STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY (EIN 55-0422958)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-07-14
- IRS object ID
- 202031969349301553
- Schema version
- 2018v3.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-07-14T08:44:40-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 550486667 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Arnett Carbis Toothman LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 2629 | AddressLine1Txt |
| City | Charleston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25329 | 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 | 550422958 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stonewall Jackson Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STON | BusinessNameControlTxt |
| Phone | 3042698059 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1Txt |
| City | Weston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26452 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Avah L Stalnaker | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3042698059 | PhoneNum |
| Signature | 2020-07-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Dolores Rose | PreparerPersonNm |
| PTIN | P01286262 | PTIN |
| Phone | 3043460441 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 216.12.119.47 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-07-01 | IPDt |
| IP Tm | 10:22:37 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DBF3DF03C93CF583714802DAD1D2E8B1989575BE | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EF272E949B022F30B68C60E053C4FB8C6906CCF1 | 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 | Avah L Stalnaker | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1Txt |
| City | Weston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26452 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $51,553,454 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.stonewallhospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1959 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | It is the mission of Stonewall Jackson Memorial Hospital to provide excellent care to all we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 547 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $18,950 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $16,783 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $28,190 | PYContributionsGrantsAmt |
| CY Contributions Grants | $51,864 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $30,255,992 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $47,277,524 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,520,265 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,382,109 | CYInvestmentIncomeAmt |
| PY Other Revenue | $233,626 | PYOtherRevenueAmt |
| CY Other Revenue | $920,862 | CYOtherRevenueAmt |
| PY Total Revenue | $33,038,073 | PYTotalRevenueAmt |
| CY Total Revenue | $50,632,359 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $11,063 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $21,550 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,515,905 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $27,314,281 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,777,664 | PYOtherExpensesAmt |
| CY Other Expenses | $26,053,527 | CYOtherExpensesAmt |
| PY Total Expenses | $39,304,632 | PYTotalExpensesAmt |
| CY Total Expenses | $53,389,358 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$6,266,559 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,756,999 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $67,957,460 | TotalAssetsBOYAmt |
| Total Assets EOY | $64,636,289 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,656,610 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,412,837 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $53,300,850 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $50,223,452 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | It is the mission of Stonewall Jackson Memorial Hospital to provide excellent care to all we serve. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $43,632,779 | ExpenseAmt |
| Revenue | $49,639,601 | RevenueAmt |
| Desc | Stonewall 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 5,402 days of inpatient care, 74,936 outpatient visits, 13,911 emergency room visits, 1,204 ambulatory surgery visits, 4,823 Home Health visits and 37,516 Physician Clinic visits. The Hospital had 154 deliveries during the year in which approximately 65% 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,150 | ExpenseAmt |
| Grant | $10,150 | GrantAmt |
| Revenue | $33,910 | RevenueAmt |
| Desc | Annual 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 and expenses are included in Line 4a above. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $11,400 | ExpenseAmt |
| Grant | $11,400 | GrantAmt |
| Revenue | $19,295 | RevenueAmt |
| Desc | William 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $43,654,329 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 185 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 547 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avah Stalnaker | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3042698050 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1Txt |
| City | Weston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 264528558 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| John Law CPA | |||||||||
| President | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Joseph Snead MD | |||||||||
| Vice-President | 22.50 | Yes (X) | Yes (X) | $136,597 | $0 | $966 | |||
| R Gerald Wood RPH | |||||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Denver Turner | |||||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Robin Poling | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| John W Wyllie III MD | |||||||||
| Director | 40.00 | Yes (X) | $383,548 | $0 | $15,703 | ||||
| C Gregory Cunningham | |||||||||
| Director | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Kimberly Gum | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Gregory St Clair | |||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| Avah Stalnaker | |||||||||
| CEO | 40.00 | Yes (X) | $292,227 | $0 | $16,016 | ||||
| David Goldberg | |||||||||
| President/CEO Mon Health | 1.00 | 39.00 | Yes (X) | $0 | $192,729 | $3,929 | |||
| Lisa Simon CPA | |||||||||
| VP Finance/CFO Mon Health | 1.00 | 39.00 | Yes (X) | $0 | $315,066 | $6,726 | |||
| Darryl Duncan | |||||||||
| Former President/CEO Mon Health | 1.00 | 39.00 | $0 | $2,093,744 | $7,465 | Yes (X) | |||
| Daris Rosencrance | |||||||||
| Former VP Finance/CFO Mon Health | 1.00 | 39.00 | $0 | $361,627 | $30,399 | Yes (X) | |||
| Ronald Pearson MD | |||||||||
| Physician | 40.00 | $449,430 | $0 | $13,750 | Yes (X) | ||||
| Doyle Sickles MD | |||||||||
| Physician | 40.00 | $564,754 | $0 | $28,724 | Yes (X) | ||||
| Michael Gregory DO | |||||||||
| Physician | 40.00 | $516,010 | $0 | $31,353 | Yes (X) | ||||
| Virgil W McMillion DO | |||||||||
| Physician | 40.00 | $474,292 | $0 | $26,365 | Yes (X) | ||||
| Thomas Benz MD | |||||||||
| Physician | 40.00 | $396,938 | $0 | $30,410 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,213,796 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,963,166 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $211,806 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 27 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Sodexo Inc & Affiliates | |||||
| PO Box 536922 | Atlanta | GA | 503536922 | Maintenance/Dietary | $622,092 |
| WV Emergency Physicians LLP | |||||
| PO Box 677979 | Dallas | TX | 752677979 | Emergency Room Physicians | $447,505 |
| Medic Management Group | |||||
| 275 Springside Drive Suite 100 | Akron | OH | 44333 | Coding | $261,052 |
| Wesley G Saher (Beach Medicine LLC) | |||||
| PO Box 520 | Frisco | NC | 27936 | Emergency Room Physicians | $249,750 |
| Laboratory Corporation | |||||
| PO Box 12140 | Burlington | NC | 272162140 | Laboratory Services | $227,881 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $14,800 | FundraisingAmt |
| All Other Contributions | $37,064 | AllOtherContributionsAmt |
| Total Contributions | $51,864 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Services | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $47,277,524 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $47,277,524 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $47,277,524 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $856,283 | TotalRevenueColumnAmt |
| Exclusion | $856,283 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $46,286 | RealAmt |
| Personal | $18,950 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $62,695 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$16,409 | RealAmt |
| Personal | $18,950 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,541 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $18,950 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$16,409 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,374,686 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $848,860 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,525,826 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,525,826 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,525,826 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $38,405 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $14,800 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $9,540 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,865 | TotalRevenueColumnAmt |
| Exclusion | $28,865 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Refunds & Expense Reimbursements | 900099 | $692,106 | $692,106 |
| Cafeteria | 722310 | $158,216 | $158,216 |
| Vending Machine Sales | 722310 | $29,950 | $29,950 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,184 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,184 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $889,456 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $50,632,359 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $49,692,806 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $18,950 | UnrelatedBusinessRevenueAmt |
| Exclusion | $868,739 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,150 | TotalAmt |
| Program Services | $10,150 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,400 | TotalAmt |
| Program Services | $11,400 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $536,814 | TotalAmt |
| Program Services | $422,097 | ProgramServicesAmt |
| Management And General | $114,717 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,488,845 | TotalAmt |
| Program Services | $17,682,979 | ProgramServicesAmt |
| Management And General | $4,805,866 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $814,448 | TotalAmt |
| Program Services | $640,400 | ProgramServicesAmt |
| Management And General | $174,048 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,021,507 | TotalAmt |
| Program Services | $1,589,511 | ProgramServicesAmt |
| Management And General | $431,996 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,452,667 | TotalAmt |
| Program Services | $1,142,232 | ProgramServicesAmt |
| Management And General | $310,435 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $883,073 | TotalAmt |
| Management And General | $883,073 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $425,136 | TotalAmt |
| Management And General | $425,136 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,673 | TotalAmt |
| Program Services | $57,143 | ProgramServicesAmt |
| Management And General | $15,530 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $306,849 | TotalAmt |
| Program Services | $241,275 | ProgramServicesAmt |
| Management And General | $65,574 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,790,900 | TotalAmt |
| Program Services | $1,407,323 | ProgramServicesAmt |
| Management And General | $383,577 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,409,193 | TotalAmt |
| Program Services | $1,108,048 | ProgramServicesAmt |
| Management And General | $301,145 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,052,931 | TotalAmt |
| Program Services | $827,920 | ProgramServicesAmt |
| Management And General | $225,011 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,858 | TotalAmt |
| Program Services | $87,168 | ProgramServicesAmt |
| Management And General | $23,690 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,131 | TotalAmt |
| Program Services | $51,999 | ProgramServicesAmt |
| Management And General | $14,132 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,560,042 | TotalAmt |
| Program Services | $2,012,961 | ProgramServicesAmt |
| Management And General | $547,081 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$25,028 | TotalAmt |
| Program Services | -$19,680 | ProgramServicesAmt |
| Management And General | -$5,348 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $8,143,585 | $8,143,585 | |
| Bad debts | $3,801,038 | $3,801,038 | |
| Purchased services | $2,475,772 | $1,946,700 | $529,072 |
| Repairs and maintenance | $1,602,280 | $1,259,873 | $342,407 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,378,094 | TotalAmt |
| Program Services | $1,230,207 | ProgramServicesAmt |
| Management And General | $147,887 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,389,358 | TotalAmt |
| Program Services | $43,654,329 | ProgramServicesAmt |
| Management And General | $9,735,029 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $360,931 | BOYAmt |
| EOY | $897,089 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,224,653 | BOYAmt |
| EOY | $3,975,564 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,417,862 | BOYAmt |
| EOY | $6,086,757 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,454,296 | BOYAmt |
| EOY | $1,099,627 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $247,402 | BOYAmt |
| EOY | $280,747 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $50,642,658 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $37,181,173 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,978,701 | BOYAmt |
| EOY | $13,461,485 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,493,711 | BOYAmt |
| EOY | $34,564,849 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $523,576 | BOYAmt |
| EOY | $523,940 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,256,328 | BOYAmt |
| EOY | $3,746,231 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,957,460 | BOYAmt |
| EOY | $64,636,289 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,654,963 | BOYAmt |
| EOY | $12,204,693 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,912 | BOYAmt |
| EOY | $48,340 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,969,735 | BOYAmt |
| EOY | $2,159,804 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,656,610 | BOYAmt |
| EOY | $14,412,837 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,844,942 | BOYAmt |
| EOY | $49,767,180 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $455,908 | BOYAmt |
| EOY | $456,272 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,300,850 | BOYAmt |
| EOY | $50,223,452 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,957,460 | BOYAmt |
| EOY | $64,636,289 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,756,999 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$320,399 | NetUnrlzdGainsLossesInvstAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $5,781 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $5,781 | 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 | A 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,519,778 | OtherCostOrOtherBasisAmt |
| Book Value | $6,519,778 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,403,703 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,640,341 | DepreciationAmt |
| Book Value | $1,763,362 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,467,708 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,540,832 | DepreciationAmt |
| Book Value | $4,926,876 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $251,469 | OtherCostOrOtherBasisAmt |
| Book Value | $251,469 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,461,485 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Other receivables | $344,292 |
| Due from SHOT | $455,263 |
| Estimated third party settlements | $2,413,866 |
| Insurance recoveries receivables | $532,810 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,746,231 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Health System follows the FASB's authoritative guidance on accounting for uncertainty in income taxes. The guidance clarifies the accounting for the recognition and measurement of the benefits of individual tax positions in the consolidated financial statements. Tax positions must meet a recognition threshold of more-likely-than-not in order for the benefit of those tax positions to be recognized in the consolidated financial statements. The Health System has determined that no material unrecognized tax benefits or obligations exist. Generally, tax returns for years ended June 30, 2016, and thereafter remain subject to examination by federal and state tax authorities. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Charity Golf Tournament | Event1Nm |
| Gross Receipts Event1 | $19,295 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $11,400 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $7,895 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $700 | CashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $3,284 | RentFacilityCostsEvent1Amt |
| Event2 | Rotary Blood Screening | Event2Nm |
| Gross Receipts Event2 | $33,910 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $3,400 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $30,510 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $5,556 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $53,205 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $14,800 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $38,405 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $700 | CashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $3,284 | RentFcltyCostsTotalEventsAmt |
| Oth Direct Expnss Total Events | $5,556 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $9,540 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $28,865 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 162.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $288,357 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $288,357 | DirectOffsettingRevenueAmt |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,913,853 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,684,606 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,229,247 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08530 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,202,210 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,972,963 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,229,247 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08530 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,202,210 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,972,963 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,229,247 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08530 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,801,038 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,388,007 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,143,821 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,278,587 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$134,766 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stonewall Jackson Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 Hospital Plaza | AddressLine1Txt |
| City | Weston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26452 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stonewall Jackson 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 |
| 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 |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.stonewalljacksonhospital.com | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.stonewalljacksonhospital.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 | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 162.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | See Part V, page 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, page 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Page 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Stonewall Jackson Memorial Hospital | Part 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 Hospital | Part V, Section B, Line 6b: Lewis County Health Department |
| Stonewall Jackson Memorial Hospital | Part V, Section B, Line 11: Drug abuse was the number one health concern of the residents. The other concerns in order of importance were: obesity, cancer, heart disease, diabetes, and high blood pressure. To combat drug abuse, SJMH's emergency department has adopted the WV Hopital 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, SJMH created a county-wide walking group; the SJMH Therapy Department provides annual physicals for student athletes at no cost. SJMH created a safe walking path in the parking lot, we established a wellness committee for our employees, and we do not serve pop at activities. We also coordinate with the City of Weston to refurbish playgrounds in the area. |
| Stonewall Jackson Memorial Hospital | Part 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. |
| Part V, Section B, Line 16A | https://www2.stonewalljacksonhospital.com/docs/SJMH_Financial_Assistance_Policy_and_Procedures-1.pdf |
| Part V, Section B, Line 16B | https://www2.stonewalljacksonhospital.com/docs/SJMH_Financial_Assistance_application_2019_good_one.pdf |
| Part V, Section B, Line 16C | www2.stonewalljacksonhospital.com/getpage.php?name=Patient _Financial_Aid&sub=Patients%20%26%20Visitors |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - Stonewall Jackson Home Care | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 456 Suite B Market Place Mall | AddressLine1Txt |
| City | Weston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26452 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Home Health Care | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $ 3,801,038. |
| Part III, Line 3: | Based on historical information, we estimate 41.7% of the bad debt expense represents amounts from patients eligible under the hospital financial assistance policy. |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rotary Club of Weston | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 222 | AddressLine1Txt |
| City | Weston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26452 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 550371556 | RecipientEIN |
| IRC Section | 501(c)4 | IRCSectionDesc |
| Cash Grant | $10,150 | CashGrantAmt |
| Purpose Of Grant | To help the Rotary support various children's programs in Lewis County. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 0 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Healthcare scholarships for recent high school graduates. | GrantTypeTxt |
| Recipient | 24 | RecipientCnt |
| Cash Grant | $11,400 | CashGrantAmt |
| Valuation Method Used | FMV - Cash | ValuationMethodUsedDesc |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| John W Wyllie III MD | ||||||||||||||
| Director | $383,548 | $0 | $0 | $0 | $0 | $0 | $13,750 | $0 | $1,953 | $0 | $399,251 | $0 | $0 | $0 |
| Avah Stalnaker | ||||||||||||||
| CEO | $286,255 | $0 | $0 | $0 | $5,972 | $0 | $5,500 | $0 | $10,516 | $0 | $308,243 | $0 | $0 | $0 |
| David Goldberg | ||||||||||||||
| President/CEO Mon Health | $0 | $115,277 | $0 | $60,000 | $0 | $17,452 | $0 | $2,538 | $0 | $1,391 | $0 | $196,658 | $0 | $0 |
| Lisa Simon CPA | ||||||||||||||
| VP Finance/CFO Mon Health | $0 | $267,247 | $0 | $0 | $0 | $47,819 | $0 | $0 | $0 | $6,726 | $0 | $321,792 | $0 | $0 |
| Darryl Duncan | ||||||||||||||
| Former President/CEO Mon Health | $0 | $438,492 | $0 | $87,656 | $0 | $1,567,596 | $0 | $6,461 | $0 | $1,004 | $0 | $2,101,209 | $0 | $0 |
| Daris Rosencrance | ||||||||||||||
| Former VP Finance/CFO Mon Health | $0 | $327,863 | $0 | $0 | $0 | $33,764 | $0 | $24,500 | $0 | $5,899 | $0 | $392,026 | $0 | $0 |
| Ronald Pearson MD | ||||||||||||||
| Physician | $449,430 | $0 | $0 | $0 | $0 | $0 | $13,750 | $0 | $0 | $0 | $463,180 | $0 | $0 | $0 |
| Doyle Sickles MD | ||||||||||||||
| Physician | $564,724 | $0 | $0 | $0 | $30 | $0 | $13,750 | $0 | $14,974 | $0 | $593,478 | $0 | $0 | $0 |
| Michael Gregory DO | ||||||||||||||
| Physician | $515,580 | $0 | $400 | $0 | $30 | $0 | $13,750 | $0 | $17,603 | $0 | $547,363 | $0 | $0 | $0 |
| Virgil W McMillion DO | ||||||||||||||
| Physician | $447,595 | $0 | $26,667 | $0 | $30 | $0 | $13,750 | $0 | $12,615 | $0 | $500,657 | $0 | $0 | $0 |
| Thomas Benz MD | ||||||||||||||
| Physician | $396,908 | $0 | $0 | $0 | $30 | $0 | $13,750 | $0 | $16,660 | $0 | $427,348 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Lines 4a-b | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING INDIVIDUALS DEFERRED THE FOLLOWING AMOUNTS UNDER A 457(F) PLAN - DARRYL DUNCAN ($50,780), DARIS ROSENCRANCE ($15,264), and Lisa Simon ($29,319). The following individual received a severance payment - Darryl Duncan ($452,449) | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | Management 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 6 | Monongalia Health System, Inc., a West Virginia non-profit corporation, is the sole member of the Hospital. |
| Form 990, Part VI, Section A, line 7a | Stonewall Jackson Memorial Hospital board members are elected or appointed by Monongalia Health System. |
| Form 990, Part VI, Section A, line 7b | Stonewall 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 11b | The governing body is provided a copy of the Form 990 for their review prior to submission. The board members are asked to inform management of any questions or revisions they may have. If changes are made, based on board member's revisions, management redistributes a final version to all board members. |
| Form 990, Part VI, Section B, line 12c | Annually, a conflict of interest questionnaire is sent out to all board members. The board then reviews all responses for possible conflicts of interest. If a conflict is noted, the board members determine which decisions the conflicted members shall not participate in. |
| Form 990, Part VI, Section B, line 15 | Annually, a consultant compiles a market data report on executive CEO compensation. This report is then reviewed by the executive committee to determine compensation for the individual. |
| Form 990, Part VI, Section C, line 19 | The 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 XII, Line 2C: | The Organization's Finance Committee of the Board of Directors selects the independent accountant. This process remains unchanged from prior years. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Monongalia County General Hospital Company | |||||||||||
| 1200 JD Anderson Drive | Morgantown | WV | 26505 | 237441353 | Hospital | WV | 501(c)(3) | Line 3 | Monongalia Health Systems Inc | 0 | |
| Mon Elder Services Inc | |||||||||||
| 1200 JD Anderson Drive | Morgantown | WV | 26505 | 311520863 | Continuing care retirement village | WV | 501(c)(3) | Line 10 | Monongalia Health Systems Inc | 0 | |
| Monongalia Emergency Medical Services Inc | |||||||||||
| 1200 JD Anderson Drive | Morgantown | WV | 26505 | 550725494 | Emergency ambulance and rescue service | WV | 501(c)(3) | Line 10 | Monongalia Health Systems Inc | 0 | |
| Monongalia Health System Inc | |||||||||||
| 1200 JD Anderson Drive | Morgantown | WV | 26505 | 550621551 | Parent/management company | WV | 501(c)(3) | Line 12c, III-FI | 0 | N/A | |
| The Foundation of Monongalia General Hospital | |||||||||||
| 1200 JD Anderson Drive | Morgantown | WV | 26505 | 550570338 | Raise funds for Monongalia General Hospital | WV | 501(c)(3) | Line 7 | 0 | N/A | |
| Preston Memorial Hospital | |||||||||||
| 150 Memorial Drive | Kingwood | WV | 26537 | 311097818 | Hospital | WV | 501(c)(3) | Line 3 | Monongalia Health Systems Inc | 0 | |
| Preston Memorial Medical Group | |||||||||||
| 150 Memorial Drive | Kingwood | WV | 26537 | 550717988 | Provide primary and urgent care | WV | 501(c)(3) | Line 3 | Monongalia Health Systems Inc | 0 | |
| Preston Memorial Hospital Foundation | |||||||||||
| 150 Memorial Drive | Kingwood | WV | 26537 | 550740121 | Support activities of other charitable organizations | WV | 501(c)(3) | Line 12a, I | Monongalia Health Systems Inc | 0 | |
| Auxiliary of Monongalia General Hospital | |||||||||||
| 1200 JD Anderson Drive | Morgantown | WV | 26505 | 550362965 | Raise funds for Monongalia General Hospital | WV | 501(c)(3) | Line 12a, I | Monongalia Health Systems Inc | 0 | |
| Liability Insurance Trust for Monongalia Health System | |||||||||||
| 1200 JD Anderson Drive | Morgantown | WV | 26505 | 550689535 | Liability Insurance Trust | WV | 501(c)(3) | Line 12a, I | Monongalia Health Systems Inc | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Stonewall Home Oxygen Therapy Inc | ||||||||||||
| 100 Market Place Mall Suite 8 | Weston | WV | 26452 | 550754278 | Oxygen Therapy Services | WV | Stonewall Jackson Memorial Hospital | C | -$38,353 | $267,797 | 1.00000 | Yes (1) |
| Mon Health Care Inc | ||||||||||||
| 1200 JD Anderson Drive | Morgantown | WV | 26505 | 550654973 | Home Medical Equipment | WV | Monongalia Health System Inc | C | 0 | |||
| Morgantown Medical Arts Building Inc | ||||||||||||
| 1199 Van Voorhis Road Suite 6 | Morgantown | WV | 26202 | 550570209 | Office Rental | WV | Monongalia Health System Inc | C | 0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | 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 | Yes (1) | 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 |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Stonewall Home Oxygen Therapy Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | A | TransactionTypeTxt |
| Involved | $18,950 | InvolvedAmt |
| Method Of Amount Determination | FMV - Cash | MethodOfAmountDeterminationTxt |