MONTGOMERY GENERAL HOSPITAL INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- MONTGOMERY GENERAL HOSPITAL INC (EIN 55-0372580)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-14
- IRS object ID
- 201923189349305827
- 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 | 2019-11-14T11:49:27-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | 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 | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550372580 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Montgomery General Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MONT | BusinessNameControlTxt |
| Phone | 3044425151 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 Sixth Avenue | AddressLine1Txt |
| City | Montgomery | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25136 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Vickie Gay | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3044425151 | PhoneNum |
| Signature | 2019-11-14 | 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 | 2019-11-14 | IPDt |
| IP Tm | 00:45:46 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 4922351D67124356B1C43EE3C9710DC6A31D3181 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A4BFA3AB87143958067DA1F41CA4A9B8234C6C6B | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-04-17 16:48:07Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Vickie Gay | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 Sixth Avenue | AddressLine1Txt |
| City | Montgomery | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25136 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,990,195 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.mghwv.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1970 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | To provide quality, cost-effective, and convenient healthcare services that meet and exceed reasonable internal and external customer expectations. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 307 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $20,429 | PYContributionsGrantsAmt |
| CY Contributions Grants | $27,320 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,045,440 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $22,144,226 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$92,598 | PYInvestmentIncomeAmt |
| CY Investment Income | $37 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,836,664 | PYOtherRevenueAmt |
| CY Other Revenue | $1,818,612 | CYOtherRevenueAmt |
| PY Total Revenue | $23,809,935 | PYTotalRevenueAmt |
| CY Total Revenue | $23,990,195 | 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 | $12,962,892 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,080,296 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,540,339 | PYOtherExpensesAmt |
| CY Other Expenses | $11,136,249 | CYOtherExpensesAmt |
| PY Total Expenses | $24,503,231 | PYTotalExpensesAmt |
| CY Total Expenses | $24,216,545 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$693,296 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$226,350 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,140,621 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,472,356 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,701,757 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,635,908 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $438,864 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $836,448 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Montgomery General Hospital is a critical access hospital. It also provides outpatient services including laboratory, radiology, surgery and therapy services; physician services; and skilled nursing services. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,886,649 | ExpenseAmt |
| Revenue | $23,896,316 | RevenueAmt |
| Desc | The Hospital provided health care services including 3,008 acute inpatient days; 12,704 skilled nursing days; 30,575 outpatient visits; 7,396 emergency room visits; 717 ambulatory surgery procedures; and 15,851 physician office visits. Charges foregone for charity care amounted to $63,373. | Desc |
| Total Program Service Expenses | $18,886,649 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 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 | 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 | 48 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 307 | 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sherri Murray | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3044421246 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 Sixth Avenue | AddressLine1Txt |
| City | Montgomery | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25136 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Raleigh Collins | ||||||||
| Chair | 0.50 | 1.50 | Yes (X) | Yes (X) | $1,400 | $0 | $0 | |
| Ghassan Dagher MD | ||||||||
| Vice Chair | 0.50 | 1.50 | Yes (X) | Yes (X) | $1,000 | $0 | $0 | |
| Joyce Brown | ||||||||
| Secretary | 0.50 | 1.50 | Yes (X) | Yes (X) | $1,400 | $0 | $0 | |
| Barbara Crist | ||||||||
| Treasurer | 0.50 | 1.50 | Yes (X) | Yes (X) | $1,000 | $0 | $0 | |
| Vickie Gay | ||||||||
| President & CEO | 39.50 | 0.50 | Yes (X) | Yes (X) | $145,359 | $0 | $0 | |
| Rita Bohanna | ||||||||
| Trustee | 0.50 | 1.50 | Yes (X) | $1,400 | $0 | $0 | ||
| Donald Smith | ||||||||
| Trustee | 0.50 | 1.50 | Yes (X) | $1,400 | $0 | $0 | ||
| Patsy Tucker | ||||||||
| Trustee | 0.50 | 1.50 | Yes (X) | $1,200 | $0 | $0 | ||
| Kelli Vance | ||||||||
| Trustee | 0.50 | 1.50 | Yes (X) | $2,000 | $0 | $0 | ||
| Garnes Reed | ||||||||
| Trustee | 0.50 | 1.50 | Yes (X) | $1,400 | $0 | $0 | ||
| Sherri Murray | ||||||||
| CFO | 39.50 | 0.50 | Yes (X) | $108,456 | $0 | $0 | ||
| Mohamad Sankari MD | ||||||||
| Physician | 24.00 | $351,588 | $0 | $280 | Yes (X) | |||
| Myra Priddy MD | ||||||||
| Physician | 36.00 | $261,180 | $0 | $0 | Yes (X) | |||
| Robert Eggleston MD | ||||||||
| Physician | 40.00 | $253,208 | $0 | $1,918 | Yes (X) | |||
| Louis Yancich MD | ||||||||
| Physician | 36.00 | $252,931 | $0 | $4,658 | Yes (X) | |||
| Samuel Davis MD | ||||||||
| Physician | 20.00 | $247,443 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,632,365 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $6,856 | 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 |
|---|---|---|---|---|---|
| Advantage Rehab | |||||
| 150 Hidden Valley Road | Scott Depot | WV | 25560 | Therapy Services | $1,113,376 |
| Kanawha Valley Radiologists | |||||
| PO Box 3428 | Charleston | WV | 25334 | Radiologist Services | $290,968 |
| Labcorp of America | |||||
| PO Box 60850 | Charlotte | NC | 28260 | Lab Services | $145,310 |
| Arnett Carbis Toothman LLP | |||||
| PO Box 2629 | Charleston | WV | 25329 | Accounting Services | $129,584 |
| Alliance Healthcare Services | |||||
| PO Box 96485 | Chicago | IL | 60693 | MRI Services | $106,691 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $19,000 | GovernmentGrantsAmt |
| All Other Contributions | $8,320 | AllOtherContributionsAmt |
| Total Contributions | $27,320 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient services | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $22,144,226 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $22,144,226 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $22,144,226 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37 | TotalRevenueColumnAmt |
| Exclusion | $37 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $66,522 | 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 | $66,522 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,522 | TotalRevenueColumnAmt |
| Exclusion | $66,522 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| 340B Program | 900099 | $1,701,679 | $1,701,679 |
| Cafeteria | 722210 | $34,711 | $34,711 |
| Refunds | 900099 | $921 | $921 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,779 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,779 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,752,090 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,990,195 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,896,316 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $66,559 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,815 | TotalAmt |
| Program Services | $187,791 | ProgramServicesAmt |
| Management And General | $66,024 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,443,963 | TotalAmt |
| Program Services | $7,727,203 | ProgramServicesAmt |
| Management And General | $2,716,760 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $246,084 | TotalAmt |
| Program Services | $182,071 | ProgramServicesAmt |
| Management And General | $64,013 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,386,324 | TotalAmt |
| Program Services | $1,025,703 | ProgramServicesAmt |
| Management And General | $360,621 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $750,110 | TotalAmt |
| Program Services | $554,986 | ProgramServicesAmt |
| Management And General | $195,124 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,835 | TotalAmt |
| Management And General | $87,835 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,706 | TotalAmt |
| Management And General | $84,706 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,106,525 | TotalAmt |
| Program Services | $1,558,561 | ProgramServicesAmt |
| Management And General | $547,964 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,860 | TotalAmt |
| Program Services | $28,751 | ProgramServicesAmt |
| Management And General | $10,109 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,026,060 | TotalAmt |
| Program Services | $1,499,027 | ProgramServicesAmt |
| Management And General | $527,033 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $483,088 | TotalAmt |
| Program Services | $357,424 | ProgramServicesAmt |
| Management And General | $125,664 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $602,546 | TotalAmt |
| Program Services | $445,807 | ProgramServicesAmt |
| Management And General | $156,739 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,381 | TotalAmt |
| Program Services | $46,894 | ProgramServicesAmt |
| Management And General | $16,487 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,206 | TotalAmt |
| Management And General | $3,206 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $585,625 | TotalAmt |
| Program Services | $433,288 | ProgramServicesAmt |
| Management And General | $152,337 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $532,075 | TotalAmt |
| Program Services | $393,668 | ProgramServicesAmt |
| Management And General | $138,407 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Bad debts | $2,250,000 | $2,250,000 | |
| Medical supplies | $1,572,841 | $1,572,841 | |
| Health care provider ta | $404,009 | $404,009 | |
| Licenses, dues & permit | $153,370 | $113,474 | $39,896 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,122 | TotalAmt |
| Program Services | $105,151 | ProgramServicesAmt |
| Management And General | $36,971 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,216,545 | TotalAmt |
| Program Services | $18,886,649 | ProgramServicesAmt |
| Management And General | $5,329,896 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $514,495 | BOYAmt |
| EOY | $57,633 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,498,603 | BOYAmt |
| EOY | $2,276,630 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $372,085 | BOYAmt |
| EOY | $439,609 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,200 | BOYAmt |
| EOY | $45,540 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $32,451,311 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $29,004,108 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,458,619 | BOYAmt |
| EOY | $3,447,203 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $192,619 | BOYAmt |
| EOY | $205,741 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,140,621 | BOYAmt |
| EOY | $6,472,356 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,324,908 | BOYAmt |
| EOY | $2,360,976 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $511,440 | BOYAmt |
| EOY | $449,304 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,865,409 | BOYAmt |
| EOY | $2,825,628 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,701,757 | BOYAmt |
| EOY | $5,635,908 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $438,864 | BOYAmt |
| EOY | $836,448 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $438,864 | BOYAmt |
| EOY | $836,448 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,140,621 | BOYAmt |
| EOY | $6,472,356 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$226,350 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $623,934 | OtherChangesInNetAssetsAmt |
| 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $869,878 | OtherCostOrOtherBasisAmt |
| Book Value | $869,878 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,579,917 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,107,820 | DepreciationAmt |
| Book Value | $472,097 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,333,361 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,517,573 | DepreciationAmt |
| Book Value | $1,815,788 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $668,155 | OtherCostOrOtherBasisAmt |
| Depreciation | $378,715 | DepreciationAmt |
| Book Value | $289,440 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,447,203 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrued pension obligation | $2,677,498 |
| Due to third party payers | $148,130 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,825,628 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $21,739,274 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,739,274 | RevenueSubtotalAmt |
| Other Revenues Not Included | $2,250,921 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,250,921 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $23,990,195 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $21,965,624 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$921 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$921 | ExpensesNotReportedAmt |
| Expenses Subtotal | $21,966,545 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,250,000 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,250,000 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $24,216,545 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | Accounting principles generally accepted in the United States of America require management of the Organization to evaluate tax positions taken by the Organization. Management has evaluated the Organization's tax positions and concluded that the Organization has maintained its tax exempt status and has taken no uncertain tax positions that require recognition or disclosure in the consolidated financial statements. Therefore, no provision or liability for income taxes has been included in the consolidated financial statements. Generally, tax returns for years ended December 31, 2015, and thereafter remain subject to examination by federal and state tax authorities. |
| Part XI, Line 4b - Other Adjustments: | Bad debt netted with revenue 2,250,000. Refund reclassified 921. |
| Part XII, Line 2d - Other Adjustments: | Refund reclassified -921. |
| Part XII, Line 4b - Other Adjustments: | Bad debt netted with revenue 2,250,000. |
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 |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 120.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 120.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $436,698 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $436,698 | DirectOffsettingRevenueAmt |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,235,489 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,951,843 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $283,646 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01290 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,672,187 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,388,541 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $283,646 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01290 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,672,187 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,388,541 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $283,646 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01290 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,250,000 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $4,723,849 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,723,849 | CostOfCareReimbursedByMedcrAmt |
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 | Montgomery General Hospital Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 Sixth Avenue | AddressLine1Txt |
| City | Montgomery | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25136 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Montgomery General Hospital Inc | 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 | 16 | 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 | See Part V, page 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, page 8 | 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 | 120.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 120.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| 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 |
| 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 |
| 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 |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| 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 (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Montgomery General Hospital, Inc. | Part V, Section B, Line 5: Data was obtained from numerous health organizations as well as interviews with community leaders, hospital staff and the Hospital's Board of Directors. A survey was conducted which included anonymous participants and key community leaders. The survey collected demographic information that assessed the health status, health care access, and health care demands of the service area. Key participants represented a variety of sectors including public health, medical providers, fire and ambulance representatives, youth services, government and educational organizations. |
| Montgomery General Hospital, Inc. | Part V, Section B, Line 11: The following are the health care needs identified in the 2016 CHNA that are being addressed by the hospital:Need: Increased focus on diabetes education and servicesThe following has been implemented by the hospital's certified dietary educator to promote diabetes education:*holds Lunch and Learn sessions open to the community*publishes a monthly newsletter*one of 4 American Diabetes AADE CDE Mentor's in WV*participates in our annual Kids Fair to promote awareness among children*advertises her services in local school sports programNeed: Improve the availability of transportation for the impoverished and elderly who are unable to drive.The social service director works with the following organizations to provide transportation:*Fayette County Senior Service*MTM- service that provides transportation for Medicaid patients*UMWA- provides transportation for UMWA patients*Local cab company- the hospital pays the costNeed: Access to mental health care (facilities and physicians)1. Need for substance abuse services *recently hired a provider that offers addiction counseling and treatment with suboxone2. Need for outpatient mental health services *Partnering with Highland Hospital to offer telehealth consults *Social services offers screening and referral assistance to patientsNeed: Improved utilization of emergency room*extended the hours at provider based clinics for non-emergent patients*walk-ins now accepted at provider based clinics*ER triage to refer non-emergencies to clinic during clinic office hours*recently added a mid-level provider to assist with less emergent patientsNeed: Outpatient oncology and infusion therapy and outpatient cardiac rehabilitation and pulmonary therapy*some infusion services are offered*hospital does not have dedicated cardiac rehab program since there were not enough participants in the past--but offers the use of a fitness center, representatives, youth services, government and educational organizations. |
| Line 16a | Link for Financial Assistance Policy (FAP):http://mghwv.com/community/financial-assistance/financial-assistance-policy |
| Line 16b | Link for FAP Application:http://mghwv.com/community/financial-assistance/financial-assistance-application |
| Line 16c | Link for FAP Plain Language Summary:http://mghwv.com/community/financial-assistance/plain-language-policy |
| Line 7a | Link for Community Health Needs Assessment (CHNA):http://www.mghwv.com/community/community-helth-needs-assessment |
| Line 10a | Link for CHNA Implementation Strategy:http://www.mghwv.com/community/community-helth-needs-assessment-2 |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 resulting charity care cost was then increased for the estimated "charity portion" of broad-based taxes paid to the State of WV. 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. 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 $ 2,250,000. |
| Part III, Line 2: | Bad debt expense as reported on the audited financial statements. |
| Part III, Line 4: | Patient Accounts Receivable: Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectable 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 costs and reimbursements were derived from the Hospital's Medicare cost report. |
| Part III, Line 9b: | Charity application is available to any person interested. Collection staff will meet with interested patient to help complete and assess all required information. |
| Part VI, Line 2: | Montgomery General Hospital provides acute care services, swing bed SNF services, skilled nursing services for both skilled patients and intermediate care patients and physicians in general practice and many specialties. As the only hospital in Fayette County, Montgomery General Hospital is aware of the health needs of the community and works to provide all necessary services to all citizens of the county. |
| Part VI, Line 3: | MGH will make reasonable efforts to explain the benefits of Medicaid and other available public and private programs to patients and provide information on those programs that may provide coverage for services. Information on public or private coverage and MGH's Financial Assistance Policy will be communicated to patients in easy-to-understand, culturally appropriate language, and in the most prevalent languages spoken in applicable hospital service area communities. MGH will make resources available to assist patients in enrolling in and/or applying for federal and government programs. Requests for financial assistance will be processed promptly and MGH will notify the patient or applicant in writing within 60 days of receipt of a completed application. |
| Part VI, Line 4: | Montgomery General Hospital is a Critical Access Hospital located in Fayette County, West Virginia. Montgomery General Hospital is the only hospital for rural Fayette County. Fayette County is a low income area that must compete with Urban Kanawha county to attract and retain physicians, nurses and medical personnel. In addition of having to pay higher salaries to attract top medical professionals, Montgomery General Hospital has a high percentage of Medicare and Medicaid patient population. Montgomery General Hospital is listed as a Health Professional Shortage Area and a Medically Underserved Area for portions of Fayette County. |
| Part VI, Line 5: | The majority of Montgomery General Hospital's board of directors is comprised of persons who reside in the Organization's primary service area. The Organization extends medical staff privileges to all qualified physicians in the community. The Organization uses surplus funds for improvements in patient care. Currently, the Organization is in the process of updating all patient rooms and implementing an EMR. The Organization operates an emergency room available to all, regardless of ability to pay. The Organization offers open MRI services and is in the process of implementing digital radiology. The Organization involves itself in the community by sponsoring health fairs as well as lunch and learn opportunities to address the diabetic population. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mohamad Sankari MD | ||||||||||||||
| Physician | $351,588 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $280 | $0 | $351,868 | $0 | $0 | $0 |
| Myra Priddy MD | ||||||||||||||
| Physician | $261,180 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $261,180 | $0 | $0 | $0 |
| Robert Eggleston MD | ||||||||||||||
| Physician | $253,208 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $1,918 | $0 | $255,126 | $0 | $0 | $0 |
| Louis Yancich MD | ||||||||||||||
| Physician | $252,931 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $4,658 | $0 | $257,589 | $0 | $0 | $0 |
| Samuel Davis MD | ||||||||||||||
| Physician | $247,443 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $247,443 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | The Form 990 is reviewed by the CFO and CEO. |
| Form 990, Part VI, Section B, line 12c | Annually board members are provided the conflict of interest policy and questionnaire. Once these are completed they are returned to administration and reviewed by our in-house counsel. |
| Form 990, Part VI, Section B, line 15 | The Board of Directors determines the President/CEO's salary based upon comparative industry standards. The CEO determines the CFO salary based upon comparative industry standards. |
| Form 990, Part VI, Section C, line 19 | The governing documents and conflict of interest policy are available upon request. The financial statements are published annually in the local newspaper. |
| Form 990, Part XI, line 9: | Transfers from related parties 200,380. Change in pension funded plan status 423,554. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Laird Health Care Foundation Inc | |||||||||||
| Washington Sixth Avenue | Montgomery | WV | 25136 | 550632743 | Support tax-exempt health care organizations | WV | 501(c)(3) | Line 7 | Montgomery General Health Care System | 0 | |
| Montgomery General Elderly Care Center | |||||||||||
| Washington Sixth Avenue | Montgomery | WV | 25136 | 550623339 | Extended care facility | WV | 501(c)(3) | Line 11 | Montgomery General Health Care System | 0 | |
| Montgomery General Health Care System Inc | |||||||||||
| Washington Sixth Avenue | Montgomery | WV | 25136 | 550632601 | Provide support to affiliated exempt health care providers | WV | 501(c)(3) | Line 12c, III-FI | 0 | N/A | |
| Montgomery MedCorp Inc | |||||||||||
| Washington Sixth Avenue | Montgomery | WV | 25136 | 550767169 | Physicians Practice | WV | 501(c)(3) | Line 11 | Montgomery General Health Care System | 0 | |
| 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 | Yes (1) | 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 | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |