2020-11-10T09:59:40-06:00 2019-12-31 550486667 Arnett Carbis Toothman LLP P O Box 2629 Charleston WV 25329 990 2019-01-01 550629032 Minnie Hamilton Health Care Center Inc MINN 3043549244 186 Hospital Drive Grantsville WV 26147 Stephen S Whited CEO 3043549244 2020-11-09 1 Dolores Rose P01286262 3043460441 216.12.119.47 2020-11-09 10:05:21 ES P 89762B9AA0C8C1D590E5D40209EB2976C0D4AEE2 CCD7E05B244C7835F43AEC16A9B89F6DA55243D7 2019 2021-01-29 14:40:06Z Minnie Hamilton Health System Stephen S Whited 186 Hospital Drive Grantsville WV 26147 25249972 0 X www.mhhcc.com X 1983 WV The organization operates a critical access hospital, community health center, federal qualified health center, and long-term care unit. 10 10 280 10 0 0 2208510 3562342 18166202 18720600 2481 -143304 2260561 2964588 22637754 25104226 150 11189 0 0 14442476 14858062 0 0 0 8251950 8122523 22694576 22991774 -56822 2112452 5025909 5169824 5604004 3635467 -578095 1534357 Minnie Hamilton Health System is dedicated to maintaining the health and improving the quality of life of all people in our service area through an innovative delivery system of services and education. 0 0 18987593 21579269 Inpatient services provided included 706 acute care days, 8,285 long-term care days; 614 swing-bed days. Outpatient services included 20,843 outpatient visits and 3,463 emergency room visits. RHC and Gilmer primary included 24,567 visits and RHC dental visits totaled 5,338 for the year. 212000 11189 85000 The hospital provides various community services that include social service case management; community outreach education; insurance eligibility assistance workers; healthcare worker recruitment and retention community projects; monetary support provided to local public schools; and and an oral health promotion project. 19199593 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 23 0 280 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Jonathan Bucher 3043549730 186 Hospital Drive Grantsville WV 26147 Ronald Blankenship President 1.50 X X 0 0 0 Jean Simers Vice President 1.50 X X 0 0 0 Kenny Goodnight Treasurer 1.00 X X 0 0 0 Shelly DeMarino Esq Secretary 0.50 X X 0 0 0 Kenneth P Goodnight II Director 0.50 X 0 0 0 Kathy Mason Director 0.50 X 0 0 0 John Westfall DDS Director 0.50 X 0 0 0 Martha Haymaker Director 0.50 X 0 0 0 Donnit Pitts Director 0.50 X 0 0 0 Dwane Weekley Director 0.50 X 0 0 0 Stephen S Whited CEO 40.00 X 177646 0 24730 Jonathan Bucher CFO 40.00 X 125873 0 0 Suresh Balasubramony MD Physician 40.00 X 663446 0 24714 Rudolph M Kevak MD Physician 58.00 X 660092 0 9425 Alfonso Cinco MD Physician 48.00 X 482038 0 9425 Timothy M Daly MD Physician 32.00 X 321726 0 0 Jason B Fincham MD Physician 44.00 X 477863 0 16393 2908684 0 84687 19 0 1 0 Odyssey Rehabilitation co West Virginia Lock Box 759418 Baltimore MD 21275 Speech and occupation therapy 495263 Athenahealth Inc PO Box 415615 Boston MA 02241 Professional Services 418027 Agiliti Health Inc PO Box 851313 Minneapolis MN 55485 Professional Services 268903 Lab Corp of America PO Box 12140 Burlington NC 27216 Laboratory Services 233406 Arnett Carbis Toothman LLP PO Box 2629 Charleston WV 25329 Accounting and consulting services 134707 5 3500801 61541 3562342 Patient Services 622110 18720600 18720600 18720600 2442 2442 20919 0 20919 20919 20919 145746 -145746 -145746 -145746 340B Revenue 900099 2558804 2558804 Rebates/Refunds 900099 110702 110702 Cafeteria Revenue 722514 77910 77910 196253 196253 2943669 25104226 21664269 0 -122385 X 11189 11189 328250 272677 55573 12220714 10151747 2068967 273844 227482 46362 1275640 1059674 215966 759614 631011 128603 24900 24900 143929 143929 2348131 1950593 397538 11309 9394 1915 852330 708031 144299 188849 156877 31972 354775 294712 60063 68962 57287 11675 59318 59318 407318 338359 68959 255481 255481 Medical supplies 1879961 1879961 Bad debts 724121 724121 Healthcare provider tax 343652 343652 Repairs and maintenance 220335 183032 37303 239152 199794 39358 22991774 19199593 3792181 0 556963 792228 1913 665232 2576271 1438053 216909 148001 80729 28487 12262854 10214202 1550177 2048652 42947 49171 5025909 5169824 3184995 2736236 20000 388130 302857 2030879 576374 5604004 3635467 X -578095 1534357 -578095 1534357 5025909 5169824 2112452 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5679 5679 0 Part II-B, Line 1: A portion of the organization's dues were used for lobbying. Dues were paid to West Virginia Hospital Association, West Virginia Health Care Association and the West Virginia Primary Care Association. 72395 72395 3043798 1953216 1090582 462218 170690 291528 8534443 8090296 444147 150000 150000 2048652 Estimated third party payor settlements 576374 576374 X 23532601 0 23532601 1571625 1571625 25104226 22267653 0 22267653 724121 724121 22991774 Part X, Line 2: Accounting principles generally accepted in the United States of America require the System to evaluate tax positions taken by the System and recognize a tax liability or asset if the System has taken an uncertain position that more likely than not would be sustained upon examination by the Internal Revenue Services (IRS). The System has concluded that as of December 31, 2019 and 2018, there are no uncertain positions taken or expected to be taken that would require recognition of a liability or asset or disclosure in the financial statements. Part XI, Line 4b - Other Adjustments: Bad debts netted against revenue on the financial statements 724,121. Grant income for capital asset acquisitions 847,504. Part XII, Line 4b - Other Adjustments: Bad debts netted against revenue in the financial statements 724,121. . 1 1 X 1 X 1 X 1 1 0 0 507273 507273 3284117 2581189 702928 0.03160 3791390 3088462 702928 0.03160 212000 85000 127000 0.00570 11189 11189 0.00050 223189 85000 138189 0.00620 4014579 3173462 841117 0.03780 0 724121 3716266 3716266 X 1 1 1 1 Minnie Hamilton Health Care Center 186 Hospital Drive Grantsville WV 26147 X X X X Long Term Care (24 beds) Minnie Hamilton Health Care Center Inc 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X See Part V, page 8 for URL X 1 19 1 See Part V, page 8 for URL 0 1 X 200.000000000000 200.000000000000 X X X X 1 1 X X X 1 X See Part V, page 8 for URL X See Part V, page 8 for URL X See Part V, page 8 for URL X X X X X X 1 X 0 X X X 1 X 0 0 Minnie Hamilton Health Care Center, Inc. Part V, Section B, Line 5: The 2019 Calhoun and Gilmer Counties CHNA process began with the commitment of the MHHS board of directors to form a Community Health Improvement Committee who worked to develop a list of key community partners. The list of partners includes both organizations, agencies, and individuals who have traditionally been involved in community health improvement efforts, as well as numerous nontraditional partners and community sectors that are historically difficult to reach. One key partner in each county, is the Family Resource Network partner who receives grant funding to conduct a community needs assessment during the timeframe for the CHNA. By combining resources, the 2019 CHNA process has led to a more comprehensive view of community needs because there is more comprehensive data available for review and more community sectors are involved and are able to advocate for their service recipients and constituents. Leaders from the following organizations were selected to provide feedback duirng the interview process:Calhoun Family Resource NetworkGilmer County Family Resource NetworkGlenville CenterWVU Cancer InstituteCalhoun Banks Minnie Hamilton Health Care Center, Inc. Part V, Section B, Line 11: The hospital is addressing significant needs identified as follows:Illegal drug use and substance abuse - will continue to provide behavioral health services as well as utilize Westbrook Health Services for substance abuse when possible, and utilize community outreach and education to help curb the opioid epidemic.Poverty/Family income and unemployment - will offer free/low cost screenings to individuals that meet criteria for financial assistance programs.Tobacco use - will educate students and the community about the effects of tobacco use and will give access to free/reduced cost tobacco cessation program.Obesity and related diseases - will promote community fitness program, hold community educational events, work closely with the farmers market to provide access to health food and support local youth activities to promote physical activities and health living.Depression and behavioral health - continue to expand and utilize our behavioral health department and provide educational measure to providers for proper diagnosis of behavioral needs.The needs identified which have not been addressed are public transportation and specialty services including: dialysis, oncology and cardiovascular. The reason such needs are not being addressed is lack of or limited resources and manpower in or near the service area. Part V, Section B, Line 7a Link for Community Health Needs Assessment located on the following webpage:https://www.mhhs.healthcare/for-our-patients.html Part V, Section B, Line 10a Link for CHNA Implementation Strategy located on following webpage:https://www.mhhs.healthcare/for-our-patients.html Part V, Section B, Line 16a Link for Financial Assistance Policy located on the following webpage:https://www.mhhs.healthcare/for-our-patients.html Part V, Section B, Line 16b Link for the Financial Assistance Application is on the following webpage:https://www.mhhs.healthcare/for-our-patients.html Part V, Section B, Line 16c Link for the Financial Assistance Plain Language Summary is on the following webpage:https://www.mhhs.healthcare/for-our-patients.html 3 1 - Glenville Clinic 921 Mineral Road Suite 101 Glenville WV 26351 Federally Qualified Health Center 2 - Grantsville Clinic 186 Hospital Drive Grantsville WV 26147 Rural Health Clinic 3 - Minnie Hamilton Health Care 186 Hospital Drive Grantsville WV 26147 Skilled Nursing Unit Part I, Line 3c: 1. The qualifications for the Sliding Fee Program are based on both the number of people in the household and the total gross income received in the household. 2. The applicants are required to complete the Sliding Fee Program application and to provide a proof of income within 30 days after filing their application. Acceptable proof of income includes: wage statement, W-2 forms, check stub, retirement statement, unemployment statement, social security check or benefit letter, alimony check, child support check, food stamp voucher, or other documents approved by financial management.3. If the patient has no income, they are asked to declare so by signing a Lack of Income Verification form. 4. The Financial Assistance Application, along with the above mentioned documents verifying income or lack of it, will be processed promptly by the cashier/clerk.5. After the patient has been approved for the Sliding Fee Program, they will receive a Sliding Fee identification card describing the benefits such as: A. Fee of $15 or $25 for an office visit, collected at the time of the visit B. 50% or 75% discount for lab tests C. 50% to 75% discount of diagnostic, non-invasive radiology services, the technical component only. D. 50% to 75% discount on respiratory procedures: Pulse Ox., EKG (Tech.& Prof.), Aerosol Treatment, Pulmonary Function Testing (PFT) and associated PFT testing. E. 50% to 75% discount on speech pathology procedures: limited to evaluations, testing and treatments. Supplies and equipment not included.6. Qualification for Sliding Fee remains in effect for one year from the date of approval, unless the patient or the household income should change within that year.7. The Sliding Fee Program benefits may apply to the outstanding patient accounts which do not exceed 365 days from the day of service. Accounts which have already been sent to a collection agency may not qualify for this program. 8. It is the patient's responsibility to reapply annually for continued participation in the Sliding Fee Program. Part I, Line 7: The cost of charity care has been calculated by obtaining gross charges from the audited financial statements for charity care write offs and multiplying these charges by the aggregate hospital cost to charge ratio. The net amount was then reduced by the estimated "charity portion" of the revenue "disproportionate share" payment received from the state.Medicaid community benefit cost was estimated based on the costs in excess of reimbursements for the hospital's skilled nursing unit and rural health clinic. Other hospital services are reimbursed by WV Medicaid at 100% of cost. Since those costs and reimbursements would net to zero community benefit expense, those amounts are not included in the Medicaid costs and off-setting revenue totals reported. 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 $ 724,121. Part III, Line 2: Bad debt expense as reported in audited financial statements. Part III, Line 4: Financial statement footnote that describes bad debt expense: Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectible accounts. In evaluating the collectability of accounts receivable, the System 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. 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. 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 System 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 or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. Recoveries of accounts previously written off are recorded as a reduction to the provision for bad debt expense when received. Interest is not charged on patient accounts receivable. Part III, Line 8: The Medicare costs and reimbursements were derived from the Medicare cost report. Part III, Line 9b: All patients are informed about the financial assistance policy and charity care policy during the registration process and/or through a collection letter. Accounts that cannot be collected by the organization after normal in-house collection procedures may be referred to a collection agency for further collection action in accordance with established guidelines. Part VI, Line 2: Records of types of visits and diagnosis are kept and analyzed for adjustment of appropriate services. Official community needs assessments are periodically performed by an outside agency. Part VI, Line 3: The organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs or under the organization's financial assistance policy by making information available as follows:1) Posting on the facility's website2) Attaching information to billing invoices3) Posting information in emergency rooms, waiting rooms and admission offices4) Providing in writing to patients on admission to the facility5) Making information available on request Part VI, Line 4: The organization services a rural area of an estimated 21,590 people in Calhoun, Gilmer and Wirt Counties. The three service area Counties have higher unemployment than the State average, and Calhoun County has one of the highest unemployment rates in the State. The service area and the State of West Virginia have a higher percentage of residents below the poverty level compared to the United States. Approximately 20.7% of the service area population is 65 and older, which is consistent with the State of West Virginia of 19.9% but significantly higher than the national average of 16.0 percent. The service area median household income is $37,463 and the State of West Virginia of $44,061 are notably lower than the national average of $57,652. The nearest Hospital is over 30 miles away. The Health Care Center is designated as a Health Professional Shortage Area (HPSA) site. Part VI, Line 5: All board members reside in the service area and none are employed by, or have contractual arrangements with Minnie Hamilton Health Care Center. The medical staff privileges are available to all qualified providers in the area. All profit and available funding is utilized for continuation and improvement of the provision of appropriate health services through staffing and acquisition of equipment and supplies. A 24-hour emergency room doctor is provided regardless of a patient's ability to pay. The nearest hospital is 40 minutes away, by car. An active auxiliary is made up of local volunteers and has been present during all years of the facilities hospital services. X X X X X 0 0 0 0 0 0 0 0 0 Stephen S Whited CEO 177646 0 0 0 0 0 0 0 24730 0 202376 0 0 0 Suresh Balasubramony MD Physician 663446 0 0 0 0 0 0 0 24714 0 688160 0 0 0 Rudolph M Kevak MD Physician 660092 0 0 0 0 0 0 0 9425 0 669517 0 0 0 Alfonso Cinco MD Physician 482038 0 0 0 0 0 0 0 9425 0 491463 0 0 0 Timothy M Daly MD Physician 321726 0 0 0 0 0 0 0 0 0 321726 0 0 0 Jason B Fincham MD Physician 477863 0 0 0 0 0 0 0 16393 0 494256 0 0 0 Form 990, Part VI, Section B, line 11b Form 990 is reviewed by Executive Management, the Finance Committee and the Board of Directors. Form 990, Part VI, Section B, line 12c The Board of Directors sign the statement annually. Individual members are excused from decision making on issues where conflicts may arise. Board of Director members recuse themselves from voting on issues where a conflict may exist. Form 990, Part VI, Section B, line 15 A survey of like facilities in the state, utilizing the Health Care Authority information that is available, to compare salaries of top executives, as well as looking at job responsibilities and years of experience. The CEO is a contracted position and approved by the Board of Directors. Executive management is approved by the CEO. Form 990, Part VI, Section C, line 19 Audited Financial Statements are available upon request to the public. Annually the audited balance sheet and income statement are published in the local newspaper as per the Health Care Authority financial disclosure requirements. Form 990, Part IX, line 11g Physician Fees: Program service expenses 9,811. Management and general expenses 1,999. Fundraising expenses 0. Total expenses 11,810. Other Purchased Services: Program service expenses 1,940,782. Management and general expenses 395,539. Fundraising expenses 0. Total expenses 2,336,321. Form 990, Page 1, Line 6 Volunteers of the organization include members of the hospital auxiliary and teenagers involved in a volunteer program.