2022-05-10T12:32:03-05:00 2021-06-30 390859910 BAKER TILLY US LLP 5700 CORPORATE SUITE 650 PITTSBURGH PA 15237 990 2020-07-01 237441353 MONONGALIA COUNTY GENERAL HOSPITAL CO MONO 3045981242 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 JEFFREY CRUDELE INTERIM CFO 3045981242 2022-05-06 1 JEFFREY CRUDELE 999009999 JEFFREY J PETRELL P00138808 4126356270 X 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z DAVID S GOLDBERG 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 319939517 0 X WWW.MONHEALTHSYS.ORG X 1972 WV 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. 14 11 1995 11 911908 0 1359636 16203308 269369369 290733011 16338190 7303347 11255574 5699851 298322769 319939517 0 0 0 0 129356255 131861635 0 0 0 166636638 198707235 295992893 330568870 2329876 -10629353 322081355 321175687 213238170 193823251 108843185 127352436 X TO ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. 0 0 281634261 295141340 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. 281634261 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 170 0 1995 1 1 1 0 0 0 0 0 0 0 0 0 X 14 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 WV X GENE TOWNSEND - CONTROLLER 3042853676 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 SENATOR ROMAN PREZIOSO CHAIR 1.00 1.00 X X 0 0 0 DONALD ROBINSON VICE CHAIR 1.00 1.00 X X 0 0 0 KIMBERLY MOYERS SECRETARY/TREASURER 1.00 1.00 X 0 0 0 SAM CHICO III DIRECTOR 1.00 1.00 X 0 0 0 VINCE KOLANKO MD DIRECTOR 1.00 1.00 X 0 0 0 PERRI DECHRISTOPHER DIRECTOR 1.00 1.00 X 0 0 0 PAT ESPOSITO DIRECTOR 1.00 1.00 X 0 0 0 RANDY BUZZO DIRECTOR 1.00 1.00 X 0 0 0 JOSEPH BLATT MD DIRECTOR 1.00 1.00 X 0 0 0 MARK GILLIAM DIRECTOR 40.00 1.00 X 0 359897 12097 WILLIAM CARR MCBEE JR MD DIRECTOR/CHIEF OF STAFF 40.00 2.00 X 1801115 0 31705 NATALIE STONE DIRECTOR 1.00 1.00 X 0 0 0 PASTOR JUNIUS LEWIS DIRECTOR 1.00 X 0 0 0 DAVID GOLDBERG PRESIDENT/CEO 1.00 49.00 X X 0 775610 5700 LISA SIMON CPA VP FINANCE/CFO 1.00 49.00 X 0 361043 49359 WISSAM GHARIB MD PHYSICIAN 40.00 X 1201781 0 31597 ALEXANDER NAGY MD SURGEON 40.00 X 1141954 0 33485 BRADFORD WARDEN MD PHYSICIAN 40.00 X 848108 0 26115 ROBERT HULL MD PHYSICIAN 40.00 X 1319996 0 29868 C ANDREW HEISKELL MD SURGEON 40.00 X 800435 0 10368 DARIS ROSENCRANCE FORMER VP FINANCE/CFO 0.00 X 0 317827 9194 DARRYL DUNCAN FORMER PRESIDENT/CEO 0.00 X 0 213610 0 7113389 2027987 239488 143 1 1 0 ALKU TECHNOLOGIES PO BOX 4147 WOBURN MA 01888 CONSULTING 5598144 NORTHSTAR ANESTHESIA OF WEST VIRGINIA 6225 N STATE HWY 161 STE 200 IRVING TX 75038 ANESTHESIA SERVICES 3485044 XTEND HEALTHCARE 90 VOLUNTEER DRIVE SUITE 200 HENDERSONVILLE TN 37075 COLLECTIONS/CODING 2620099 FOCUSONE SOLUTIONS PO BOX 310861 DES MOINES IA 50331 NURSING AGENCY 1825311 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LABS 1758213 42 15352194 851114 16203308 PATIENT SERVICE REVENUE 621990 290733011 290733011 290733011 1787581 1787581 379614 0 379614 379614 379614 5515766 0 5515766 5515766 5515766 MISCELLANEOUS REVENUE 900099 4408329 4408329 LAB INCOME 621500 911908 911908 5320237 319939517 295141340 911908 7682961 110199101 100694265 9504836 1067098 975059 92039 14291552 13058884 1232668 6303884 5760165 543719 23546421 23546421 9444 9444 125888 125888 29223293 27242441 1980852 5581 2791 2790 2829101 2809925 19176 39021 39021 4444484 3555587 888897 140554 124716 15838 4505379 3604303 901076 18187561 9093781 9093780 2213346 2213346 MEDICAL SUPPLIES 65691105 65691105 BAD DEBT 20369058 20369058 MEDICAID TAX 8093319 8093319 EQUIPMENT AND SUPPLIES 4434748 4434676 72 14848932 13871819 977113 330568870 281634261 48934609 0 35685782 18430743 33729917 49106904 7965808 9127866 3084733 2756478 322835576 197076078 133200776 125759498 75170557 71806734 5283516 5007204 27960266 39180260 322081355 321175687 30014870 26263375 27086817 23998136 99725632 96995537 56410851 46566203 213238170 193823251 X 108843185 127352436 108843185 127352436 322081355 321175687 X -10629353 10534235 18604369 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8038933 8038933 175662146 106938422 68723724 135975716 89746297 46229419 3158781 391359 2767422 125759498 INVESTMENTS 71806734 F 71806734 OTHER RECEIVABLES 1677008 DUE FROM THIRD-PARTY PAYORS 1060373 UNDER BOND INDENTURE AGREEMENTS HELD BY TRUST 8230812 TAX INCREMENT FINANCING BONDS HELD BY TRUSTEES 3095090 SELF INSURANCE FUNDING AGREEMENT 5789645 INSURANCE RECOVERIES RECEIVABLE 1152281 DUE FROM AFFILIATES 8787969 OTHER ASSETS 211204 OPERATING LEASE 9175878 39180260 ACCRUAL FOR ESTIMATED PROFESSIONAL AND GENERAL 3477356 DUE TO AFFILIATES 98522 INTEREST RATE SWAP AGREEMENT 16309555 ACCRUED PENSION COSTS 14509924 RABBI TRUST LIABILITY 1171965 DUE TO THIRD PARTY PAYORS 1213733 CAPITAL LEASE 609270 OPERATING LEASE 9175878 46566203 X 315508679 10534235 5529873 16064108 299444571 20494946 20494946 319939517 310073924 0 310073924 20494946 20494946 330568870 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. 1 1 1 X 0 1 1 0 1 1 1061817 1061817 0.00340 32082151 10022398 22059753 0.07110 33143968 10022398 23121570 0.07450 455951 455951 0.00150 455951 455951 0.00150 33599919 10022398 23577521 0.07600 0 6105051 53164764 71995084 -18830320 X 1 1 1 1 MONONGALIA GENERAL HOSPITAL 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 X X X MONONGALIA GENERAL HOSPITAL 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X WWW.MONGENERAL.COM/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X 1 19 1 WWW.MONGENERAL.COM/MAIN/COMMUNITY-HEALTH-NEEDS-ASSESSMENT 0 1 X 200.000000000000 200.000000000000 X X X 1 1 X X X 1 X MONGENERAL.COM/MAIN/FINANCIAL-ASSISTANCE.ASPX X MONGENERAL.COM/MAIN/FINANCIAL-ASSISTANCE.ASPX X MONGENERAL.COM/MAIN/FINANCIAL-ASSISTANCE.ASPX X X X X X 1 X 0 1 X 0 0 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. 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. 1 1 0 0 0 0 0 0 0 WILLIAM CARR MCBEE JR MD DIRECTOR/CHIEF OF STAFF 1787679 0 10000 0 3436 0 25200 0 6505 0 1832820 0 0 0 ROBERT HULL MD PHYSICIAN 1214117 0 100000 0 5879 0 25200 0 4668 0 1349864 0 0 0 WISSAM GHARIB MD PHYSICIAN 998127 0 200000 0 3654 0 25200 0 6397 0 1233378 0 0 0 ALEXANDER NAGY MD SURGEON 1036075 0 100000 0 5879 0 25200 0 8285 0 1175439 0 0 0 BRADFORD WARDEN MD PHYSICIAN 743233 0 100000 0 4875 0 25200 0 915 0 874223 0 0 0 C ANDREW HEISKELL MD SURGEON 788450 0 0 0 11985 0 5700 0 4668 0 810803 0 0 0 DAVID GOLDBERG PRESIDENT/CEO 0 532081 0 112500 0 131029 0 5700 0 0 0 781310 0 0 LISA SIMON CPA VP FINANCE/CFO 0 359753 0 0 0 1290 0 42474 0 6885 0 410402 0 0 MARK GILLIAM DIRECTOR 0 355744 0 1742 0 2411 0 5700 0 6397 0 371994 0 0 DARIS ROSENCRANCE FORMER VP FINANCE/CFO 0 86508 0 0 0 231319 0 8009 0 1185 0 327021 0 0 DARRYL DUNCAN FORMER PRESIDENT/CEO 0 166691 0 0 0 46919 0 0 0 0 0 213610 0 0 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). A MONONGALIA COUNTY BUILDING COMMISSION 550714648 610208CK4 2011-04-20 9515218 REFUND A PORTION OF VARIABLE RATE BONDS TAX 0 0 0 B MONONGALIA COUNTY BUILDING COMMISSION 550714648 610208BRC 2008-02-13 48145000 CONSTRUCTION AND EXPANSION OF FACILITIES 0 0 0 C MONONGALIA COUNTY BUILDING COMMISSION 550714648 610218BN8 2015-04-28 51450000 REFUNDING AND IMPROVEMENT REVENUE BOND 0 0 0 A 3007144 9515218 9324914 190305 2011 0 1 0 1 B 3163238 48145000 13151213 705242 34288545 2009 0 1 0 1 C 16448397 61954096 55978763 776865 5198468 0 1 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 B 0 0 0 1 1 1 RAYMOND JAMES 32.400000000000 0 0 0 0 0 C 0 0 0 1 0 0 0 0 0 A 1 B 1 C 1 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. 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 MONONGALIA HEALTH SYSTEM INC 0 THE FOUNDATION OF MONONGALIA GENERAL HOSPITAL 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550570338 RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL WV 501(C)(3) LINE 7 MONONGALIA COUNTY GENERAL HOSPITAL CO 1 PRESTON MEMORIAL HOSPITAL 300 SOUTH PRICE STREET KINGWOOD WV 26537 311097818 HOSPITAL WV 501(C)(3) LINE 3 MONONGALIA HEALTH SYSTEM INC 0 PRESTON MEMORIAL MEDICAL GROUP 300 SOUTH PRICE STREET KINGWOOD WV 26537 550717988 PRIMARY AND URGENT CARE WV 501(C)(3) LINE 3 PRESTON MEMORIAL HOSPITAL 0 PRESTON MEMORIAL HEALTH FOUNDATION 300 SOUTH PRICE STREET KINGWOOD WV 26537 550740121 RAISE FUNDS FOR PRESTON HOSPITAL WV 501(C)(3) LINE 12B, II PRESTON MEMORIAL HOSPITAL 0 AUXILIARY OF MONONGALIA GENERAL HOSPITAL 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550362965 RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL WV 501(C)(3) LINE 12A, I MONONGALIA COUNTY GENERAL HOSPITAL CO 1 LIABILITY INSURANCE TRUST FOR MONONGALIA HEALTH SYSTEM 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550689535 LIABILITY INSURANCE TRUST WV 501(C)(3) LINE 12A, I MONONGALIA HEALTH SYSTEM INC 0 STONEWALL JACKSON MEMORIAL HOSPITAL 230 HOSPITAL PLAZA WESTON WV 26452 550422958 HOSPITAL WV 501(C)(3) LINE 3 MONONGALIA HEALTH SYSTEM INC 0 MON HEALTH MARION NEIGHBORHOOD HOSPITAL 140 MIDDLETOWN LOOP WHITEHALL WV 26554 853994078 HOSPITAL WV 501(C)(3) LINE 3 MONONGALIA HEALTH SYSTEM INC 0 MGH SURGERY LLC 2000 MON HEALTH MEDICAL PARK DR MORGANTOWN WV 26505 472736896 SURGERY CENTER WV MONONGALIA COUNTY GENERAL HOSPITAL CO RELATED 736576 2996980 0 0 0.51000 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 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 1 1 0 0