MONONGALIA COUNTY GENERAL HOSPITAL COMPANY: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- MONONGALIA COUNTY GENERAL HOSPITAL COMPANY (EIN 23-7441353)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-10
- IRS object ID
- 202231309349303013
- 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 D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-10T12:32:03-05:00 | 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 | 5700 CORPORATE SUITE 650 | AddressLine1Txt |
| City | PITTSBURGH | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15237 | 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 | 237441353 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONONGALIA COUNTY GENERAL HOSPITAL CO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MONO | 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 | JEFFREY CRUDELE | PersonNm |
| Person Title | INTERIM CFO | PersonTitleTxt |
| Phone | 3045981242 | 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 | JEFFREY | PersonFirstNm |
| Person Last | CRUDELE | 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 | 4126356270 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
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 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 | $319,939,517 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MONHEALTHSYS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | TO DELIVER THE BEST HEALTHCARE AND REMAIN THE PROVIDER OF CHOICE IN OUR REGIONAL SERVICE AREA BECAUSE OF OUR QUALITY, RESPECT, INTEGRITY, AND CREATIVITY, AS WELL AS OUR DEDICATION TO PATIENT SAFETY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 1995 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $911,908 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,359,636 | PYContributionsGrantsAmt |
| CY Contributions Grants | $16,203,308 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $269,369,369 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $290,733,011 | CYProgramServiceRevenueAmt |
| PY Investment Income | $16,338,190 | PYInvestmentIncomeAmt |
| CY Investment Income | $7,303,347 | CYInvestmentIncomeAmt |
| PY Other Revenue | $11,255,574 | PYOtherRevenueAmt |
| CY Other Revenue | $5,699,851 | CYOtherRevenueAmt |
| PY Total Revenue | $298,322,769 | PYTotalRevenueAmt |
| CY Total Revenue | $319,939,517 | 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 | $129,356,255 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $131,861,635 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $166,636,638 | PYOtherExpensesAmt |
| CY Other Expenses | $198,707,235 | CYOtherExpensesAmt |
| PY Total Expenses | $295,992,893 | PYTotalExpensesAmt |
| CY Total Expenses | $330,568,870 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,329,876 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$10,629,353 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $322,081,355 | TotalAssetsBOYAmt |
| Total Assets EOY | $321,175,687 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $213,238,170 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $193,823,251 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $108,843,185 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $127,352,436 | 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 | $281,634,261 | ExpenseAmt |
| Revenue | $295,141,340 | RevenueAmt |
| Desc | MONONGALIA GENERAL HOSPITAL (MGH)IS A 189-BED GENERAL, ACUTE CARE HOSPITAL IN MORGANTOWN, WV.MGH PROVIDES A WIDE ARRAY OF OUTPATIENT SERVICES INCLUDING OUTPATIENT SURGERY (10,570 SURGERIES), PHYSICIAN OFFICES (167,584 VISITS), AND MANY OTHER SERVICES. SOME OTHER SERVICES INCLUDE CARDIAC CATHETERIZATION, CT SCAN, MRI, NUCLEAR MEDICINE, AND ULTRASOUND.MGH IS LICENSED FOR 189 INPATIENT BEDS WHICH ARE ALL PRIVATE ROOMS. MGH HAD 6,783 DISCHARGES FOR THE YEAR WITH A TOTAL OF 29,952 PATIENT DAYS. MGH HAD 878 DELIVERIES FOR THE YEAR. INPATIENT GENERAL SURGERY (2,777) AND OPEN HEART SURGERY (142) ARE ALSO OFFERED.MGH HAS AN EMERGENCY DEPARTMENT SERVING MONONGALIA AND SURROUNDING COUNTIES WITH A TOTAL OF 21,811 VISITS DURING THE YEAR. | Desc |
| Total Program Service Expenses | $281,634,261 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | 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 | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 170 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1995 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 11 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| 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 (22 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 |
|---|---|---|---|---|---|---|---|---|---|
| SENATOR ROMAN PREZIOSO | |||||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DONALD ROBINSON | |||||||||
| VICE CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KIMBERLY MOYERS | |||||||||
| SECRETARY/TREASURER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SAM CHICO III | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| VINCE KOLANKO MD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PERRI DECHRISTOPHER | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PAT ESPOSITO | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RANDY BUZZO | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOSEPH BLATT MD | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK GILLIAM | |||||||||
| DIRECTOR | 40.00 | 1.00 | Yes (X) | $0 | $359,897 | $12,097 | |||
| WILLIAM CARR MCBEE JR MD | |||||||||
| DIRECTOR/CHIEF OF STAFF | 40.00 | 2.00 | Yes (X) | $1,801,115 | $0 | $31,705 | |||
| NATALIE STONE | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PASTOR JUNIUS LEWIS | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAVID GOLDBERG | |||||||||
| PRESIDENT/CEO | 1.00 | 49.00 | Yes (X) | Yes (X) | $0 | $775,610 | $5,700 | ||
| LISA SIMON CPA | |||||||||
| VP FINANCE/CFO | 1.00 | 49.00 | Yes (X) | $0 | $361,043 | $49,359 | |||
| WISSAM GHARIB MD | |||||||||
| PHYSICIAN | 40.00 | $1,201,781 | $0 | $31,597 | Yes (X) | ||||
| ALEXANDER NAGY MD | |||||||||
| SURGEON | 40.00 | $1,141,954 | $0 | $33,485 | Yes (X) | ||||
| BRADFORD WARDEN MD | |||||||||
| PHYSICIAN | 40.00 | $848,108 | $0 | $26,115 | Yes (X) | ||||
| ROBERT HULL MD | |||||||||
| PHYSICIAN | 40.00 | $1,319,996 | $0 | $29,868 | Yes (X) | ||||
| C ANDREW HEISKELL MD | |||||||||
| SURGEON | 40.00 | $800,435 | $0 | $10,368 | Yes (X) | ||||
| DARIS ROSENCRANCE | |||||||||
| FORMER VP FINANCE/CFO | 0.00 | $0 | $317,827 | $9,194 | Yes (X) | ||||
| DARRYL DUNCAN | |||||||||
| FORMER PRESIDENT/CEO | 0.00 | $0 | $213,610 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $7,113,389 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,027,987 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $239,488 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 143 | 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 |
|---|---|---|---|---|---|
| ALKU TECHNOLOGIES | |||||
| PO BOX 4147 | WOBURN | MA | 01888 | CONSULTING | $5,598,144 |
| NORTHSTAR ANESTHESIA OF WEST VIRGINIA | |||||
| 6225 N STATE HWY 161 STE 200 | IRVING | TX | 75038 | ANESTHESIA SERVICES | $3,485,044 |
| XTEND HEALTHCARE | |||||
| 90 VOLUNTEER DRIVE SUITE 200 | HENDERSONVILLE | TN | 37075 | COLLECTIONS/CODING | $2,620,099 |
| FOCUSONE SOLUTIONS | |||||
| PO BOX 310861 | DES MOINES | IA | 50331 | NURSING AGENCY | $1,825,311 |
| LABORATORY CORPORATION OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LABS | $1,758,213 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 42 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $15,352,194 | GovernmentGrantsAmt |
| All Other Contributions | $851,114 | AllOtherContributionsAmt |
| Total Contributions | $16,203,308 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $290,733,011 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $290,733,011 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $290,733,011 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,787,581 | TotalRevenueColumnAmt |
| Exclusion | $1,787,581 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $379,614 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $379,614 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $379,614 | TotalRevenueColumnAmt |
| Exclusion | $379,614 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,515,766 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $5,515,766 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,515,766 | TotalRevenueColumnAmt |
| Exclusion | $5,515,766 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| MISCELLANEOUS REVENUE | 900099 | $4,408,329 | $4,408,329 | |
| LAB INCOME | 621500 | $911,908 | $911,908 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,320,237 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $319,939,517 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $295,141,340 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $911,908 | UnrelatedBusinessRevenueAmt |
| Exclusion | $7,682,961 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,199,101 | TotalAmt |
| Program Services | $100,694,265 | ProgramServicesAmt |
| Management And General | $9,504,836 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,067,098 | TotalAmt |
| Program Services | $975,059 | ProgramServicesAmt |
| Management And General | $92,039 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,291,552 | TotalAmt |
| Program Services | $13,058,884 | ProgramServicesAmt |
| Management And General | $1,232,668 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,303,884 | TotalAmt |
| Program Services | $5,760,165 | ProgramServicesAmt |
| Management And General | $543,719 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,546,421 | TotalAmt |
| Management And General | $23,546,421 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,444 | TotalAmt |
| Management And General | $9,444 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,888 | TotalAmt |
| Management And General | $125,888 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,223,293 | TotalAmt |
| Program Services | $27,242,441 | ProgramServicesAmt |
| Management And General | $1,980,852 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,581 | TotalAmt |
| Program Services | $2,791 | ProgramServicesAmt |
| Management And General | $2,790 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,829,101 | TotalAmt |
| Program Services | $2,809,925 | ProgramServicesAmt |
| Management And General | $19,176 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,021 | TotalAmt |
| Program Services | $39,021 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,444,484 | TotalAmt |
| Program Services | $3,555,587 | ProgramServicesAmt |
| Management And General | $888,897 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,554 | TotalAmt |
| Program Services | $124,716 | ProgramServicesAmt |
| Management And General | $15,838 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,505,379 | TotalAmt |
| Program Services | $3,604,303 | ProgramServicesAmt |
| Management And General | $901,076 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,187,561 | TotalAmt |
| Program Services | $9,093,781 | ProgramServicesAmt |
| Management And General | $9,093,780 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,213,346 | TotalAmt |
| Program Services | $2,213,346 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $65,691,105 | $65,691,105 | |
| BAD DEBT | $20,369,058 | $20,369,058 | |
| MEDICAID TAX | $8,093,319 | $8,093,319 | |
| EQUIPMENT AND SUPPLIES | $4,434,748 | $4,434,676 | $72 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,848,932 | TotalAmt |
| Program Services | $13,871,819 | ProgramServicesAmt |
| Management And General | $977,113 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,568,870 | TotalAmt |
| Program Services | $281,634,261 | ProgramServicesAmt |
| Management And General | $48,934,609 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,685,782 | BOYAmt |
| EOY | $18,430,743 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,729,917 | BOYAmt |
| EOY | $49,106,904 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,965,808 | BOYAmt |
| EOY | $9,127,866 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,084,733 | BOYAmt |
| EOY | $2,756,478 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $322,835,576 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $197,076,078 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $133,200,776 | BOYAmt |
| EOY | $125,759,498 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,170,557 | BOYAmt |
| EOY | $71,806,734 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,283,516 | BOYAmt |
| EOY | $5,007,204 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,960,266 | BOYAmt |
| EOY | $39,180,260 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $322,081,355 | BOYAmt |
| EOY | $321,175,687 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,014,870 | BOYAmt |
| EOY | $26,263,375 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,086,817 | BOYAmt |
| EOY | $23,998,136 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,725,632 | BOYAmt |
| EOY | $96,995,537 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,410,851 | BOYAmt |
| EOY | $46,566,203 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $213,238,170 | BOYAmt |
| EOY | $193,823,251 | 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 | $108,843,185 | BOYAmt |
| EOY | $127,352,436 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,843,185 | BOYAmt |
| EOY | $127,352,436 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $322,081,355 | BOYAmt |
| EOY | $321,175,687 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$10,629,353 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $10,534,235 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $18,604,369 | 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,038,933 | OtherCostOrOtherBasisAmt |
| Book Value | $8,038,933 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $175,662,146 | OtherCostOrOtherBasisAmt |
| Depreciation | $106,938,422 | DepreciationAmt |
| Book Value | $68,723,724 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $135,975,716 | OtherCostOrOtherBasisAmt |
| Depreciation | $89,746,297 | DepreciationAmt |
| Book Value | $46,229,419 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,158,781 | OtherCostOrOtherBasisAmt |
| Depreciation | $391,359 | DepreciationAmt |
| Book Value | $2,767,422 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $125,759,498 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS | Desc |
| Book Value | $71,806,734 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $71,806,734 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (9 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER RECEIVABLES | $1,677,008 |
| DUE FROM THIRD-PARTY PAYORS | $1,060,373 |
| UNDER BOND INDENTURE AGREEMENTS HELD BY TRUST | $8,230,812 |
| TAX INCREMENT FINANCING BONDS HELD BY TRUSTEES | $3,095,090 |
| SELF INSURANCE FUNDING AGREEMENT | $5,789,645 |
| INSURANCE RECOVERIES RECEIVABLE | $1,152,281 |
| DUE FROM AFFILIATES | $8,787,969 |
| OTHER ASSETS | $211,204 |
| OPERATING LEASE | $9,175,878 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $39,180,260 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUAL FOR ESTIMATED PROFESSIONAL AND GENERAL | $3,477,356 |
| DUE TO AFFILIATES | $98,522 |
| INTEREST RATE SWAP AGREEMENT | $16,309,555 |
| ACCRUED PENSION COSTS | $14,509,924 |
| RABBI TRUST LIABILITY | $1,171,965 |
| DUE TO THIRD PARTY PAYORS | $1,213,733 |
| CAPITAL LEASE | $609,270 |
| OPERATING LEASE | $9,175,878 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $46,566,203 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $315,508,679 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $10,534,235 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $5,529,873 | OtherRevenueAmt |
| Revenue Not Reported | $16,064,108 | RevenueNotReportedAmt |
| Revenue Subtotal | $299,444,571 | RevenueSubtotalAmt |
| Other Revenues Not Included | $20,494,946 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $20,494,946 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $319,939,517 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $310,073,924 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $310,073,924 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $20,494,946 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $20,494,946 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $330,568,870 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HEALTH SYSTEM FOLLOWS THE FASB'S AUTHORITATIVE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE GUIDANCE CLARIFIES THE ACCOUNTING FOR THE RECOGNITION AND MEASUREMENT OF THE BENEFITS OF INDIVIDUAL TAX POSITIONS IN THE CONSOLIDATED FINANCIAL STATEMENTS. TAX POSITIONS MUST MEET A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT IN ORDER FOR THE BENEFIT OF THOSE TAX POSITIONS TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE HEALTH SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS EXIST. GENERALLY, TAX RETURNS FOR YEARS ENDED JUNE 30, 2018, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS 5,529,873. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 20,369,058. INVESTMENT MANAGEMENT FEES 125,888. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 20,369,058. INVESTMENT MANAGEMENT FEES 125,888. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| 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 | $1,061,817 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,061,817 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00340 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,082,151 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,022,398 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,059,753 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07110 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $33,143,968 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,022,398 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,121,570 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07450 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $455,951 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $455,951 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $455,951 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $455,951 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $33,599,919 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,022,398 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,577,521 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07600 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $6,105,051 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $53,164,764 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $71,995,084 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$18,830,320 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| 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 | MONONGALIA GENERAL HOSPITAL | BusinessNameLine1Txt |
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) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONONGALIA GENERAL 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 | 19 | 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 | WWW.MONGENERAL.COM/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENT | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.MONGENERAL.COM/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENT | 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 |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| 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 | MONGENERAL.COM/MAIN/FINANCIAL-ASSISTANCE.ASPX | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | MONGENERAL.COM/MAIN/FINANCIAL-ASSISTANCE.ASPX | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | MONGENERAL.COM/MAIN/FINANCIAL-ASSISTANCE.ASPX | 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 |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| 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 |
|---|---|
| MONONGALIA GENERAL HOSPITAL | PART V, SECTION B, LINE 5: THE CONSULTANT ASSISTING WITH THE CHNA UTILIZED DATA FROM VARIOUS SOURCES AND INTERVIEWS WITH HOSPITAL REPRESENTATIVES AND COMMUNITY STAKEHOLDERS. |
| MONONGALIA GENERAL HOSPITAL | PART V, SECTION B, LINE 11: THOUGH COMMUNITY HEALTH NEEDS WERE IDENTIFIED, MANY NEEDS ARE OUTSIDE OF THE SCOPE OF SERVICES OFFERED BY MONONGALIA GENERAL HOSPITAL. FOR NEEDS WITHIN THE SCOPE OF MONONGALIA GENERAL HOSPITAL, THE BOARD AND ADMINISTRATION HAVE DEVELOPED AN IMPLEMENTATION STRATEGY. |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE HOSPITAL USED A COST-TO-CHARGE RATIO DERIVED FROM MEDICARE COST REPORT FOR TOTAL PROGRAM COSTS AND TOTAL PROGRAM CHARGES TO ESTIMATE THE OVERALL COST-TO-CHARGE RATIO (CCR). THIS CCR WAS USED IN COMPUTATIONS FOR UNREIMBURSED MEDICAID AND CHARITY CARE. |
| PART I, LN 7 COL(F): | THE BAD DEBT EXPENSE OF 20,369,058 INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN A WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE OF TOTAL EXPENSES. |
| PART III, LINE 4: | PATIENT ACCOUNTS RECEIVABLE ARE CARRIED AT THE ORIGINAL CHARGE LESS AN ESTIMATE MADE FOR DOUBTFUL OR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE IS BASED UPON A REVIEW OF THE OUTSTANDING BALANCES AGED BY FINANCIAL CLASS. MANAGEMENT USES COLLECTION PERCENTAGES BASED UPON HISTORICAL COLLECTION EXPERIENCE TO DETERMINE COLLECTABILITY. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS MGH RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE BASED ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. RECOVERIES OF ACCOUNTS PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION TO THE PROVISION FOR BAD DEBT EXPENSE WHEN RECEIVED. INTEREST IS NOT CHARGED ON PATIENT ACCOUNTS RECEIVABLE. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. THE COSTS ARE ALLOCATED TO THE VARIOUS DEPARTMENTS USING A STEP DOWN APPROACH AND REMOVING ANY COSTS THAT ARE NOT ALLOWABLE UNDER MEDICARE RULES. THE ORGANIZATION IS A TAX EXEMPT, NOT-FOR-PROFIT ENTITY THAT SERVES MONONGALIA AND SURROUNDING COUNTIES PATIENT POPULATION REGARDLESS OF THEIR MEANS TO PAY OR HEALTH INSURANCE STATUS. MEDICARE PATIENTS IN OUR SERVICE AREA DEPEND ON THE ORGANIZATION TO DELIVER THEIR HEALTH CARE AND MEET THEIR MEDICAL NEEDS REGARDLESS OF MEDICARE COVERAGE OF COST FOR PROVIDING THE NEEDED SERVICE. SINCE THE ORGANIZATION CONSTANTLY WORK TO OPERATE AS COST EFFICIENT AS POSSIBLE, WE FEEL STRONGLY THAT MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. |
| PART III, LINE 9B: | THERE ARE PROVISIONS IN THE DEBT COLLECTION POLICY TO BE FOLLOWED FOR PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. THE POLICY STATES THAT FINANCIAL ASSISTANCE SHALL BE OFFERED TO THE HOSPITAL'S UNINSURED AND UNDERINSURED PATIENTS ON A NONDISCRIMINATORY BASIS TO MEET THE NEED OF THE COMMUNITY. CHARITY CARE REQUESTS WILL BE REVIEWED AND EVALUATED BY THE CFO AND DIRECTOR OF PATIENT ACCOUNTING FOR APPROVAL. PATIENTS THAT QUALIFY FOR 100% CHARITY CARE ARE NOT PURSUED FOR COLLECTION. PATIENTS THAT QUALIFY FOR PARTIAL ASSISTANCE HAVE THEIR BALANCE REDUCED ACCORDINGLY AND NORMAL COLLECTION EFFORTS ARE USED TO COLLECT THE BALANCE. |
| PART VI, LINE 2: | THE NEEDS OF THE COMMUNITY WERE ASSESSED BASED ON DISCUSSIONS AMONGST MANAGEMENT AND CROSS-SECTION OF COMMUNITY MEMBERS, WHICH PROVIDES OPINIONS FROM VARYING DEMOGRAPHICS. |
| PART VI, LINE 3: | THE PLAIN LANGUAGE SUMMARY OF THE FAP AND FAP APPLICATION ARE AVAILABLE ON THE HOSPITAL'S WEBSITE. PAPER COPIES OF THE FAP, PLAIN LANGUAGE SUMMARY OF THE FAP, AND FAP APPLICATION ARE AVAILABLE UPON REQUEST AND COPIES ARE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. THE HOSPITAL HAS SIGNS THAT NOTIFY THE PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. UNINSURED PATIENTS ARE PROVIDED A PLAIN LANGUAGE SUMMARY AND FAP APPLICATION FORM. BILLING STATEMENTS INCLUDE A NOTICE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO OBTAIN INFORMATION. THE HOSPITAL HAS FINANCIAL COUNSELORS AVAILABLE TO EDUCATE PATIENTS ON THE ELIGIBILITY OF ASSISTANCE. |
| PART VI, LINE 4: | THE HOSPITAL SERVES PRIMARILY MONONGALIA COUNTY, HOWEVER, THERE IS UTILIZATION BY MANY SURROUNDING COUNTIES AS WELL. MONONGALIA COUNTY HAS APPROXIMATELY 100,000 RESIDENTS, OF WHICH A SIZEABLE PORTION ARE STUDENTS AT WEST VIRGINIA UNIVERSITY (SOME BUT NOT ALL OF THE 30,000 ARE INCLUDED IN THE COUNT). MONONGALIA COUNTY IS PROJECTED TO GROW OVER THE NEXT FIVE YEARS, AS OPPOSED TO THE STATE OF WEST VIRGINIA. THE COUNTY'S RACIAL AND ETHNIC CHARACTERISTICS ARE FAIRLY SIMILAR TO THE NATION AS A WHOLE, WITH APPROXIMATELY 9% IDENTIFIED AS MINORITIES. THE COUNTY'S MEDIAN INCOME IS HIGHER THAN THAT OF WV, BUT LESS THAN THE NATION AS A WHOLE. THERE IS CURRENTLY ONE OTHER HOSPITAL SERVING MONONGALIA COUNTY AND THERE ARE NO FEDERAL MEDICALLY UNDERSERVED AREAS OR POPULATIONS PRESENT IN THE COMMUNITY. |
| PART VI, LINE 5: | THE HOSPITAL HAS AN OPEN MEDICAL STAFF SERVING A MULTITUDE OF SPECIALTIES. THE BOARD OF DIRECTORS IS COMPRISED OF VARIOUS MEMBERS OF THE COMMUNITY AS REQUIRED UNDER ITS BYLAWS. THE ORGANIZATION SPONSORS AN ANNUAL HEALTH FAIR AT THE LOCAL MALL, IN WHICH THOUSANDS OF CITIZENS FROM THE LOCAL COMMUNITY COME TO LEARN ABOUT SERVICES OFFERED AND ARE PROVIDED THE OPPORTUNITY TO RECEIVE MULTIPHASIC BLOODWORK FOR A NOMINAL FEE. |
| PART VI, LINE 6: | THE HOSPITAL IS PART OF MONONGALIA HEALTH SYSTEM, INC. WHICH INCLUDES THE FOLLOWING OTHER HEALTH CARE ENTITIES IN THE COMMUNITY: MONONGALIA EMERGENCY MEDICAL SERVICES, INC., MON ELDER SERVICES, INC. DBA THE VILLAGE AT HERITAGE POINT, MON HEALTH CARE, INC., PRESTON MEMORIAL HOSPITAL, AND PRESTON MEMORIAL MEDICAL GROUP. MONONGALIA EMERGENCY MEDICAL SERVICES, INC. IS A NOT-FOR-PROFIT ENTITY WHICH PROVIDES AMBULANCE SERVICES TO THE COMMUNITY AND IS THE PRIMARY EMERGENCY CONTACT TRANSPORT SERVICE FOR 911 CALLS IN THE COUNTY. MON ELDER SERVICES, INC. IS A NOT-FOR-PROFIT RESIDENTIAL AND ASSISTED LIVING PROVIDER. MON HEALTH CARE, INC. IS A FOR-PROFIT DURABLE MEDICAL EQUIPMENT RETAILER. PRESTON MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL. PRESTON MEMORIAL MEDICAL CENTER GROUP IS A NOT-FOR-PROFIT ENTITY WHICH PROVIDES PRIMARY AND URGERT CARE. |
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 (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM CARR MCBEE JR MD | ||||||||||||||
| DIRECTOR/CHIEF OF STAFF | $1,787,679 | $0 | $10,000 | $0 | $3,436 | $0 | $25,200 | $0 | $6,505 | $0 | $1,832,820 | $0 | $0 | $0 |
| ROBERT HULL MD | ||||||||||||||
| PHYSICIAN | $1,214,117 | $0 | $100,000 | $0 | $5,879 | $0 | $25,200 | $0 | $4,668 | $0 | $1,349,864 | $0 | $0 | $0 |
| WISSAM GHARIB MD | ||||||||||||||
| PHYSICIAN | $998,127 | $0 | $200,000 | $0 | $3,654 | $0 | $25,200 | $0 | $6,397 | $0 | $1,233,378 | $0 | $0 | $0 |
| ALEXANDER NAGY MD | ||||||||||||||
| SURGEON | $1,036,075 | $0 | $100,000 | $0 | $5,879 | $0 | $25,200 | $0 | $8,285 | $0 | $1,175,439 | $0 | $0 | $0 |
| BRADFORD WARDEN MD | ||||||||||||||
| PHYSICIAN | $743,233 | $0 | $100,000 | $0 | $4,875 | $0 | $25,200 | $0 | $915 | $0 | $874,223 | $0 | $0 | $0 |
| C ANDREW HEISKELL MD | ||||||||||||||
| SURGEON | $788,450 | $0 | $0 | $0 | $11,985 | $0 | $5,700 | $0 | $4,668 | $0 | $810,803 | $0 | $0 | $0 |
| DAVID GOLDBERG | ||||||||||||||
| PRESIDENT/CEO | $0 | $532,081 | $0 | $112,500 | $0 | $131,029 | $0 | $5,700 | $0 | $0 | $0 | $781,310 | $0 | $0 |
| LISA SIMON CPA | ||||||||||||||
| VP FINANCE/CFO | $0 | $359,753 | $0 | $0 | $0 | $1,290 | $0 | $42,474 | $0 | $6,885 | $0 | $410,402 | $0 | $0 |
| MARK GILLIAM | ||||||||||||||
| DIRECTOR | $0 | $355,744 | $0 | $1,742 | $0 | $2,411 | $0 | $5,700 | $0 | $6,397 | $0 | $371,994 | $0 | $0 |
| DARIS ROSENCRANCE | ||||||||||||||
| FORMER VP FINANCE/CFO | $0 | $86,508 | $0 | $0 | $0 | $231,319 | $0 | $8,009 | $0 | $1,185 | $0 | $327,021 | $0 | $0 |
| DARRYL DUNCAN | ||||||||||||||
| FORMER PRESIDENT/CEO | $0 | $166,691 | $0 | $0 | $0 | $46,919 | $0 | $0 | $0 | $0 | $0 | $213,610 | $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 K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| MONONGALIA COUNTY BUILDING COMMISSION | ||||||||
| A | 550714648 | 610208CK4 | 2011-04-20 | $9,515,218 | REFUND A PORTION OF VARIABLE RATE BONDS TAX | 0 | 0 | 0 |
| MONONGALIA COUNTY BUILDING COMMISSION | ||||||||
| B | 550714648 | 610208BRC | 2008-02-13 | $48,145,000 | CONSTRUCTION AND EXPANSION OF FACILITIES | 0 | 0 | 0 |
| MONONGALIA COUNTY BUILDING COMMISSION | ||||||||
| C | 550714648 | 610218BN8 | 2015-04-28 | $51,450,000 | REFUNDING AND IMPROVEMENT REVENUE BOND | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $3,007,144 | $9,515,218 | $9,324,914 | $190,305 | 2011 | 0 | Yes (1) | 0 | Yes (1) | |
| B | $3,163,238 | $48,145,000 | $13,151,213 | $705,242 | 2009 | 0 | Yes (1) | 0 | Yes (1) | $34,288,545 |
| C | $16,448,397 | $61,954,096 | $55,978,763 | $776,865 | 0 | Yes (1) | 0 | Yes (1) | $5,198,468 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| C | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| (no name) | ||||||||||||
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | |||
| RAYMOND JAMES | ||||||||||||
| B | 0 | 0 | 0 | Yes (1) | Yes (1) | Yes (1) | 0 | 0 | 0 | 32.400000000000 | 0 | 0 |
| (no name) | ||||||||||||
| C | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | |||
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF MONONGALIA COUNTY GENERAL HOSPITAL IS MONONGALIA HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7A | MONONGALIA COUNTY GENERAL HOSPITAL'S BOARD MEMBERS ARE ELECTED OR APPOINTED BY MONONGALIA HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7B | MONONGALIA COUNTY GENERAL 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 TO 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 BOARD MEMBERS ARE ASKED TO INFORM MANAGEMENT OF ANY QUESTIONS OR REVISIONS THEY MAY HAVE. IF CHANGES ARE MADE, BASED ON BOARD 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 THEN REVIEWS ALL RESPONSES FOR POSSIBLE CONFLICTS OF INTEREST. IF A CONFLICT IS NOTED, THE BOARD MEMBERS DETERMINE WHICH DECISIONS THE CONFLICTED MEMBER SHALL NOT PARTICIPATE IN. |
| 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 EXECUTIVE CEO COMPENSATION. THIS REPORT IS THEN REVIEWED BY THE EXECUTIVE COMMITTEE TO DETERMINE COMPENSATION FOR THE INDIVIDUAL. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATION MAKES IT FORMS 990 AND 990-T AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE KEPT ONSITE AT MONONGALIA GENERAL HOSPITAL AND ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN MINIMUM PENSION LIABILITY 13,074,496. CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS 5,529,873. |
| 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 | |
| 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 | Yes (1) | 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 | Yes (1) | 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 Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MONONGALIA COUNTY GENERAL HOSPITAL CO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $736,576 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $2,996,980 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.51000 | OwnershipPct |
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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | 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 | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |