GRANT MEMORIAL HOSPITAL: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- GRANT MEMORIAL HOSPITAL (EIN 55-0562976)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-06-30
- IRS object ID
- 202001829349300330
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-06-30T09:49:18-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560747981 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550562976 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANT MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GRAN | BusinessNameControlTxt |
| Phone | 3042575802 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 117 HOSPITAL DRIVE | AddressLine1Txt |
| City | PETERSBURG | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26847 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID APPLEWOOD | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3042575802 | PhoneNum |
| Signature | 2020-06-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMY BIBBY | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 96.255.208.156 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-06-15 | IPDt |
| IP Tm | 14:27:55 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 32F9AC66A2B04758B89F16BB940F117C042CAF37 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 839A658C77C9BD915FB92B1F12127266767FB63C | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT MILVET | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 117 HOSPITAL DRIVE | AddressLine1Txt |
| City | PETERSBURG | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26847 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $35,596,039 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GRANTMEMORIAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1957 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | TAX-EXEMPT HOSPITAL DEDICATED TO SERVICING THE COUNTIES OF GRANT, HARDY, & PENDLETON IN WEST VIRGINIA | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 448 | TotalEmployeeCnt |
| Total Volunteers | 8 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,016 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,925 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $37,539,213 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $34,503,455 | CYProgramServiceRevenueAmt |
| PY Investment Income | $606,314 | PYInvestmentIncomeAmt |
| CY Investment Income | $233,352 | CYInvestmentIncomeAmt |
| PY Other Revenue | $412,199 | PYOtherRevenueAmt |
| CY Other Revenue | $427,194 | CYOtherRevenueAmt |
| PY Total Revenue | $38,558,742 | PYTotalRevenueAmt |
| CY Total Revenue | $35,167,926 | 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 | $17,764,727 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,708,502 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,866,579 | PYOtherExpensesAmt |
| CY Other Expenses | $22,352,942 | CYOtherExpensesAmt |
| PY Total Expenses | $38,631,306 | PYTotalExpensesAmt |
| CY Total Expenses | $40,061,444 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$72,564 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,893,518 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $23,173,878 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,183,817 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,618,324 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,521,781 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $15,555,554 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,662,036 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE GRANT MEMORIAL HOSPITAL IS A REGIONAL PROVIDER OF QUALITY, COST EFFECTIVE HEALTH CARE SERVICE RESPONSIVE TO THE COMMUNITY NEEDS AND SUPPORTED BY INNOVATIVE EFFORTS WITH OTHERS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $31,685,833 | ExpenseAmt |
| Revenue | $34,855,790 | RevenueAmt |
| Desc | THE HOSPITAL PROVIDES A FULL COMPLEMENT OF HEALTH SERVICES INCLUDING INPATIENT ACUTE, OBSTETRICS, INTENSIVE CARE, SWING-BED SERVICES, NURSING FACILITY SERVICES (BOTH SKILLED AND INTERMEDIATE), TRADITIONAL OUTPATIENT SERVICES AND PHYSICIAN SERVICES TO THE RESIDENTS OF GRANT, HARDY, AND PENDLETON COUNTIES OF WEST VIRGINIA. THE LONG TERM CARE FACILITY WAS CLOSED IN APRIL 2019. THE HOSPITAL IS LOCATED IN THE EASTERN PANHANDLE OF WEST VIRGINIA WITH THE CLOSEST HOSPITALS LOCATED 1.5 HOURS AWAY DURING GOOD WEATHER. DURING THE WINTER, IT WILL TYPICALLY TAKE LONGER DEPENDING ON WEATHER CONDITIONS. DURING THE YEAR, THE HOSPITAL HAD 4,156 ADULT AND PEDIATRIC DAYS, 1,302 SWING-BED DAYS, 473 NURSERY DAYS, 279 SKILLED CARE DAYS, AND 3,270 NURSING FACILITY DAYS. | Desc |
| Total Program Service Expenses | $31,685,833 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 103 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 448 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
| Other | Yes (X) | OtherInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ACCOUNTING DEPARTMENT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3042575802 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 117 HOSPITAL DRIVE | AddressLine1Txt |
| City | PETERSBURG | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26847 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| TAMMY KESNER | ||||||||
| CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| THOMAS HEDRICK | ||||||||
| VICE CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ALLAN KILE SR | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JANET FRYE | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFF BERG | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JENNIFER GARTIN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JULIA HARTMAN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TEDDY KETTERMAN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CAROLINE ARMSTRONG DO | ||||||||
| TRUSTEE, PHYSICIAN, CHIEF OF STAFF | 40.00 | Yes (X) | $336,255 | $0 | $0 | |||
| BEN LESLIE | ||||||||
| TRUSTEE, PHYSICIAN, VICE CHIEF OF STAFF | 40.00 | Yes (X) | $350,160 | $0 | $0 | |||
| ROBERT MILVET | ||||||||
| CEO (START 08.28.18) | 40.00 | Yes (X) | Yes (X) | $98,647 | $0 | $7,280 | 1.00 | |
| RAYMOND SNEAD | ||||||||
| INTERIM CEO (03/18 - 08/18) | 40.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| GEORGE HALAMA | ||||||||
| CFO (THROUGH DEC 18) | 40.00 | Yes (X) | $125,654 | $0 | $8,773 | 1.00 | ||
| DAVID APPLEWOOD | ||||||||
| CFO (START DEC 18) | 40.00 | Yes (X) | $6,958 | $0 | $0 | 1.00 | ||
| ANIL MAKANI | ||||||||
| PHYSICIAN | 40.00 | $629,645 | $0 | $33,061 | Yes (X) | |||
| SCOTT ROBERTS | ||||||||
| PHYSICIAN | 40.00 | $541,231 | $0 | $19,135 | Yes (X) | |||
| ULUNNA MACBEAN | ||||||||
| PHYSICIAN | 40.00 | $259,425 | $0 | $17,033 | Yes (X) | |||
| AMANDA BORROR | ||||||||
| PHYSICIAN | 40.00 | $241,984 | $0 | $20,278 | Yes (X) | |||
| NISHAT ALLY | ||||||||
| PHYSICIAN | 40.00 | $215,954 | $0 | $7,736 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,805,913 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $113,296 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | 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 |
|---|---|---|---|---|---|
| UNITED PHYSICIANS CARE INC | |||||
| ATTN SARA GOFF PO BOX 897 | MORGANTOWN | WV | 265070000 | PHYSICIANS | $1,760,470 |
| CLINICAL COLLEAGUES INC | |||||
| PO BOX 824246 | PHILADELPHIA | PA | 191824246 | MANAGEMENT AND CONSULTING | $491,672 |
| JACKSON KELLY PLLC | |||||
| PO BOX 45705 | BALTIMORE | MD | 212975705 | LEGAL SERVICES | $483,346 |
| MEDHOST OF TENNESSEE INC | |||||
| 2739 MONUMENTUM PLACE | CHICAGO | IL | 606895327 | IT AND CONSULTING | $480,308 |
| US MOBILE IMAGING LLC | |||||
| PO BOX 808 | CUMBERLAN | MD | 215010808 | IMAGING SERVICES | $438,257 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 42 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $3,925 | AllOtherContributionsAmt |
| Total Contributions | $3,925 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $34,503,455 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,503,455 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $34,503,455 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $661,465 | TotalRevenueColumnAmt |
| Exclusion | $661,465 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $74,859 | 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 | $74,859 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $74,859 | TotalRevenueColumnAmt |
| Exclusion | $74,859 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $428,113 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$428,113 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$428,113 | TotalRevenueColumnAmt |
| Exclusion | -$428,113 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA | 722210 | $158,219 | $158,219 |
| MISCELLANEOUS REVENUE | 900099 | $151,933 | $151,933 |
| OTHER OPERATING REVENUE | 900099 | $42,183 | $42,183 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $352,335 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,167,926 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,855,790 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $308,211 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,367,843 | TotalAmt |
| Program Services | $11,363,971 | ProgramServicesAmt |
| Management And General | $3,003,872 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $445,282 | TotalAmt |
| Program Services | $352,187 | ProgramServicesAmt |
| Management And General | $93,095 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,890,852 | TotalAmt |
| Program Services | $1,495,533 | ProgramServicesAmt |
| Management And General | $395,319 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,004,525 | TotalAmt |
| Program Services | $794,510 | ProgramServicesAmt |
| Management And General | $210,015 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,154,599 | TotalAmt |
| Management And General | $1,154,599 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,875 | TotalAmt |
| Management And General | $175,875 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,225,572 | TotalAmt |
| Program Services | $6,505,859 | ProgramServicesAmt |
| Management And General | $1,719,713 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,822 | TotalAmt |
| Program Services | $80,534 | ProgramServicesAmt |
| Management And General | $21,288 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $484,003 | TotalAmt |
| Program Services | $382,814 | ProgramServicesAmt |
| Management And General | $101,189 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $724,568 | TotalAmt |
| Program Services | $573,083 | ProgramServicesAmt |
| Management And General | $151,485 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,783 | TotalAmt |
| Program Services | $59,148 | ProgramServicesAmt |
| Management And General | $15,635 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,395 | TotalAmt |
| Program Services | $24,040 | ProgramServicesAmt |
| Management And General | $6,355 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,008 | TotalAmt |
| Program Services | $34,807 | ProgramServicesAmt |
| Management And General | $9,201 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,206,656 | TotalAmt |
| Program Services | $954,381 | ProgramServicesAmt |
| Management And General | $252,275 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $386,679 | TotalAmt |
| Program Services | $305,836 | ProgramServicesAmt |
| Management And General | $80,843 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $5,630,105 | $5,505,337 | $124,768 |
| BAD DEBT EXPENSE | $2,333,405 | $1,845,562 | $487,843 |
| REPAIRS AND MAINTENANCE | $938,089 | $741,964 | $196,125 |
| LICENSES AND TAXES | $842,383 | $666,267 | $176,116 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,061,444 | TotalAmt |
| Program Services | $31,685,833 | ProgramServicesAmt |
| Management And General | $8,375,611 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,831 | BOYAmt |
| EOY | $6,036 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,464,181 | BOYAmt |
| EOY | $1,435,670 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,568,129 | BOYAmt |
| EOY | $2,524,593 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,161,483 | BOYAmt |
| EOY | $1,123,374 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $203,357 | BOYAmt |
| EOY | $246,829 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $31,049,004 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $25,732,674 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,221,308 | BOYAmt |
| EOY | $5,316,330 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,950,030 | BOYAmt |
| EOY | $6,383,224 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $857,761 | BOYAmt |
| EOY | $147,761 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $709,798 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,173,878 | BOYAmt |
| EOY | $17,183,817 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,826,726 | BOYAmt |
| EOY | $3,472,640 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $966 | BOYAmt |
| EOY | $1,500 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $482,260 | BOYAmt |
| EOY | $169,066 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,308,372 | BOYAmt |
| EOY | $2,878,575 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,618,324 | BOYAmt |
| EOY | $6,521,781 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,555,554 | BOYAmt |
| EOY | $10,662,036 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,555,554 | BOYAmt |
| EOY | $10,662,036 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,173,878 | BOYAmt |
| EOY | $17,183,817 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$4,893,518 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $4,804 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,804 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION, THE WV HOSPITAL ASSOCIATION AND THE AMERICAN HEALTH CARE ASSOCIATION. A PORTION OF THESE DUES ARE USED FOR LOBBYING ACTIVITIES BY THESE ASSOCIATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,684 | OtherCostOrOtherBasisAmt |
| Book Value | $70,684 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,240,266 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,567,306 | DepreciationAmt |
| Book Value | $2,672,960 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,581,776 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,165,368 | DepreciationAmt |
| Book Value | $2,416,408 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $156,278 | OtherCostOrOtherBasisAmt |
| Book Value | $156,278 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,316,330 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD PARTY PAYOR SETTLEMENTS | Desc |
| Amt | $2,878,575 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,878,575 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $33,500,513 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $33,500,513 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,667,413 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,667,413 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $35,167,926 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $38,394,031 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $38,394,031 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,667,413 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,667,413 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $40,061,444 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, THEREFORE, IS NOT SUBJECT TO FEDERAL INCOME TAX UNDER CURRENT INCOME TAX REGULATIONS. CURRENT ACCOUNTING STANDARDS DEFINE THE THRESHOLD FOR RECOGNIZING UNCERTAIN INCOME TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS AS "MORE LIKELY THAN NOT" THAT THE POSITION IS SUSTAINABLE, BASED ON ITS TECHNICAL MERITS AND ALSO PROVIDE GUIDANCE ON THE MEASUREMENT, CLASSIFICATION AND DISCLOSURE OF TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS. MANAGEMENT BELIEVES THERE IS NO IMPACT ON THE ACCOMPANYING FINANCIAL STATEMENTS RELATED TO UNCERTAIN INCOME TAX POSITIONS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | PROVISIONS FOR BAD DEBT 2,333,405. INTEREST EXPENSE 44,008. IMPAIRMENT OF GOODWILL -710,000. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISIONS FOR BAD DEBT 2,333,405. INTEREST EXPENSE 44,008. IMPAIRMENT OF GOODWILL -710,000. |
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 | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,913,701 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,913,701 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05070 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,826,327 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,295,707 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,740,028 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,295,707 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,913,701 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05070 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $762,623 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $762,623 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02020 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $549,353 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $549,353 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01460 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $84,508 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $84,508 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,396,484 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,396,484 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03700 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,136,512 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,295,707 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,310,185 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08770 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,792 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,792 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,792 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,792 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,333,405 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $10,940,729 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,828,173 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $112,556 | 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 | GRANT MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 117 HOSPITAL DRIVE | AddressLine1Txt |
| City | PETERSBURG | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26847 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.GRANTMEMORIAL.COM | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Emergency Room Other | Yes (X) | EmergencyRoomOtherInd |
| Other | SNF/NF & PRIMARY CARE PHYSICIAN SERVICES | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANT MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.GRANTMEMORIAL.COM/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.GRANTMEMORIAL.COM/ | 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 | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.GRANTMEMORIAL.COM/INDEX.PHP/RESOURCES/CHARITY-CARE-GUIDELINES | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.GRANTMEMORIAL.COM/INDEX.PHP/RESOURCES/CHARITY-CARE-GUIDELINES | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.GRANTMEMORIAL.COM/INDEX.PHP/RESOURCES/CHARITY-CARE-GUIDELINES | 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 |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GRANT MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: THE HOSPITAL PERFORMED TELEPHONE SURVEYS TO RESIDENTS OF THE SERVICE AREAS. THE DATA FROM THE TELEPHONE SURVEYS WAS USED DURING THE COMMUNITY SUMMIT WITH COMMUNITY LEADERS AND OTHER CITIZENS THROUGHOUT THE COMMUNITY. THE COMMUNITY LEADERS INCLUDED PHYSICIANS, A SCHOOL PRINCIPAL, A COUNTY COMMISSIONER, A BANKER, A TEACHER, THE CEO OF THE LOCAL COMMUNITY HEALTH CENTER, BOARD MEMBERS AND HOSPITAL LEADERSHIP. THE DATA THAT RESULTED FROM THE COMMUNITY SUMMIT WAS THEN REVIEWED BY HOSPITAL LEADERSHIP TO DETERMINE THE NEEDS TO BE ADDRESSED. |
| GRANT MEMORIAL HOSPITAL | PART V, SECTION B, LINE 7D: THE HOSPITAL CONDUCTED A FORUM THAT PROVIDED THE RESULTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. PERSONS WHO PARTICIPATED IN THE ASSESSMENTS WERE INVITED AND THE FORUM WAS ALSO OPEN TO THE PUBLIC. |
| GRANT MEMORIAL HOSPITAL | PART V, SECTION B, LINE 11. IT IS UNDERSTOOD THAT IN ORDER TO BE THE MOST EFFECTIVE AND MAKE THE GREATEST IMPACT, THAT NOT ALL COMMUNITY NEEDS CAN BE ADDRESSED AT ONCE IN AN IMPLEMENTATION PLAN. IT IS IMPORTANT TO NOTE THAT WHILE THREE NEEDS WERE PRIORITIZED AND ADOPTED BY THE HOSPITAL FOR ITS IMPLEMENTATION PLAN, FOR THOSE NEEDS THAT THE HOSPITAL DID NOT MAKE A PRIORITY, WE CONTINUE TO WORK WITH THE COMMUNITY ORGANIZATIONS TO HELP ADDRESS THOSE NEEDS. THE NEEDS THAT ARE BEING ADDRESSED ARE AROUND CANCER, SUBSTANCE USE AND ABUSE, OBESITY AND CO-MORBID ISSUES. |
| GRANT MEMORIAL HOSPITAL | PART V, SECTION B, LINE 16J. 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. |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | A COST-TO-CHARGE RATIO WAS DETERMINED BASED UPON MEDICARE PRINCIPLES OF REIMBURSEMENT FOR MEDICAID INPATIENT AND OUTPATIENT REIMBURSEMENT, THE ACTUAL COSTS WERE DETERMINED BASED UPON THE MEDICAID COST REPORT. THE COST FOR FINANCIAL ASSISTANCE WAS ALSO COMPUTED BASED UPON ACTUAL COST-TO-CHARGE RATIOS FOR THE FINANCIAL COSTS AND ALLOCATED OVERHEAD COSTS DERIVED FROM THE MEDICARE COST REPORT. |
| PART I, LN 7 COL(F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $2,333,405. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE HOSPITAL IS LOCATED IN THE POTOMAC HIGHLANDS IN THE MOUNTAINS OF THE EASTERN PANHANDLE OF WEST VIRGINIA. THE CLOSEST HOSPITALS ARE LOCATED APPROXIMATELY 1.5 HOURS AWAY DURING GOOD WEATHER. DURING THE WINTER, IT TYPICALLY WILL TAKE MUCH LONGER DEPENDING ON WEATHER CONDITIONS. THE HOSPITAL'S PRIMARY SERVICE AREA IS COMPOSED OF THE WEST VIRGINIA COUNTIES OF GRANT, HARDY, PENDLETON, MINERAL AND HAMPSHIRE. THE TOTAL POPULATION OF THE FIVE COUNTIES COMBINED IS APPROXIMATELY 30,000. DUE TO THE DISTANCE FROM OTHER AREA HOSPITALS, THE HOSPITAL DOES PROVIDE OB SERVICES. DURING THIS TAX YEAR, THE HOSPITAL HAD APPROXIMATELY 285 DELIVERIES WITH THE VAST MAJORITY OF THESE PATIENTS BEING COVERED UNDER THE MEDICAID PROGRAM. THE HOSPITAL BOARD BELIEVES THAT THIS SERVICE MUST BE PROVIDED EVEN AT A LOSS. IN ADDITION, DUE TO THE LACK OF MOBILITY OF THE ELDERLY AND THE FACT THAT FAMILY MEMBERS NO LONGER RESIDE IN THE COMMUNITY, THE ELDERLY POPULATION IS DEPENDENT UPON THE HOSPITAL FOR THE PROVISION OF HEALTHCARE SERVICES. THE HOSPITAL ALSO HAS TO COORDINATE CARE FOR ITS PATIENTS AS THEY MOVE THROUGH THE CONTINUUM OF CARE AS NURSING HOMES, PHYSICIANS, HOME HEALTH AND HOSPICE SERVICES. THE ECONOMY IS PRIMARILY AGRICULTURAL, HARDWOOD MANUFACTURING, AND POULTRY PROCESSING. THE MAJOR EMPLOYERS ARE POULTRY PROCESSING PLANTS AND HARDWOOD COMPANIES, THE VARIOUS BOARDS OF EDUCATION AND THE HOSPITAL. DURING THE LAST COUPLE OF YEARS THERE HAVE BEEN SIGNIFICANT REDUCTIONS IN STAFF AT BOTH HARDWOOD COMPANIES. SINCE THE HOSPITAL IS A POLITICAL SUB-DIVISION OF GRANT COUNTY, THE BOARD MEMBERS ARE APPOINTED BY THE GRANT COUNTY COMMISSION. UNDER WEST VIRGINIA LAW, THE COMPOSITION OF THE BOARD MUST REPRESENT A BROAD SECTION OF THE HOSPITAL'S SERVICE AREA. AS A RESULT, OCCUPATIONS OF THE BOARD MEMBERS ARE BANKERS, EDUCATORS, SMALL BUSINESS AND UNION MEMBERS. |
| PART III, LINE 4: | PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE BILLED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| PART III, LINE 8: | THE COSTING METHODOLOGY WAS OBTAINED FROM THE MEDICARE COST REPORT WHICH IS BASED ON COST-TO-CHARGE RATIOS. AS WITH ANY BUSINESS, A HOSPITAL MUST GENERATE A PROFIT TO CONTINUE TO PROVIDE SERVICES TO THE RESIDENTS OF THE AREA IN WHICH THE HOSPITAL SERVES. THESE DISCOUNTS ARE DICTATED BY THE MEDICAID PROGRAM, AND DUE TO BUDGET CONSTRAINTS, THE MEDICARE PROGRAM HISTORICALLY HAS PROVIDED MOST OF THE PAYMENT REDUCTIONS ON HOSPITALS. THE HOSPITAL HAS NO CONTROL OVER REDUCTIONS, AND THE LARGEST CONSUMER OF HEALTH SERVICES ARE MEDICARE BENEFICIARIES. PRIOR TO 1966 WHEN THE MEDICARE PROGRAM WAS IMPLEMENTED, MANY ELDERLY PEOPLE WERE GOING WITHOUT CARE OR WERE RECEIVING A SUB STANDARD OF CARE. IN ADDITION, THESE PATIENTS, DUE TO THEIR AGE, UTILIZE THE HIGHEST LEVEL OF RESOURCES THAT ARE PROVIDED TO THE HOSPITAL'S PATIENTS. THE HOSPITAL IS DESIGNATED BY THE MEDICARE/MEDICAID PROGRAMS AS A CRITICAL ACCESS HOSPITAL (CAH). WHEN THIS DESIGNATION WAS ESTABLISHED BY THE MEDICARE PROGRAMS IN THE 1990S, THIS PROGRAM WAS DESIGNED TO PROVIDE SAFETY NET HOSPITALS THAT ARE LOCATED IN RURAL, ISOLATED AREAS, THE ADDITIONAL REIMBURSEMENT THAT WILL ALLOW THEM TO REMAIN OPEN. HOWEVER, AGAIN DUE TO BUDGET CONSTRAINTS, THE MEDICARE PROGRAM HAS SIGNIFICANTLY REDUCED REIMBURSEMENT TO THESE SAFETY NET HOSPITALS. THE HOSPITAL MUST TAKE THE LEAD IN ENSURING THAT QUALITY HEALTHCARE SERVICES ARE BEING PROVIDED. THE HOSPITAL PARTICIPATES IN A MEDICAL EDUCATION PROGRAM WHERE STUDENTS FROM VARIOUS MEDICAL SCHOOLS WILL DO RURAL ROTATIONS AT THE HOSPITAL. THE HOSPITAL ALSO SUPPORTS RN EDUCATION AT THE LOCAL COMMUNITY COLLEGE TO PROVIDE QUALIFIED RNS FOR THE AREA. THE HOSPITAL ENCOURAGES EMPLOYEES TO OBTAIN FACULTY POSITIONS FOR OTHER PROGRAMS AT THE LOCAL COMMUNITY COLLEGE, AND THE HOSPITAL IS WILLING TO ACCOMMODATE WORK SCHEDULES FOR EMPLOYEES THAT DO TEACH OTHER TRAINING PROGRAMS. ALSO, DUE TO THE LIMITED RESOURCES IN THE COMMUNITY, THE HOSPITAL MUST ALSO TAKE THE LEAD IN RECRUITING PHYSICIANS TO THE AREA. |
| PART III, LINE 9B: | IF IT IS DETERMINED THAT A PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE, THE PATIENT IS ADVISED TO APPLY FOR FINANCIAL ASSISTANCE. IF APPROVED FOR FINANCIAL ASSISTANCE, THE PATIENT'S BILL WOULD BE PAID BY FINANCIAL ASSISTANCE. IF THE PATIENT CANNOT QUALIFY FOR FINANCIAL ASSISTANCE, HE OR SHE MUST COMPLETE THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION. INCOME IS PRIMARILY USED TO DETERMINE ELIGIBILITY, BUT THE PATIENT'S ASSETS ARE ALSO CONSIDERED. THE PATIENT MUST PROVIDE DOCUMENTATION OF INCOME SUCH AS INCOME TAX RETURNS, W-2'S, ETC. THE POVERTY INCOME GUIDELINES AS DEVELOPED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) ARE USED TO DETERMINE ELIGIBILITY. IF A PERSON'S INCOME IS FROM 201% - 250% OF THESE GUIDELINES, THE PATIENT WILL RECEIVE A 50% FINANCIAL ASSISTANCE WRITE-OFF. FROM 251% - 300% OF THE INCOME GUIDELINE WILL EARN A FINANCIAL ASSISTANCE WRITE-OFF, THIS INCOME GUIDELINE WILL RECEIVE A 25% FINANCIAL ASSISTANCE DISCOUNT. IT IS POLICY THAT IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THERE IS NO COLLECTION AGAINST THAT AMOUNT THAT THEY QUALIFY FOR. IN SPITE OF THE HOSPITAL'S COLLECTION POLICIES, PATIENTS ARE NOT DENIED TREATMENT. IN FACT, FOR PATIENTS WHO PRESENT THEMSELVES TO THE EMERGENCY ROOM FOR SERVICES, NO FINANCIAL INFORMATION IS REQUESTED UNTIL AFTER THE PATIENT HAS RECEIVED AN INITIAL MEDICAL EVALUATION. IF THE PATIENT DOES NOT HAVE INSURANCE OR MAKE PAYMENT, SERVICES ARE STILL PROVIDED TO THE PATIENT. THE SAME IS TRUE FOR PATIENTS THAT ARE ADMITTED TO THE HOSPITAL. |
| PART VI, LINE 2: | THE NEEDS ASSESSMENT MADE DURING THE 2018 TAX YEAR OBTAINED THE NEEDS OF THE COMMUNITY THROUGH TELEPHONE SURVEYS AND A COMMUNITY SUMMIT. THE COMMUNITY SUMMIT INCLUDED SPECIFIC COMMUNITY LEADERSHIP AS NOTED ABOVE, AS WELL AS OTHER CITIZENS. THE DATA GATHERED WAS REVIEWED BY THE BOARD OF DIRECTORS AND HOSPITAL LEADERSHIP TO DEVELOP THE IMPLEMENTATION PLAN TO ADDRESS NEEDS IDENTIFIED. IT IS ALSO BASED UPON WHAT RNS, SOCIAL WORKERS AND OTHER CLINICAL PERSONNEL SEE ON A DAILY BASIS IN THE PROVISION OF MEDICAL CARE. |
| PART VI, LINE 3: | WHENEVER A PATIENT PRESENTS THEMSELVES FOR SERVICE AND DOES NOT HAVE INSURANCE COVERAGE, THE HOSPITAL REQUESTS THAT A FINANCIAL ASSISTANCE APPLICATION BE COMPLETED AND RETURNED TO THE HOSPITAL ALONG WITH ALL DOCUMENTATION NEEDED TO SUPPORT INCOME AMOUNTS THAT WILL BE USED TO DETERMINE IF AND HOW MUCH FINANCIAL ASSISTANCE THE PATIENT MAY QUALIFY. THE HOSPITAL USES THE CURRENT FEDERAL POVERTY GUIDELINES TO MAKE THIS DETERMINATION. IF THE PATIENT IS RESPONSIBLE FOR A PORTION OF THE BALANCE, THE HOSPITAL DOES HAVE PAYMENT SCHEDULES TO ASSIST THE PATIENT IN MEETING HIS/HER FINANCIAL OBLIGATIONS. AT THE TIME THE FINANCIAL ASSISTANCE APPLICATION IS BEING PREPARED, THE HOSPITAL REQUIRES THAT THE PATIENT APPLY FOR MEDICAID COVERAGE AT THE DHHR. IN CONNECTION WITH SERVICES PROVIDED IN THE HOSPITAL'S EMERGENCY ROOM, NO FINANCIAL INFORMATION IS OBTAINED UNTIL AFTER THE PATIENT HAS BEEN TRIAGED BY AN RN. CONSEQUENTLY, THE HOSPITAL'S POLICY FOLLOWS A LESS RESTRICTIVE POLICY THAN IS MANDATED BY EMTALA. IN A TRUE EMERGENCY SITUATION, NO FINANCIAL INFORMATION IS REQUESTED UNTIL AFTER THE PATIENT HAS BEEN STABILIZED. THE HOSPITAL ALSO HAS AN ENROLLMENT SPECIALIST, WHO ON A DAILY BASIS, REVIEWS ADMISSIONS AND OUTPATIENT REGISTRATIONS FROM THE PRIOR DAY TO DETERMINE IF THEY CAN QUALIFY FOR FINANCIAL ASSISTANCE. AS PART OF THIS PROCESS, THE HOSPITAL ALSO MAKES THE DETERMINATION AS TO WHETHER THE PATIENT MAY QUALIFY FOR MEDICAID. BASED UPON THE INFORMATION THAT THE ENROLLMENT SPECIALIST OBTAINS, THE HOSPITAL CAN PRESUMPTIVELY APPROVE A PATIENT FOR MEDICAID COVERAGE THAT AT LEAST WILL COVER THAT STAY REGISTRATION. CLERKS DURING THE ADMISSIONS PROCESS WILL ALSO ADVISE THE PATIENT THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE ON AN ANNUAL BASIS. TO FURTHER EDUCATE PATIENTS ABOUT FINANCIAL ASSISTANCE, INFORMATION IS ON THE HOSPITAL'S WEBSITE, AND A FINANCIAL COUNSELOR IS MADE AVAILABLE UPON REQUEST AND THROUGHOUT NORMAL BUSINESS HOURS. |
| PART VI, LINE 5: | MEMBERSHIP TO THE MEDICAL STAFF IS OPEN TO ANY PROVIDER WHO POSSESSES THE APPROPRIATE QUALIFICATIONS TO PROVIDE HEALTHCARE SERVICES TO THE COMMUNITY. THE HOSPITAL PERFORMS BACKGROUND CHECKS ON EDUCATION, STATE LICENSES, EXPERIENCE, ANY ACTIONS WHERE THE PHYSICIAN MAY HAVE BEEN REPORTED TO THE NATIONAL DATA BANK, POTENTIAL LITIGATION AND CRIMINAL ISSUES. IF THESE COME BACK FAVORABLE TO THE PHYSICIAN, THE PROSPECTIVE MEMBER IS INTERVIEWED BY THE CHIEF OF STAFF. BASED UPON THIS PROCESS, THE CHIEF OF STAFF WILL MAKE A RECOMMENDATION TO EITHER ACCEPT OR REJECT THE PROSPECTIVE MEMBER TO THE MEDICAL STAFF. IF THE RECOMMENDATION IS TO ACCEPT THE PROSPECTIVE MEMBER, THE MEDICAL STAFF WILL HOLD A FORMAL VOTE ON WHETHER TO ACCEPT OR REJECT THE PHYSICIAN. IF THE MEDICAL STAFF APPROVES THE PHYSICIAN FOR MEMBERSHIP TO THE MEDICAL STAFF, THIS IS THEN TAKEN TO THE BOARD OF TRUSTEES FOR A VOTE. THE CURRENT MEDICAL STAFF HAS A VERY DIVERSE BACKGROUND IN THAT THERE ARE BOTH MEN AND WOMEN ON THE MEDICAL STAFF AS WELL AS MEMBERS WHO WERE BORN IN FOREIGN COUNTRIES AS WELL AS THE UNITED STATES. THE HOSPITAL HAS RECRUITED NEW PHYSICIANS DURING THE LAST COUPLE OF YEARS, AND THIS TREND HAS CONTINUED. SINCE THE HOSPITAL IS A POLITICAL SUB-DIVISION OF GRANT COUNTY, THE GRANT COUNTY COMMISSION APPOINTS MEMBERS TO THE BOARD. UNDER WEST VIRGINIA LAW, THE COMPOSITION OF THE BOARD MUST REPRESENT A BROAD SECTION OF THE HOSPITAL'S SERVICE AREA. CONSEQUENTLY, OCCUPATIONS OF THE BOARD MEMBERS ARE BANKERS, EDUCATORS, OWNERS OF SMALL BUSINESS, RETIRED CITIZENS AND UNION MEMBERS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WV |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CAROLINE ARMSTRONG DO | ||||||||||||||
| TRUSTEE, PHYSICIAN, CHIEF OF STAFF | $336,255 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $336,255 | $0 | $0 | $0 |
| BEN LESLIE | ||||||||||||||
| TRUSTEE, PHYSICIAN, VICE CHIEF OF ST | $350,160 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $350,160 | $0 | $0 | $0 |
| ANIL MAKANI | ||||||||||||||
| PHYSICIAN | $521,285 | $0 | $108,360 | $0 | $0 | $0 | $18,889 | $0 | $14,172 | $0 | $662,706 | $0 | $0 | $0 |
| SCOTT ROBERTS | ||||||||||||||
| PHYSICIAN | $480,069 | $0 | $61,162 | $0 | $0 | $0 | $16,237 | $0 | $2,898 | $0 | $560,366 | $0 | $0 | $0 |
| ULUNNA MACBEAN | ||||||||||||||
| PHYSICIAN | $239,425 | $0 | $0 | $0 | $20,000 | $0 | $7,783 | $0 | $9,250 | $0 | $276,458 | $0 | $0 | $0 |
| AMANDA BORROR | ||||||||||||||
| PHYSICIAN | $228,781 | $0 | $3,203 | $0 | $10,000 | $0 | $7,259 | $0 | $13,019 | $0 | $262,262 | $0 | $0 | $0 |
| NISHAT ALLY | ||||||||||||||
| PHYSICIAN | $213,542 | $0 | $2,412 | $0 | $0 | $0 | $6,479 | $0 | $1,257 | $0 | $223,690 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THIS COMMITTEE SHALL CONSIST OF THE CHAIRPERSON, VICE CHAIRPERSON, THREE (3) OTHER VOTING MEMBERS OF THE BOARD, AND THE CEO AND CHIEF OF THE MEDICAL STAFF IN EX-OFFICIO, NON-VOTING CAPACITY. DURING THE INTERVALS BETWEEN MEETINGS OF THE BOARD, THE EXECUTIVE COMMITTEE MAY ACT IN THE NAME, AND WITH THE FULL POWER, OF THE BOARD PROVIDED THAT ANY SUCH ACTION SHALL NOT CONFLICT WITH THE POLICIES OF THE BOARD OF TRUSTEES AND BE OCCASIONED BY AN EMERGENT SITUATION IN WHICH AN EMERGENCY MEETING CANNOT BE HELD. ANY ACTION TAKEN BY THE EXECUTIVE COMMITTEE SHALL SET FORTH THE REASON ACTION WAS REQUIRED TO BE TAKEN PRIOR TO THE NEXT SCHEDULED MEETING OF THE BOARD AND WHY AN EMERGENCY MEETING WAS NOT CALLED. THIS COMMITTEE MAY REQUEST THE CHAIRPERSON TO CALL A SPECIAL MEETING OF THE BOARD OF TRUSTEES WHEN A SITUATION DICTATES. THIS COMMITTEE SHALL MEET AS NECESSARY AND SHALL REPORT TO THE BOARD AS A WHOLE. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE HOSPITAL HAS A DUAL CERTIFICATION IN THAT IT IS A POLITICAL SUB-DIVISION OF GRANT COUNTY. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE GRANT COUNTY COMMISSION APPOINTS MEMBERS TO THE BOARD WHO RESIDE IN GRANT COUNTY. THE HOSPITAL IS A POLITICAL SUB-DIVISION OR COMPONENT UNIT OF GRANT COUNTY (COUNTY HOSPITAL). |
| FORM 990, PART VI, SECTION B, LINE 11B | THE TAX RETURN WILL BE REVIEWED BY MANAGEMENT AND IS GIVEN TO EVERY BOARD MEMBER OF THE BOARD AFTER THE RETURN IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | TRUSTEES AND ADMINISTRATION OFFICIALS SHALL BE REQUIRED TO COMPLETE A WRITTEN CONFLICT OF INTEREST STATEMENT ANNUALLY WHICH SHALL DISCLOSE THE EXTENT OF FINANCIAL DEALINGS WITH THE ORGANIZATION BY ALL BUSINESSES OR OTHER ORGANIZATIONS IN WHICH THEY, OR MEMBERS OF THEIR IMMEDIATE FAMILIES, HAVE A BENEFICIAL INTEREST. A BENEFICIAL INTEREST WITH AN ORGANIZATION WILL BE CONSIDERED TO EXIST WHEN A TRUSTEE OR ADMINISTRATION OFFICIAL OR A MEMBER OF HIS/HER IMMEDIATE FAMILY IS AN OFFICER, DIRECTOR, TRUSTEE, PARTNER, EMPLOYEE OR AGENT OF THE ORGANIZATION, OR OWNS FIVE PERCENT OF THE VOTING STOCK OR CONTROLLING INTEREST IN THAT ORGANIZATION, OR HAS ANY OTHER SUBSTANTIAL INTEREST OR DEALINGS WITH THE ORGANIZATION. AT SUCH TIME, IF ANY MATTER SHOULD COME BEFORE THE BOARD OF TRUSTEES IN SUCH A WAY AS TO GIVE THE RISE TO A CONFLICT OF INTEREST, THE AFFECTED MEMBER OF THE BOARD SHALL MAKE KNOWN THE POTENTIAL CONFLICT AND IF ADVISABLE, WITHDRAW FROM THE MEETING FOR SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION. SHOULD THE MATTER BE BROUGHT TO VOTE, THE AFFECTED MEMBER SHALL NOT VOTE, NOR BE COUNTED IN ESTABLISHING A QUORUM FOR THE VOTE ON THAT MATTER. PROCEEDINGS RELATED TO THE CONFLICT OF INTEREST MATTERS BEFORE THE BOARD OF TRUSTEES SHALL BE DOCUMENTED IN THE MINUTES OF THAT MEETING. EVERY JANUARY, THE CEO AND CHAIRMAN ENSURE THE CONFLICT OF INTEREST FORMS ARE COMPLETED. THEY REVIEW THE FORMS TO IDENTIFY ANY INSTANCES THEY CAN FORESEE AND DISCUSS THEM WITH THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15A | EVERY YEAR A SURVEY IS CONDUCTED THROUGH THE STATE ON AVERAGE SALARIES FOR THE CEO OF THE ORGANIZATION. THIS ENSURES THE HOSPITAL IS PAYING NO MORE THAN FAIR MARKET VALUE FOR THE CEO COMPENSATION. THE COMPENSATION AVERAGES ARE GIVEN TO THE BOARD OF TRUSTEES AND THEY HAVE FINAL SAY ON THE ACTUAL COMPENSATION FOR THE CEO OF THE HOSPITAL |
| FORM 990, PART VI, SECTION C, LINE 18 | THE TAX RETURN IS SUBMITTED TO THE WEST VIRGINIA HEALTHCARE AUTHORITY UNDER THE STATE OF WEST VIRGINIA'S FINANCIAL DISCLOSURE STATUTE. |
| FORM 990, PART VI, SECTION C, LINE 19 | IT IS REQUIRED BY WEST VIRGINIA LAW THAT ALL HOSPITALS FILE AUDITED FINANCIAL STATEMENTS, MEDICARE/MEDICAID COST REPORTS, CHARGEMASTER AND SIGNED COPY OF WORKSHEET 12 OF THE UNIFORM REPORT N TO THE WEST VIRGINIA HEALTH CARE AUTHORITY. INFORMATION SUBMITTED TO THE WEST VIRGINIA HEALTH CARE AUTHORITY MAY BE OBTAINED UNDER THE FREEDOM OF INFORMATION ACT. THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY WILL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER FEES: PROGRAM SERVICE EXPENSES 6,505,859. MANAGEMENT AND GENERAL EXPENSES 1,719,713. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,225,572. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATION'S BOARD OF DIRECTORS ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THE PROCESS IS CONSISTENT WITH PRIOR YEARS AND HAS NOT CHANGED. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANT MEMORIAL HOSPITAL TRUST FOUNDATION INCORPORATED | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1019 | AddressLine1Txt |
| City | PETERSBURG | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26847 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550491787 | EIN |
| Primary Activities | SUPPORT GRANT MEMORIAL HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12C, III-FI | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |