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STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY (EIN 55-0422958)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-17
IRS object ID
202141379349305494
Schema version
2019v5.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-17T13:38:40-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN550486667PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Arnett Carbis Toothman LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1P O Box 2629AddressLine1Txt
CityCharlestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25329ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550422958EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Stonewall Jackson Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSTONBusinessNameControlTxt
Phone3042698059PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1230 Hospital PlazaAddressLine1Txt
CityWestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26452ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKevin StalnakerPersonNm
Person TitleCOOPersonTitleTxt
Phone3042698059PhoneNum
Signature2021-05-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDolores RosePreparerPersonNm
PTINP01286262PTIN
Phone3043460441PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKevin StalnakerPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1230 Hospital PlazaAddressLine1Txt
CityWestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26452ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$57,213,832GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.stonewallhospital.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1959FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionIt is the mission of Stonewall Jackson Memorial Hospital to provide excellent care to all we serve.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee494TotalEmployeeCnt
Total Volunteers15TotalVolunteersCnt
Total Gross UBI$18,350TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$16,241NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$51,864PYContributionsGrantsAmt
CY Contributions Grants$71,312CYContributionsGrantsAmt
PY Program Service Revenue$47,277,524PYProgramServiceRevenueAmt
CY Program Service Revenue$44,190,885CYProgramServiceRevenueAmt
PY Investment Income$2,382,109PYInvestmentIncomeAmt
CY Investment Income$6,146,137CYInvestmentIncomeAmt
PY Other Revenue$920,862PYOtherRevenueAmt
CY Other Revenue$5,919,207CYOtherRevenueAmt
PY Total Revenue$50,632,359PYTotalRevenueAmt
CY Total Revenue$56,327,541CYTotalRevenueAmt
PY Grants And Similar Paid$21,550PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$22,705CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$27,314,281PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$26,864,550CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$26,053,527PYOtherExpensesAmt
CY Other Expenses$28,666,514CYOtherExpensesAmt
PY Total Expenses$53,389,358PYTotalExpensesAmt
CY Total Expenses$55,553,769CYTotalExpensesAmt
PY Revenues Less Expenses-$2,756,999PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$773,772CYRevenuesLessExpensesAmt
Total Assets BOY$64,636,289TotalAssetsBOYAmt
Total Assets EOY$66,727,715TotalAssetsEOYAmt
Total Liabilities BOY$14,412,837TotalLiabilitiesBOYAmt
Total Liabilities EOY$20,760,932TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$50,223,452NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$45,966,783NetAssetsOrFundBalancesEOYAmt
MissionIt is the mission of Stonewall Jackson Memorial Hospital to provide excellent care to all we serve.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$46,960,448ExpenseAmt
Revenue$50,043,868RevenueAmt
DescStonewall Jackson Memorial Hospital provides acute medical and outpatient services to residents of Weston, West Virginia and surrounding communities which covers 10 different counties. Services included 4,241 days of inpatient care, 74,378 outpatient visits, 11,936 emergency room visits, 1,370 ambulatory surgery visits, 4,003 Home Health visits and 35,488 Physician Clinic visits. The Hospital had 157 deliveries during the year in which approximately 60% were Medicaid patients. Many of these babies had significant substance abuse problems. Due to the drug addiction problems of the Mothers, very few of these women have received prenatal care.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,605ExpenseAmt
Grant$3,605GrantAmt
DescAnnual Blood Screening: Stonewall Jackson Memorial Hospital provides all supplies and staff to operate the program. A portion of the excess revenue is forwarded to the local Rotary Club to promote charitable services. Other programs include: scoliosis screening at county elementary and middle schools, health fairs at the local senior citizens center, free sports physicals to middle and high school students, Children's Safety Day to promote healthy choices to children under 12 years of age, events for free osteoporosis screenings, events for free Dermascans to screen for skin cancer, Weston Walk-run to promote exercise as a way to improve cardiac health, free women's health screening for breast and cervical cancer, free vein screenings and free hearing screenings. Revenue is included in Line 4a above.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$19,100ExpenseAmt
Grant$19,100GrantAmt
DescWilliam Adler Scholarship Fund - Stonewall Jackson Memorial Hospital sponsored program to provide scholarships to local graduating high school seniors who are pursuing a career in the health care field. It is hoped that this program will encourage more students to seek health care professions and lesson the health care staffing shortage.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$46,983,153TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document185IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee494EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWVStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Kevin StalnakerBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3042698059PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1230 Hospital PlazaAddressLine1Txt
CityWestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP264528558ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Robin Poling
Chairman1.00Yes (X)Yes (X)$0$0$0
C Gregory Cunningham
Vice Chairman1.00Yes (X)Yes (X)$0$0$0
Kimberly Gum
Secretary/Treasurer1.00Yes (X)Yes (X)$0$0$0
David Goldberg
President/CEO MonHealth1.00Yes (X)Yes (X)$0$640,159$100,60439.00
Kevin Stalnaker
COO40.00Yes (X)Yes (X)$0$250,313$41,547
John Law CPA
Director1.00Yes (X)$0$0$0
Joseph Snead MD
Director23.00Yes (X)$105,250$0$537
John W Wyllie III MD
Director40.00Yes (X)$377,464$0$48,580
Gregory St Clair
Director1.00Yes (X)$0$0$0
R Gerald Wood RPH
Director1.00Yes (X)$0$0$0
Denver Turner
Director1.00Yes (X)$0$0$0
Robert Harris MD
Director40.00Yes (X)$399,056$0$42,926
Avah Stalnaker
CEO Term 12-31-1940.00Yes (X)$0$392,591$27,447
Lisa Simon CPA
VP Finance/CFO MonHealth1.00Yes (X)$0$495,447$72,76839.00
Darryl Duncan
Former President/CEO MonHealth1.00$0$790,295$039.00Yes (X)
Daris Rosencrance
Former VP Finance/CFO MonHealth1.00$0$455,368$63,77439.00Yes (X)
Michael Gregory DO
Physician40.00$570,057$0$42,926Yes (X)
Doyle Sickles MD
Physician40.00$560,030$0$24,118Yes (X)
Ronald Pearson MD
Physician40.00$448,877$0$25,546Yes (X)
Virgil W McMillion DO
Physician40.00$446,793$0$30,222Yes (X)
Christine Evankovich-Edwards MD
Physician37.50$247,095$0$17,631Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,154,622TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,024,173TotReportableCompRltdOrgAmt
Total Other Compensation$538,626TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K35IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Sodexo Inc & Affiliates
PO Box 536922AtlantaGA503536922Maintenance/Dietary$721,099
Synergy Surgicalists
280 W Kagy Blvd Suite D 320BozemanMT59715Contract Orthopedic Surgeons$585,000
WV Emergency Physicians LLP
PO Box 677979DallasTX752677979Emergency Room Physicians$328,903
Comprehensive Pharmacy Services (CPS)
655 Metro Place South Suite 450DublinOH43017Contract Pharmacy Services$243,589
Laboratory Corporation
PO Box 12140BurlingtonNC272162140Laboratory Services$231,174
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K16CntrctRcvdGreaterThan100KCnt
Fundraising$3,100FundraisingAmt
All Other Contributions$68,212AllOtherContributionsAmt
Total Contributions$71,312TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient ServicesDesc
Business622110BusinessCd
Total Revenue Column$44,190,885TotalRevenueColumnAmt
Related Or Exempt Func Income$44,190,885RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$44,190,885TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$961,147TotalRevenueColumnAmt
Exclusion$961,147ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$67,386RealAmt
Personal$18,350PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$30,852RealAmt
Personal$0PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$36,534RealAmt
Personal$18,350PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$54,884TotalRevenueColumnAmt
Unrelated Business Revenue$18,350UnrelatedBusinessRevenueAmt
Exclusion$36,534ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$6,038,474SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$853,484SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$5,184,990SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,184,990TotalRevenueColumnAmt
Exclusion$5,184,990ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$13,295FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$3,100ContriRptFundraisingEventAmt
Fundraising Direct Expenses$1,955FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,340TotalRevenueColumnAmt
Exclusion$11,340ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Refunds & Expense Reimbursements/900099$5,662,039$5,662,039
Cafeteria722310$160,187$160,187
Vending Machine Sales722310$20,824$20,824

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,933TotalRevenueColumnAmt
Related Or Exempt Func Income$9,933RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$5,852,983OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$56,327,541TotalRevenueColumnAmt
Related Or Exempt Func Income$50,043,868RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$18,350UnrelatedBusinessRevenueAmt
Exclusion$6,194,011ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$3,605TotalAmt
Program Services$3,605ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$19,100TotalAmt
Program Services$19,100ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,218,747TotalAmt
Program Services$1,033,497ProgramServicesAmt
Management And General$185,250ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$20,241,337TotalAmt
Program Services$17,164,654ProgramServicesAmt
Management And General$3,076,683ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$818,385TotalAmt
Program Services$693,990ProgramServicesAmt
Management And General$124,395ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,273,915TotalAmt
Program Services$2,776,280ProgramServicesAmt
Management And General$497,635ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,312,166TotalAmt
Program Services$1,112,717ProgramServicesAmt
Management And General$199,449ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,171,238TotalAmt
Management And General$2,171,238ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$134,659TotalAmt
Management And General$134,659ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$180,346TotalAmt
Program Services$152,933ProgramServicesAmt
Management And General$27,413ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$362,501TotalAmt
Program Services$307,401ProgramServicesAmt
Management And General$55,100ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,779,893TotalAmt
Program Services$1,509,388ProgramServicesAmt
Management And General$270,505ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,183,083TotalAmt
Program Services$1,003,254ProgramServicesAmt
Management And General$179,829ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$996,840TotalAmt
Program Services$845,320ProgramServicesAmt
Management And General$151,520ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$93,181TotalAmt
Program Services$79,017ProgramServicesAmt
Management And General$14,164ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$56,419TotalAmt
Program Services$47,843ProgramServicesAmt
Management And General$8,576ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,292,370TotalAmt
Program Services$1,943,930ProgramServicesAmt
Management And General$348,440ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$914,028TotalAmt
Program Services$775,096ProgramServicesAmt
Management And General$138,932ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical supplies$7,526,659$7,526,659
Purchased services$4,077,013$3,457,307$619,706
Bad debts$3,845,214$3,845,214
Repairs and maintenance$1,575,218$1,335,785$239,433

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,477,852TotalAmt
Program Services$1,350,163ProgramServicesAmt
Management And General$127,689ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$55,553,769TotalAmt
Program Services$46,983,153ProgramServicesAmt
Management And General$8,570,616ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$897,089BOYAmt
EOY$12,283,157EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,975,564BOYAmt
EOY$2,152,866EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,086,757BOYAmt
EOY$3,439,833EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,099,627BOYAmt
EOY$1,107,591EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$280,747BOYAmt
EOY$210,693EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$51,534,041LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$39,499,919LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$13,461,485BOYAmt
EOY$12,034,122EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$34,564,849BOYAmt
EOY$32,378,141EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$523,940BOYAmt
EOY$517,129EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,746,231BOYAmt
EOY$2,604,183EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$64,636,289BOYAmt
EOY$66,727,715EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$12,204,693BOYAmt
EOY$15,636,283EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$48,340BOYAmt
EOY$26,318EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,159,804BOYAmt
EOY$5,098,331EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,412,837BOYAmt
EOY$20,760,932EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$49,767,180BOYAmt
EOY$45,517,322EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$456,272BOYAmt
EOY$449,461EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$50,223,452BOYAmt
EOY$45,966,783EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$64,636,289BOYAmt
EOY$66,727,715EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$773,772ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$5,563,583NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$533,142OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$5,769GrantsOtherOrganizationsAmt
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$5,769TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationA portion of dues paid by the hospital to the American Hospital Assocation and the West Virginia Hospital Association is attributable to lobbying.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,519,778OtherCostOrOtherBasisAmt
Book Value$6,519,778BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,403,703OtherCostOrOtherBasisAmt
Depreciation$11,956,340DepreciationAmt
Book Value$1,447,363BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$31,359,091OtherCostOrOtherBasisAmt
Depreciation$27,543,579DepreciationAmt
Book Value$3,815,512BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$251,469OtherCostOrOtherBasisAmt
Book Value$251,469BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,034,122TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationThe 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, 2017, and thereafter remain subject to examination by federal and state tax authorities.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Rotary Blood ScreeningEvent1Nm
Gross Receipts Event1$16,395GrossReceiptsEvent1Amt
Charitable Contri Event1$3,100CharitableContriEvent1Amt
Gross Revenue Event1$13,295GrossRevenueEvent1Amt
Rent Facility Costs Event1$1,955RentFacilityCostsEvent1Amt
Gross Receipts Total$16,395GrossReceiptsTotalAmt
Charitable Contributions Tot$3,100CharitableContributionsTotAmt
Gross Revenue Total Events$13,295GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$1,955RentFcltyCostsTotalEventsAmt
Direct Expense Summary Events$1,955DirectExpenseSummaryEventsAmt
Net Income Summary$11,340NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other162.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$503,957TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$458,820DirectOffsettingRevenueAmt
Net Community Benefit Expns$45,137NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,403,121TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,000,947DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,402,174NetCommunityBenefitExpnsAmt
Total Expense0.06580TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,907,078TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,459,767DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,447,311NetCommunityBenefitExpnsAmt
Total Expense0.06670TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,907,078TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,459,767DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,447,311NetCommunityBenefitExpnsAmt
Total Expense0.06670TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,845,214BadDebtExpenseAmt
Reimbursed By Medicare$7,311,219ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$7,800,457CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$489,238MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Stonewall Jackson Memorial HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1230 Hospital PlazaAddressLine1Txt
CityWestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26452ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Stonewall Jackson Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://www2.stonewalljacksonhospital.com/docs/lewis_co_health_dept.pdfOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttps://www2.stonewalljacksonhospital.com/docs/lewis_co_health_dept.pdfStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care162.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://www2.stonewalljacksonhospital.com/docs/sjmh_financial_assistance_poFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://www2.stonewalljacksonhospital.com/docs/Financial_Aid_Application_2.FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://www.stonewalljacksonhospital.com/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Stonewall Jackson Memorial HospitalPart V, Section B, Line 5: The Hospital took into account input from community leaders at the health department, schools, local businesses and the town Mayor. Three hundred ninety-two people participated in a survey from July 2018 to February 2019. The survey was promoted in the local newspaper, local radio stations, social media and email. Another 70 paper surveys were completed at the Lewis County Health Department, waiting areas in SJMH, physician offices, senior center and other areas in the county. In April 2019, a staff member from SJMH coordinated two focus groups. Participants of the focus groups included representatives from the Lewis County Health Department, Day Report Center, the William R. Sharpe Hospital, the City of Weston and the hospital.
Stonewall Jackson Memorial HospitalPart V, Section B, Line 6b: Lewis County Health Department
Stonewall Jackson Memorial HospitalPart V, Section B, Line 11: Drug abuse was the number one health concern of the residents. The other concerns in order of importance: obesity, cancer, heart disease, diabetes, and high blood pressure. To combat drug abuse, SJMH's emergency department has adopted the WV Hospital Association Guidelines for prescribing opiates. Lewis County now has a drug court. All nursing staff at SJMH are required to complete continuing education on "drug diversion education on opiates". All SJMH pharmacists must complete continuing education on drug diversion education on opiates, and all SJMH physicians are registered with the WV board of pharmacies. The second concern for the community was obesity. To combat this, SJMH has an adult fitness program; created a county-wide walking group; and the Therapy Department provided annual physicals for student athletes at no cost. SJMH created a safe walking path in the parking lot, established a wellness committee for employees, and does not serve soda pops at activities. SJMH coordinated with the City of Weston to refurbish playgrounds in the area.
Stonewall Jackson Memorial HospitalPart V, Section B, Line 13h: Patients whose family income exceeds 162% of the FPL may be eligible to receive discounted rates on a case-by-case basis based on their specific circumstances, such as catastrophic illness or medical indigence, at the discretion of SJMH; however the discounted rates shall not be greater than the amounts generally billed to (received by the hospital for) commercially insured or Medicare patients.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - Stonewall Jackson Home CareBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1456 Suite B Market Place MallAddressLine1Txt
CityWestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26452ZIPCd
FieldValueIRS element (for citing)
FacilityHome Health CareFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:The Health Resources and Services Administration eligibility guidelines are used. We also evaluate the patient's assets and the amount of medical debt. We have signs posted at Registration, around and in the Emergency Department and in all physician clinics. We send letters to patients who are not paying their bills and give the application to private pay inpatients. We also tell the patients during telephone conversations if the patient indicates he/she is not able to pay the bill or pay all of the bill.
Part I, Line 7:The cost of charity care was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.The unreimbursed cost of Medicaid was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.
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 $ 3,845,214.
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. Management also reviews troubled, aged accounts to determine collection potential. Patient accounts receivable are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received. Interest is not charged on patient accounts receivable.
Part III, Line 8:The Medicare cost report was used to determine revenue allowable costs associated with the revenue.
Part III, Line 9b:Our collections policy applies to all patients regardless of financial class or any other classification. During our collections process, if the patient indicates they do not have the ability to pay their bill, the credit staff offers exoneration.
Part VI, Line 2:The assessment was conducted in three phases: The first phase was attaining background information on the healthcare problems of the local area and state. The second phase was a survey conducted online and by paper. The last phase was a focus group conducted by an experienced mediator.
Part VI, Line 3:We have signs posted at Registration, around and in the Emergency Department, and in all physician clinics. We send letters to patients who are not paying their bills. We give the application to Private Pay inpatients. We tell the patients during telephone conversations, if the patient indicates he/she is not able to pay the bill or pay all of the bill.
Part VI, Line 4:Stonewall Jackson Memorial Hospital serves a relatively large rural population of about 65,000 people with an average household income of $32,000. 30% of the population is disabled. Approximately 30% are Medicaid Eligible or are uninsured. We are the largest hospital in our service area, which includes two other hospitals, one being a Critical Access Hospital. We are located in a federally-designated medically underserved area.
Part VI, Line 5:Stonewall Jackson Memorial Hospital (SJMH) is a 70 bed rural acute care hospital located in Lewis county West Virginia. SJMH is the only hospital located in the county as such it is solely responsible for the healthcare of this rural community. SJMH provides a 24 hour Emergency Room and Obstetrics services and provides care regardless of the patient's ability to pay. The majority of the governing body is comprised of community members. Medical privileges are offered to all qualified physicians in the community and SJMH has worked diligently to provide other physician services by expanding the services they provide.SJMH continues to make capital improvement to the facility and expand patient care services to meet the needs of the community.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Rotary Club of WestonBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 222AddressLine1Txt
CityWestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26452ZIPCd
FieldValueIRS element (for citing)
Recipient EIN550371556RecipientEIN
IRC Section501(c)4IRCSectionDesc
Cash Grant$3,605CashGrantAmt
Purpose Of GrantTo help the Rotary support various children's programs in Lewis County.PurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org0Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeHealthcare scholarships for recent high school graduates.GrantTypeTxt
Recipient39RecipientCnt
Cash Grant$19,100CashGrantAmt
Valuation Method UsedFMV - CashValuationMethodUsedDesc

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
David Goldberg
President/CEO MonHealth$0$555,538$0$0$0$84,621$0$97,590$0$3,014$0$740,763$0$0
Kevin Stalnaker
COO$0$250,313$0$0$0$0$0$22,005$0$19,542$0$291,860$0$0
John W Wyllie III MD
Director$375,613$0$0$0$1,851$0$38,750$0$9,830$0$426,044$0$0$0
Robert Harris MD
Director$315,000$0$84,026$0$30$0$13,750$0$29,176$0$441,982$0$0$0
Avah Stalnaker
CEO Term 12-31-19$0$307,499$0$28,828$0$56,264$0$25,000$0$2,447$0$420,038$0$0
Lisa Simon CPA
VP Finance/CFO MonHealth$0$346,499$0$86,625$0$62,323$0$64,978$0$7,790$0$568,215$0$0
Darryl Duncan
Former President/CEO MonHealth$0$619,139$0$0$0$171,156$0$0$0$0$0$790,295$0$0
Daris Rosencrance
Former VP Finance/CFO MonHealth$0$316,988$0$16,437$0$121,943$0$57,744$0$6,030$0$519,142$0$0
Michael Gregory DO
Physician$570,027$0$0$0$30$0$13,750$0$29,176$0$612,983$0$0$0
Doyle Sickles MD
Physician$560,000$0$0$0$30$0$13,750$0$10,368$0$584,148$0$0$0
Ronald Pearson MD
Physician$448,877$0$0$0$0$0$13,750$0$11,796$0$474,423$0$0$0
Virgil W McMillion DO
Physician$395,460$0$51,333$0$0$0$13,750$0$16,472$0$477,015$0$0$0
Christine Evankovich-Edwards MD
Physician$240,364$0$0$0$6,731$0$14,540$0$3,091$0$264,726$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Lines 4a-bFormAndLineReferenceDesc
ExplanationThe following individuals deferrred the following amounts under a 457(f) plan - Daris Rosencrance ($13,744), David Goldberg (59,590) and Lisa Simon ($43,312). The following individual received a severance payment - Darryl Duncan ($619,139).ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 3Management duties customarily are performed under the direct supervision of officers, directors, trustees or key employees, but the Hospital has contracted out the management duties of the Maintenance department. The manager of the Maintenance department (also considered a department head) is employed by the Maintenance company. All other Maintenance staff are employees of the Hospital. The Hospital contracts out the management duties of the Pharmacy department. The manager of the Pharmacy department (also considered a department head) is employed by the Pharmacy company. All other Pharmacy staff are employees of the Hospital. The Hospital contracts out the management duties of the Dietary department. The manager of the Dietary department (also considered a department head) is employed by the Dietary company. The certified Dietary Manager and the Dietitian are also the employees of the Dietary company. All other Dietary staff are employees of the Hospital.
Form 990, Part VI, Section A, line 6Monongalia Health System, Inc., a West Virginia non-profit corporation, is the sole member of the Hospital.
Form 990, Part VI, Section A, line 7aStonewall Jackson Memorial Hospital board members are elected or appointed by Monongalia Health System.
Form 990, Part VI, Section A, line 7bStonewall Jackson 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 11bThe 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 12cAnnually, 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 members shall not participate in.
Form 990, Part VI, Section B, line 15Annually, 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 19The Hospital places a publication in the local newspaper stating the governing documents, conflicts of interest policy and financial statements are available upon request.
Form 990, Part XI, line 9:Net asset transfer and change of beneficial interest held by others 533,142.
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 (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Monongalia County General Hospital Company
1200 JD Anderson DriveMorgantownWV26505237441353HospitalWV501(c)(3)Line 3Monongalia Health Systems Inc0
Mon Elder Services Inc
1200 JD Anderson DriveMorgantownWV26505311520863Continuing care retirement villageWV501(c)(3)Line 10Monongalia Health Systems Inc0
Monongalia Health System Inc
1200 JD Anderson DriveMorgantownWV26505550621551Parent/management companyWV501(c)(3)Line 12c, III-FI0N/A
The Foundation of Monongalia General Hospital
1200 JD Anderson DriveMorgantownWV26505550570338Raise funds for Monongalia General HospitalWV501(c)(3)Line 70N/A
Preston Memorial Hospital
150 Memorial DriveKingwoodWV26537311097818HospitalWV501(c)(3)Line 3Monongalia Health Systems Inc0
Preston Memorial Medical Group
150 Memorial DriveKingwoodWV26537550717988Provide primary and urgent careWV501(c)(3)Line 3Monongalia Health Systems Inc0
Preston Memorial Hospital Foundation
150 Memorial DriveKingwoodWV26537550740121Support activities of other charitable organizationsWV501(c)(3)Line 12a, IMonongalia Health Systems Inc0
Auxiliary of Monongalia General Hospital
1200 JD Anderson DriveMorgantownWV26505550362965Raise funds for Monongalia General HospitalWV501(c)(3)Line 12a, IMonongalia Health Systems Inc0
Liability Insurance Trust for Monongalia Health System
1200 JD Anderson DriveMorgantownWV26505550689535Liability Insurance TrustWV501(c)(3)Line 12a, IMonongalia Health Systems Inc0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
Stonewall Home Oxygen Therapy Inc
100 Market Place Mall Suite 8WestonWV26452550754278Oxygen Therapy ServicesWVStonewall Jackson Memorial HospitalC$413,2281.00000Yes (1)
Mon Health Care Inc
1200 JD Anderson DriveMorgantownWV26505550654973Home Medical EquipmentWVMonongalia Health System IncC0
Morgantown Medical Arts Building Inc
1199 Van Voorhis Road Suite 6MorgantownWV26202550570209Office RentalWVMonongalia Health System IncC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Stonewall Home Oxygen Therapy IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeATransactionTypeTxt
Involved$18,350InvolvedAmt
Method Of Amount DeterminationFMV - CashMethodOfAmountDeterminationTxt