes (X) | Yes (X) | $0 | $775,610 | $5,700 | ||
| LISA SIMON CPA | |||||||||
| MHS VP FINANCE/CFO | 1.00 | 49.00 | Yes (X) | Yes (X) | $0 | $361,043 | $49,359 | ||
| KEVIN GESSLER JR CPA CFE CHFP | |||||||||
| VP OF FINANCIAL SERVICES | 40.00 | 10.00 | Yes (X) | $0 | $172,362 | $16,079 | |||
| JAMES HOLEHOUSE MD | |||||||||
| PHYSICIAN | 40.00 | $277,846 | $0 | $49,699 | Yes (X) | ||||
| MARISA DOWNEY DO | |||||||||
| PHYSICIAN | 40.00 | $386,145 | $0 | $46,195 | Yes (X) | ||||
| LORN A WOLFE MD | |||||||||
| PHYSICIAN | 40.00 | $402,688 | $0 | $49,490 | Yes (X) | ||||
| DAVID M FOURQUREAN MD | |||||||||
| PHYSICIAN | 40.00 | $456,175 | $0 | $37,453 | Yes (X) | ||||
| FRANK M ABRAHAM MD | |||||||||
| PHYSICIAN | 40.00 | $579,190 | $0 | $67,388 | Yes (X) | ||||
| DARIS ROSENCRANCE | |||||||||
| MHS FORMER VP FINANCE/CFO | 0.00 | $0 | $317,827 | $9,194 | Yes (X) | ||||
| DARRYL DUNCAN | |||||||||
| MHS FORMER PRESIDENT/CEO | 0.00 | $0 | $213,610 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,249,001 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,062,210 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $361,760 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 29 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SYNERGY SURGICALISTS WV INC | |||||
| 280 W KAGY BOULEVARD SUITE D 320 | BOZEMAN | MT | 59715 | ORTHOPEDIC DOCTORS | $1,404,368 |
| RURAL PHYSICIANS GROUP | |||||
| 10624 S EASTERN AVENUE SUITE A-26 | HENDERSON | NV | 89052 | HOSPITALISTS | $779,082 |
| LABORATORY CORPORATION | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LAB TESTING SERVICES | $264,660 |
| ALLIANCE HEALTHCARE SERVICES | |||||
| PO BOX 735714 | DALLAS | TX | 75373 | MRI SERVICES | $243,180 |
| FUSION MEDICAL STAFFING LLC | |||||
| PO BOX 82674 | LINCOLN | NE | 68501 | NURSE STAFFING SERVICES | $230,615 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,677,329 | GovernmentGrantsAmt |
| All Other Contributions | $32,848 | AllOtherContributionsAmt |
| Total Contributions | $4,710,177 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES | 622110 | $44,832,011 | $44,832,011 |
| 340B DRUG PROGRAM | 900099 | $517,735 | $517,735 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $45,349,746 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $191,272 | TotalRevenueColumnAmt |
| Exclusion | $191,272 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,000 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,000 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,000 | TotalRevenueColumnAmt |
| Exclusion | $2,000 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAFETERIA SALES | Desc |
| Business | 722212 | BusinessCd |
| Total Revenue Column | $144,367 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $144,367 | RelatedOrExemptFuncIncomeAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $158,121 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $158,121 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $302,488 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $50,555,683 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $45,652,234 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $193,272 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,385 | TotalAmt |
| Program Services | $119,644 | ProgramServicesAmt |
| Management And General | $51,741 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,893,322 | TotalAmt |
| Program Services | $13,189,428 | ProgramServicesAmt |
| Management And General | $5,703,894 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $536,344 | TotalAmt |
| Program Services | $374,422 | ProgramServicesAmt |
| Management And General | $161,922 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,061,157 | TotalAmt |
| Program Services | $2,835,094 | ProgramServicesAmt |
| Management And General | $1,226,063 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,321,907 | TotalAmt |
| Program Services | $922,823 | ProgramServicesAmt |
| Management And General | $399,084 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,123,817 | TotalAmt |
| Management And General | $2,123,817 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,313 | TotalAmt |
| Management And General | $42,313 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,250 | TotalAmt |
| Management And General | $22,250 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,574 | TotalAmt |
| Management And General | $11,574 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,737,205 | TotalAmt |
| Program Services | $4,761,769 | ProgramServicesAmt |
| Management And General | $975,436 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,722 | TotalAmt |
| Program Services | $52,862 | ProgramServicesAmt |
| Management And General | $22,860 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,297,056 | TotalAmt |
| Program Services | $904,216 | ProgramServicesAmt |
| Management And General | $392,840 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $259,146 | TotalAmt |
| Program Services | $180,910 | ProgramServicesAmt |
| Management And General | $78,236 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $460,334 | TotalAmt |
| Program Services | $321,359 | ProgramServicesAmt |
| Management And General | $138,975 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,372 | TotalAmt |
| Program Services | $40,051 | ProgramServicesAmt |
| Management And General | $17,321 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,064,140 | TotalAmt |
| Management And General | $1,064,140 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,655,469 | TotalAmt |
| Program Services | $1,853,783 | ProgramServicesAmt |
| Management And General | $801,686 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$193,119 | TotalAmt |
| Program Services | -$134,855 | ProgramServicesAmt |
| Management And General | -$58,264 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,233,868 | $3,233,868 | |
| BAD DEBT | $2,391,825 | $2,391,825 | |
| REPAIRS & MAINTENANCE | $884,095 | $617,187 | $266,908 |
| HEALTHCARE PROVIDER TAX | $841,819 | $841,819 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $586,612 | TotalAmt |
| Program Services | $409,514 | ProgramServicesAmt |
| Management And General | $177,098 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,535,613 | TotalAmt |
| Program Services | $32,915,719 | ProgramServicesAmt |
| Management And General | $13,619,894 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,747,661 | BOYAmt |
| EOY | $14,027,590 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,353,369 | BOYAmt |
| EOY | $5,738,379 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $865,002 | BOYAmt |
| EOY | $950,904 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $218,841 | BOYAmt |
| EOY | $152,468 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $55,331,226 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $30,133,166 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,244,913 | BOYAmt |
| EOY | $25,198,060 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,801,109 | BOYAmt |
| EOY | $12,617,192 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $109,739 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,061,279 | BOYAmt |
| EOY | $2,013,312 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,292,174 | BOYAmt |
| EOY | $60,807,644 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,875,504 | BOYAmt |
| EOY | $4,068,517 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,062,175 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,049,245 | BOYAmt |
| EOY | $33,197,652 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,825 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,885,134 | BOYAmt |
| EOY | $11,411,611 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,983,883 | BOYAmt |
| EOY | $48,677,780 | 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 | $5,308,291 | BOYAmt |
| EOY | $12,129,864 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,308,291 | BOYAmt |
| EOY | $12,129,864 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,292,174 | BOYAmt |
| EOY | $60,807,644 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,020,070 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,651,761 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,149,742 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $4,448 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $4,448 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS MEMBERSHIP FEES TO THE WEST VIRGINIA HOSPITAL ASSOCIATION WHICH PARTICIPATES IN LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,085,000 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $31,195 | OtherCostOrOtherBasisAmt |
| Book Value | $1,116,195 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,078,027 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,200,319 | DepreciationAmt |
| Book Value | $10,877,708 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $130,748 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,329 | DepreciationAmt |
| Book Value | $102,419 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,230,642 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,783,625 | DepreciationAmt |
| Book Value | $10,447,017 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,775,614 | OtherCostOrOtherBasisAmt |
| Depreciation | $120,893 | DepreciationAmt |
| Book Value | $2,654,721 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $25,198,060 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| FUNDED DEPRECIATION-CMB | $1,009,667 | F |
| FUNDED DEPRECIATION-PNC | $11,607,525 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $12,617,192 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO 3RD PARTY PAYORS | $4,200,186 |
| DUE TO RELATED PARTY | $703,097 |
| HHS STIMULUS AND OTHER COVID FUNDING | $4,925,308 |
| OPERATING LEASE LIABILITY | $77,795 |
| ESTIMATED PROFESSIONAL LIABILITY OBLIGATION | $1,413,000 |
| ACCRUED PENSION OBLIGATION | $92,225 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,411,611 | 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 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 H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $738,013 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $738,013 | DirectOffsettingRevenueAmt |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,921,269 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,107,637 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,813,632 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04110 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $965,218 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $467,521 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $497,697 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01130 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,624,500 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,313,171 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,311,329 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05240 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $451,515 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,921 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $419,594 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00950 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $451,168 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $451,168 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,990 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $36,990 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $939,673 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,921 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $907,752 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02050 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,564,173 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,345,092 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,219,081 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07290 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,391,825 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $8,920,657 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,920,657 | CostOfCareReimbursedByMedcrAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRESTON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 MEMORIAL DRIVE | AddressLine1Txt |
| City | KINGWOOD | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26537 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://WWW.PRESTONMEMORIAL.ORG/ | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | 24X7 LAB AND RADIOLOGY. CENTER OF EXCELLENCE IN BARIATRIC SURGERY. | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRESTON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.MONHEALTH.COM/PRESTON-MEMORIAL/WELLNESS-INITIATIVES | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.MONHEALTH.COM/PRESTON-MEMORIAL/WELLNESS-INITIATIVES | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.MONHEALTH.COM/PRESTON-MEMORIAL/PATIENT-PAYMENTS | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.MONHEALTH.COM/PRESTON-MEMORIAL/PATIENT-PAYMENTS | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.MONHEALTH.COM/PRESTON-MEMORIAL/PATIENT-PAYMENTS | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PRESTON MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: THE HOSPITAL RECEIVED COMMUNITY INPUT FROM THE FOLLOWING EXPERT ADVISORS: PRESTON COUNTY COMMISSIONER; PRESTON COUNTY HEALTH DEPARTMENT ADMINISTRATOR; WVU-NUTRITION OUTREACH INSTRUCTOR; PRESTON MEMORIAL HOSPITAL FOUNDATION DIRECTOR; WESBANCO BANKING CENTER MANAGER; PRESTON MEMORIAL HOSPITAL CEO; FAMILY PRACTICE PHYSICIAN; PRESTON-TAYLOR COMMUNITY HEALTH CENTER CFO; OWNER OF PRESTON HEALTHCARE SERVICES; OFFICE MANAGER OF FAMILY PRACTICE OFFICE; GENERAL SURGEON FROM PRESTON MEMORIAL HOSPITAL. WHEN THE SURVEY ANALYSIS WAS COMPLETE, THE INFORMATION AND SUMMARY CONCLUSIONS WAS PUT BEFORE THE LOCAL GROUP OF EXPERTS WHO WERE ASKED TO AGREE OR DISAGREE WITH THE SUMMARY CONCLUSIONS. |
| PRESTON MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11: PRESTON MEMORIAL HOSPITAL DEVELOPED AN IMPLEMENTATION PLAN THAT ADDRESSED ALL OF THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA. THE SIGNIFICANT NEEDS IDENTIFIED: OBESITY; CHRONIC LUNG DISEASE; OPIOID ABUSE; DIABETES; AND CORONARY HEART DISEASE. OTHER SIGNIFICANT AREAS WHERE IMPROVEMENT REMAINS TO ACHIEVE STATE AND NATIONAL AVERAGES INCLUDE: ADULT SMOKING; ACCESS TO EXERCISE OPPORTUNITIES; PRIMARY CARE PHYSICIAN SUPPLY, HIGH SCHOOL GRADUATION, AND COLLEGE GRADUATION. |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE VP OF FINANCIAL SERVICES AND FINANCIAL COUNSELOR REVIEW ALL CHARITY APPLICATIONS. THE VP OF FINANCIAL SERVICES AND COUNSELOR THEN DETERMINE, BASED ON FINANCIAL INFORMATION GIVEN BY THE PATIENT (TAX RETURNS, PAY STUBS, HOUSEHOLD EXPENSES, AND OTHER FAMILY CONSIDERATIONS), IF DEEP DISCOUNTS CAN BE PROVIDED TO THE PATIENT, OR IF A COMPLETE WRITE-OFF TO FREE-CARE IS DEEMED APPROPRIATE. |
| PART I, LINE 7: | ACTUAL REVENUE AND COSTS WERE TAKEN FROM THE GENERAL LEDGER. REASONABLE ESTIMATES WERE USED WHERE APPROPRIATE. FINANCIAL ASSISTANCE AT COST WAS CALCULATED BASED ON THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. UNREIMBURSED MEDICAID AND UNREIMBURSED COST - OTHER MEANS-TESTED GOVERNMENT PROGRAMS WERE CALCULATED USING THE CALCULATED COST-TO-CHARGE RATIO. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AND HEALTH PROFESSIONS EDUCATION WERE CALCULATED USING INTERNAL COST ACCOUNTING SYSTEMS THAT USE DIRECT AND INDIRECT COST REPORTING. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,391,825. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | PRESTON OFFERS ITS CONFERENCE ROOM SPACE FOR MULTIPLE COMMUNITY MEETINGS, INCLUDING BIRTHING CLASSES, CPR, EMS & FIRST RESPONDER CLASSES, PARENTING CLASSES, ETC. |
| PART III, LINE 2: | BAD DEBT EXPENSE AS REPORTED ON THE AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 4: | PATIENTS SEEKING FINANCIAL ASSISTANCE COMPLETE FINANCIAL ASSISTANCE APPLICATIONS AND WORK WITH THE HOSPITAL'S FINANCIAL COUNSELOR TO DETERMINE APPROPRIATE LEVELS OF DISCOUNTS (OR COMPLETE FREE CARE) BASED ON INFORMATION SUPPLIED BY THE PATIENT. ALL SELF-PAY PATIENTS ARE OFFERED BASELINE DISCOUNTS OF 10% FROM CHARGES, AND AN ADDITIONAL 30% PROMPT PAYMENT DISCOUNT IF PAYMENT IS MADE WITHIN A CERTAIN TIME PERIOD AFTER RECEIVING A BILL. PATIENTS WHO REFUSE ASSISTANCE AND REFUSE PAYMENT OPTIONS ARE TURNED OVER TO A COLLECTION AGENCY AFTER 3 BILLS HAVE BEEN SUBMITTED, AND BAD DEBT IS RECOGNIZED AT THAT TIME. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE HOSPITAL'S MEDICARE COST REPORT. |
| PART III, LINE 9B: | THE HOSPITAL FINANCIAL COUNSELING STAFF HELPS PATIENTS SEEK FINANCIAL ASSISTANCE THROUGH GOVERNMENT PROGRAMS OR OTHER PAYMENT SERVICES BEFORE APPLYING FOR CHARITY CARE. IF GOVERNMENT PROGRAMS OR OTHER SERVICES ARE DENIED, A FINANCIAL COUNSELOR WORKS WITH PATIENT TO OBTAIN FINANCIAL INFORMATION LIKE TAX RETURNS, HOUSEHOLD BILLS, BANK ACCOUNT INFORMATION, ETC. THE FINANCIAL COUNSELOR WORKS WITH THE VP OF FINANCIAL SERVICES TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FULL OR PARTIAL CHARITY CARE. ONCE THIS DETERMINATION IS MADE, THE FINANCIAL COUNSELOR COMMUNICATES RESULTS WITH THE PATIENT. IF PARTIAL PAYMENT IS DUE AFTER A DISCOUNT HAS BEEN RECOMMENDED, THE FINANCIAL COUNSELOR WORKS WITH THE PATIENT ON A PAYMENT ARRANGEMENT. IF A PATIENT, WHO HAS BEEN DEEMED ELIGIBLE FOR PARTIAL CHARITY CARE, AGREES TO A PAYMENT PLAN AND THEN FAILS TO PAY THE REMAINING BALANCE AGREED TO, THE REMAINING BALANCE WILL BE ADJUSTED OFF AS BAD DEBT. THE REMAINING BALANCE WILL BE TURNED OVER TO A COLLECTION AGENCY. |
| PART VI, LINE 2: | THE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT DURING THE YEAR ENDED JUNE 30, 2019 TO IDENTIFY LOCAL HEALTH AND MEDICAL NEEDS OF THE RESIDENTS SERVED BY THE HOSPITAL. TO COMPLETE THE ASSESSMENT THE HOSPITAL PERFORMED SEVERAL INDEPENDENT DATA ANALYSES BASED ON SECONDARY SOURCE DATA AND COMBINED THE RESULTS WITH LOCAL SURVEY DATA AND OPINIONS FROM LOCAL EXPERTS. |
| PART VI, LINE 3: | THE HOSPITAL PERSONNEL INSTRUCT PATIENTS DURING THE REGISTRATION PROCESS WHO DO NOT HAVE INSURANCE OR THE INABILITY TO PAY, TO COMPLETE AN APPLICATION FOR CHARITY CARE AFTER ALL OTHER SOURCES OF FINANCIAL ASSISTANCE HAVE BEEN DENIED. HOSPITAL PERSONNEL ASSIST PATIENTS WITH OBTAINING OTHER FINANCIAL ASSISTANCE BEFORE APPLYING FOR CHARITY CARE. THE FINANCIAL COUNSELING POLICY IS POSTED IN THE WAITING ROOMS AND AT THE FRONT-DESK. THE HOSPITAL ALSO HAS A FORMAL RESOLUTION IN PLACE WITH THE PRESTON COUNTY COMMMISSION (LOCAL GOVERNMENT) INFORMING ALL LOCAL CITIZENS OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. |
| PART VI, LINE 4: | PRESTON MEMORIAL HOSPITAL LOCATED IN KINGWOOD, WV, IS SITUATED IN A RURAL GEOGRAPHIC LOCATION. PRESTON COUNTY HAS A POPULATION OF 33,679 (2018), WITH MORE THAN 19% OF THE SERVICE AREA POPULATION OVER THE AGE OF 65. THE MEDIAN HOUSEHOLD INCOME WAS $46,673 WHICH IS HIGHER THAN THE STATE MEDIAN INCOME OF $44,061, BUT LOWER THAN THE NATIONAL MEDIAN INCOME OF $57,652. THE HOSPITAL'S MEDICAID UTILIZATION IS 17%, MEDICARE UTILIZATION IS 40%, AND AN ESTIMATED 10% OF THE HOSPITAL'S PATIENTS SERVED ARE UNINSURED (OR UNDERINSURED). PRESTON MEMORIAL HOSPITAL IS THE ONLY HOSPITAL IN THE COUNTY. THERE ARE 2 MAJOR COMPETITORS OUTSIDE OF THE COUNTY - WEST VIRGINIA UNIVERSITY HOSPITALS AND MONONGALIA GENERAL HOSPITAL. BOTH HOSPITALS ARE LOCATED APPROXIMATELY 50 MINUTES AWAY FROM THE HOSPITAL AND ARE SITUATED IN URBANIZED LOCATIONS IN MONONGALIA COUNTY, WV. OTHER HOSPITALS ARE ALSO APPROXIMATELY 45 MINUTES TO ONE HOUR DRIVING DISTANCE FROM PRESTON MEMORIAL HOSPTIAL. THERE IS A FQHC LOCATED IN THE COUNTY (PRESTON-TAYLOR COMMUNITY HEALTH CENTER). THERE ARE NO OTHER DESIGNATED MEDICALLY UNDERSERVED AREAS IN THE COUNTY. |
| PART VI, LINE 5: | PRESTON MEMORIAL HOSPITAL HAS A GOVERNING BODY COMPRISED OF CITIZENS OF PRESTON COUNTY. THEY ARE NOT EMPLOYEES, CONTRACTORS OR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS PRIVILEGES TO QUALIFIED PHYSICIANS IN THE COMMUNITY AND BEYOND TO HELP TAKE CARE OF THE NEEDS OF ITS PATIENTS. THE ORGANIZATION ROUTINELY DOES NOT HAVE SURPLUS FUNDS AVAILABLE FROM OPERATIONS. HOWEVER, THE HOSPITAL HAS IDENTIFIED RESOURCES THROUGH BORROWING OR FUNDRAISING TO INVEST IN NEW TECHNOLOGIES FOR IMAGING SERVICES, ELECTRONIC HEALTH RECORDS, FACILITY IMPROVEMENTS, PATIENT CARE ROOM UPGRADES AND OTHER CLINICAL CAPITAL IMPROVEMENTS (E.G., MONITORS, VENTS, SURGICAL EQUIPMENT, ETC.). THE HOSPITAL ALSO PROVIDES 24 X 7 EMERGENCY SERVICES AND A LEVEL 4 TRAUMA CENTER. THE HOSPITAL'S EMERGENCY DEPARTMENT AND ALL OTHER CLINICAL SERVICES WHERE MEDICAL NEED IS DEMONSTRATED IS AVAILABLE TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL'S SPECIALIZED SERVICES INCLUDE: ENT, OB/GYN CARE, GENERAL SURGERY, ORTHOPEDICS, PSYCHIATRY, PHYSICAL THERAPY, CARDIOLOGY, LABORATORY, RADIOLOGY, AND NEUROLOGY. IF THESE SERVICES WERE NOT AVAILABLE, PATIENTS IN THE PRIMARY SERVICE AREA WOULD HAVE TO TRAVEL MORE THAN 45 MINUTES TO OBTAIN THESE SERVICES ELSEWHERE. THE HOSPITAL WORKS DILIGENTLY TO ATTRACT CHARITABLE SUPPORT THROUGH ITS FOUNDATION, AND ENGAGES OVER 30 VOLUNTEERS TO SUPPORT MULTIPLE ACTIVITIES AT THE HOSPITAL. |
| PART VI, LINE 6: | AS OF 2/28/2014, PRESTON MEMORIAL HOSPITAL, COLLECTIVELY WITH PRESTON MEMORIAL FOUNDATION AND PRESTON MEMORIAL MEDICAL GROUP, IS PART OF THE MON HEALTH SYSTEM, INC. THE MON HEALTH SYSTEM INCLUDES MONONGALIA COUNTY GENERAL HOSPITAL COMPANY, MON ELDER SERVICES, INC., MON HEALTH CARE AND STONEWALL JACKSON MEMORIAL HOSPITAL. ALL ENTITIES ARE UNDER COMMON GOVERNANCE AND CONTROL, AND COLLECTIVELY OPERATE TO SERVE THE HEALTHCARE NEEDS AND CHARITABLE NEEDS OF THE COMMUNITY. THE MEDICAL GROUP PROVIDES OFFICE RENTAL SPACE TO OTHER HEALTH CARE PROVIDERS IN THE COMMUNITY. THE FOUNDATION SERVES AS A FUNDRAISING ARM OF THE HOSPITAL TO HELP PROVIDE SUPPORT FOR CAPITAL IMPROVEMENTS, MAINTENANCE COSTS FOR THE RADIOLOGY DEPARTMENT, AND TO SUPPORT COMMUNITY ACTIVITIES THROUGH CHARITABLE GIVING. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | 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 (12 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 | ||||||||||||||
| MHS PRESIDENT/CEO | $0 | $532,081 | $0 | $112,500 | $0 | $131,029 | $0 | $5,700 | $0 | $0 | $0 | $781,310 | $0 | $0 |
| FRANK M ABRAHAM MD | ||||||||||||||
| PHYSICIAN | $579,190 | $0 | $0 | $0 | $0 | $0 | $26,000 | $0 | $41,388 | $0 | $646,578 | $0 | $0 | $0 |
| DAVID M FOURQUREAN MD | ||||||||||||||
| PHYSICIAN | $334,325 | $0 | $0 | $0 | $121,850 | $0 | $19,500 | $0 | $17,953 | $0 | $493,628 | $0 | $0 | $0 |
| LORN A WOLFE MD | ||||||||||||||
| PHYSICIAN | $369,428 | $0 | $0 | $0 | $33,260 | $0 | $26,000 | $0 | $23,490 | $0 | $452,178 | $0 | $0 | $0 |
| MARISA DOWNEY DO | ||||||||||||||
| PHYSICIAN | $312,195 | $0 | $0 | $0 | $73,950 | $0 | $19,500 | $0 | $26,695 | $0 | $432,340 | $0 | $0 | $0 |
| LISA SIMON CPA | ||||||||||||||
| MHS VP FINANCE/CFO | $0 | $359,753 | $0 | $0 | $0 | $1,290 | $0 | $42,474 | $0 | $6,885 | $0 | $410,402 | $0 | $0 |
| JAMES HOLEHOUSE MD | ||||||||||||||
| PHYSICIAN | $277,846 | $0 | $0 | $0 | $0 | $0 | $26,000 | $0 | $23,699 | $0 | $327,545 | $0 | $0 | $0 |
| DARIS ROSENCRANCE | ||||||||||||||
| MHS FORMER VP FINANCE/CFO | $0 | $86,508 | $0 | $0 | $0 | $231,319 | $0 | $8,009 | $0 | $1,185 | $0 | $327,021 | $0 | $0 |
| MELISSA LOCKWOOD | ||||||||||||||
| PMH CAO | $0 | $220,664 | $0 | $0 | $0 | $1,094 | $0 | $4,466 | $0 | $3,167 | $0 | $229,391 | $0 | $0 |
| DARRYL DUNCAN | ||||||||||||||
| MHS FORMER PRESIDENT/CEO | $0 | $166,691 | $0 | $0 | $0 | $46,919 | $0 | $0 | $0 | $0 | $0 | $213,610 | $0 | $0 |
| KEVIN GESSLER JR CPA CFE CHFP | ||||||||||||||
| VP OF FINANCIAL SERVICES | $0 | $164,862 | $0 | $7,500 | $0 | $0 | $0 | $11,684 | $0 | $4,395 | $0 | $188,441 | $0 | $0 |
| BONNIE FORMAN MD | ||||||||||||||
| CHIEF OF STAFF | $146,099 | $0 | $0 | $0 | $858 | $0 | $14,789 | $0 | $8,781 | $0 | $170,527 | $0 | $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, LINES 4A-B | THE FOLLOWING INDIVIDUALS DEFERRED THE FOLLOWING AMOUNTS UNDER A 457(F) PLAN- DAVID GOLDBERG ($109,029) AND LISA SIMON ($36,774). THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT - DARIS ROSENCRANCE ($230,783) |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF PRESTON MEMORIAL HOSPITAL IS MONONGALIA HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7A | PRESTON MEMORIAL HOSPITAL'S BOARD MEMBERS ARE ELECTED OR APPOINTED BY MONONGALIA HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7B | PRESTON MEMORIAL HOSPITAL'S BOARD SHALL GIVE NOTICE TO MONONGALIA HEALTH SYSTEM AND RECEIVE ITS APPROVAL BEFORE ACTING ON ANY OF THE FOLLOWING MATTERS: (A) AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE HOSPITAL OR THE BYLAWS; (B) SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF THE HOSPITAL AND ANY EXPENDITURE IN EXCESS OF $750,000; (C) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION; (D) ELECTION TO DISSOLVE THE HOSPITAL ENTITY; (E) APPROVAL OF THE BUDGET OF THE HOSPITAL; (F) APPROVAL IN ADVANCE OF THE HIRING OF THE PRESIDENT OF THE HOSPITAL. |
| 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 ASKSED 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 BOARD 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 EXCUTIVE COMMITTEE TO DETERMINE COMPENSATION FOR THE INDIVIDUAL. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATION MAKES ITS 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. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE THROUGH PUBLIC DISCLOSURE WITH THE WV HEALTH CARE AUTHORITY. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,818,645. MANAGEMENT AND GENERAL EXPENSES 786,491. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,605,136. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 2,895,065. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,895,065. BILLING & CODING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 188,945. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 188,945. ACUTE CARE SERVICES: PROGRAM SERVICE EXPENSES 48,059. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 48,059. |
| FORM 990, PART XI, LINE 9: | CHANGE IN MINIMUM PENSION OBLIGATION 1,083,443. EQUITY TRANSFERS 12,451. INCREASE IN VALUE OF ASSETS HELD BY OTHERS 53,848. |
| 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. |
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 |
| MON ELDER SERVICES INC | ||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 311520863 | RETIREMENT COMMUNITY | WV | 501(C)(3) | LINE 12C, III-FI | 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 MEDICAL GROUP | ||||||||||
| 300 SOUTH PRICE STREET | KINGWOOD | WV | 26537 | 550717988 | PRIMARY AND URGENT CARE | WV | 501(C)(3) | LINE 3 | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |