2019-05-15T07:20:08-05:00 2018-06-30 550486667 Arnett Carbis Toothman LLP P O Box 2629 Charleston WV 25329 990 2017-07-01 311097818 Preston Memorial Hospital Corporation PRES 3043291400 150 Memorial Drive Kingwood WV 265371442 Kevin Gessler VP of Financial Services 3043291400 2019-05-14 1 Dolores Rose P01286262 3043460441 216.12.119.47 2019-05-14 18:00:39 ED P 8F537CE45D6BD65E6EB7CB60BD4FF135E15258F7 189E7E0A389CD25A9DA3FDB9013AAEDF90286210 2017 2019-02-21 02:37:17Z Melissa Lockwood 150 Memorial Drive Kingwood WV 265371442 42020636 0 X prestonmemorial.org X 1955 WV To offer access to high quality, patient centered, and affordable healthcare to all our patients. 11 9 430 52 0 0 11096 19429 37946646 41527254 55072 128772 269668 345181 38282482 42020636 0 0 0 0 21154159 23351585 0 0 0 17884962 19110011 39039121 42461596 -756639 -440960 49037174 48344833 43595266 43323724 5441908 5021109 X To offer access to high quality, patient centered, and affordable healthcare to all our patients. 0 0 29514026 41838870 The Hospital had 2,441 inpatient days, cared for 9,105 emergency patients and treated 60,385 patients in its outpatient clinics. The Hospital provides care regardless of the patient's ability to pay. Charges foregone for charity care amounted to $850,285.The Hospital promotes and provides activities such as health fairs, blood drives, and a fitness center to improve the health and welfare of its patients. The Hospital also conducts community-wide speaker bureaus to help educate the community on specific health and wellness matters.The Hospital strives to provide and promote needed services in the community by partnering with local agencies such as the Preston County Health Department, Family Resource Network, Preston Prevention Partnership, and the Preston County Chamber of Commerce. 527553 33565 The organization sponsored health fairs, blood drives, cancer screenings, CPR/first aid classes, crisis intervention, diabetes intervention, family/parenting/sibling education, fitness education, flu shots, nutrition/weight maintenance, school based programs, senior education and outreach programs, sports injury prevention, substance abuse and tobacco/smoking cessation. 30041579 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 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 1 0 0 0 1 62 0 430 1 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Kevin Gessler VP Finance 3043291400 150 Memorial Drive Kingwood WV 265371442 Kathy McNeill Chair 1.00 1.00 X X 0 0 0 Ron Crites Vice Chair/Treasurer 1.00 1.00 X X 0 0 0 Rita McCrobie Secretary 1.00 1.00 X X 0 0 0 Melissa Lockwood President/CEO 40.00 1.00 X X 0 225120 14268 Roger Hardesty Board Member 1.00 1.00 X 0 0 0 Sandy Murray Board Member 1.00 1.00 X 0 0 0 Nick Taylor Board Member 1.00 1.00 X 0 0 0 Ray Thompson Board Member 1.00 1.00 X 0 0 0 Larry Williams Board Member 1.00 1.00 X 0 0 0 Bonnie Forman MD Chief of Staff 20.00 X 108510 0 3255 Tim Calvert Board Member 1.00 X 0 0 0 Kevin Gessler VP of Financial Services 40.00 1.00 X 0 143870 10611 Darryl Duncan President/CEO Mon Health 5.00 35.00 X 0 603779 153416 Daris Rosencrance Sr VP Finance/CFO Mon Health 5.00 35.00 X 0 403166 57652 Marisa Downey DO Physician 40.00 X 380650 0 20696 Theresa S Rutledge DO Physician 40.00 X 338427 0 33544 Frank Abraham MD Physician 40.00 X 515007 0 34409 James Holehouse MD Physician 40.00 X 233044 0 6624 Frederick Conley II MD Physician 40.00 X 213466 0 22077 1789104 1375935 356552 24 0 1 0 Sanjay Bharti MC PLLC 4000 Hampton Center Suite B Morgantown WV 26505 Hospitalist Services 285000 Weatheby Locums Inc PO Box 972633 Dallas TX 75397 ER Physician Staffing 249468 Fusion Medical Staffing LLC PO Box 82674 Lincoln NE 68501 Nurse Staffing Services 222687 Alliance Healthcare Services PO Box 96485 Chicago IL 60693 MRI Services 201600 Laboratory Corporation PO Box 12140 Burlington NC 27216 Lab Services 153297 8 17929 1500 19429 Patient services 622110 40873633 40873633 340B Drug Program 900099 653621 653621 41527254 32439 32439 96333 0 96333 96333 96333 Cafeteria Sales 722212 176933 176933 Drugs 900099 51962 51962 Rebates and Refunds 900099 29272 29272 87014 87014 345181 42020636 41872435 0 128772 111765 77341 34424 17532985 12132826 5400159 528877 365983 162894 3955146 2736961 1218185 1222812 846186 376626 586067 586067 127821 127821 59455 59455 3336288 2413125 923163 222949 154281 68668 1460153 1009303 450850 228764 158305 70459 435437 301322 134115 144607 100068 44539 1294220 1294220 3050029 2110620 939409 489648 338836 150812 Medical supplies 2890835 2890835 Bad Debt 2828946 2828946 Repairs & maintenance 741868 513373 228495 Healthcare provider tax 727032 727032 485892 336236 149656 42461596 30041579 12420017 0 5468147 6381077 3515821 4286015 26840 0 553325 563154 198572 213154 53555263 21548291 34515208 32006972 3208145 3313529 1551116 1580932 49037174 48344833 5057387 5391209 36300692 35576618 143389 133515 2093798 2222382 43595266 43323724 X 5441908 5021109 5441908 5021109 49037174 48344833 X -440960 20161 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 28661 28661 0 Part II-B, Line 1: The organization pays membership fees to the West Virginia Hospital Association which participates in lobbying activities. 31195 31195 26497583 10926870 15570713 24272828 10504424 13768404 2753657 116997 2636660 32006972 Funded depreciation 2171853 F Restricted investment account 1141676 F 3313529 Due to 3rd Party Payors 2014702 Due to related party 207680 2222382 X Part X, Line 2: Summary from the consolidated audited financial statements of the Health System: The Hospital follows the FASB's authoritative guidance on accounting for uncertainty in income taxes. The Hospital has determined that no material unrecognized tax benefits or obligations exist. Generally, tax returns for years ended June 30, 2015, and thereafter remain subject to examination by federal and state tax authorities. 1 1 X 1 X 1 X 1 1 0 1 1 355239 355239 0.00900 1667827 1667827 564165 564165 0.01420 2587231 1667827 919404 0.02320 527553 33565 493988 0.01250 279855 279855 0.00710 65131 65131 0.00160 872539 33565 838974 0.02120 3459770 1701392 1758378 0.04440 0 2829128 8859490 8859490 X 1 1 1 1 Preston Memorial Hospital 150 Memorial Drive Kingwood WV 26537 http://www.prestonmemorial.org/ X X X X 24X7 lab and radiology. Center of Excellence in Bariatric Surgery. Preston Memorial Hospital 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X https://www.mongeneral.com/preston-memorial/wellness-initiatives X 1 15 1 https://www.mongeneral.com/preston-memorial/wellness-initiatives 0 1 X 200.000000000000 200.000000000000 X X X X 1 1 X X X 1 X https://www.mongeneral.com/preston-memorial/patient-payments X https://www.mongeneral.com/preston-memorial/patient-payments X https://www.mongeneral.com/preston-memorial/patient-payments X X X X X 1 X 0 X X X 1 X 0 0 Preston Memorial Hospital Part V, Section B, Line 5: The Hospital received community input from the following expert advisors: Preston County Commissioner; Preston County Health Department Administrator; WVU-Nutrition Outreach Instructor; Preston Memorial Hospital Foundation Director; Wesbanco Banking Center Manager; Preston Memorial Hospital CEO; Family Practice Physician; Preston-Taylor Community Health Center CFO; Owner of Preston Healthcare Services; Office Manager of Family Practice office; General Surgeon from Preston Memorial Hospital. When the survey analysis was complete, the information and summary conclusions was put before the local group of experts who were asked to agree or disagree with the summary conclusions. Preston Memorial Hospital Part V, Section B, Line 11: Preston Memorial Hospital developed an implementation plan that addressed all of the significant needs identified in the CHNA. The significant needs identified: obesity; cancer; affordability of healthcare; smoking/abuse of controlled narcotics; and coronary heart disease. Part I, Line 3c: The VP of Financial Services and financial counselor review all charity applications. The VP of Financial Services and counselor then determine, based on financial information given by the patient (tax returns, pay stubs, household expenses, and other family considerations), if deep discounts can be provided to the patient, or if a complete write-off to free-care is deemed appropriate. Part I, Line 7: Actual revenue and costs were taken from the general ledger. Reasonable estimates were used where appropriate. Financial assistance at cost was calculated based on the cost-to-charge ratio from Worksheet 2 of the Schedule H instructions. Unreimbursed Medicaid and unreimbursed cost - other means-tested government programs were calculated using the calculated cost-to-charge ratio. Community health improvement services and community benefit operations and health professions education were calculated using internal cost accounting systems that use direct and indirect cost reporting. Part I, Line 7g: Emergency room and Level 4 trauma services. 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 $ 2,829,128. Part II, Community Building Activities: Preston offers its conference room space for multiple community meetings, including birthing classes, CPR, EMS & First Responder classes, parenting classes, etc. Part III, Line 4: Patients seeking financial assistance complete financial assistance applications and work with the hospital's financial counselor to determine appropriate levels of discounts (or complete free care) based on information supplied by the patient. All self-pay patients are offered baseline discounts of 10% from charges, and an additional 30% prompt payment discount if payment is made within a certain time period after receiving a bill. Patients who refuse assistance and refuse payment options are turned over to a collection agency after 3 bills have been submitted, and bad debt is recognized at that time. Part III, Line 8: Medicare allowable costs were obtained from the Hospital's Medicare cost report. Part III, Line 9b: The hospital financial counseling staff helps patients seek financial assistance through government programs or other payment services before applying for charity care. If government programs or other services are denied, a financial counselor works with patient to obtain financial information like tax returns, household bills, bank account information, etc. The financial counselor works with the VP of Financial Services to determine if a patient is eligible for full or partial charity care. Once this determination is made, the financial counselor communicates results with the patient. If partial payment is due after a discount has been recommended, the financial counselor works with the patient on a payment arrangement. If a patient, who has been deemed eligible for partial charity care, agrees to a payment plan and then fails to pay the remaining balance agreed to, the remaining balance will be adjusted off as bad debt. The remaining balance will be turned over to a collection agency. Part VI, Line 2: The Hospital conducted a Community Health Needs Assessment during the year ended June 30, 2016 to identify local health and medical needs of the residents served by the Hospital. To complete the Assessment the Hospital performed several independent data analyses based on secondary source data and combined the results with local survey data and opinions from local experts. Part VI, Line 3: The Hospital personnel instruct patients during the registration process who do not have insurance or the inability to pay, to complete an application for charity care after all other sources of financial assistance have been denied. Hospital personnel assist patients with obtaining other financial assistance before applying for charity care. The financial counseling policy is posted in the waiting rooms and at the front-desk. The hospital also has a formal resolution in place with the Preston County Commmission (local government) informing all local citizens of the Hospital's financial assistance program. Part VI, Line 4: Preston Memorial Hospital located in Kingwood, WV, is situated in a rural geographic location. Preston County has a population of 33,940 (2015), with more than 16% of the service area population over the age of 65. The median household income was $43,434 which is higher than the State median income of $39,550, but lower than the national median income of $53,657. The Hospital's Medicaid utilization is 17%, Medicare utilization is 40%, and an estimated 10% of the Hospital's patients served are uninsured (or underinsured). Preston Memorial Hospital is the only hospital in the county. There are 2 major competitors outside of the county - West Virginia University Hospitals and Monongalia General Hospital. Both hospitals are located approximately 50 minutes away from the hospital and are situated in urbanized locations in Monongalia County, WV. Other hospitals are also approximately 45 minutes to one hour driving distance from Preston Memorial Hosptial. There is a FQHC located in the county (Preston-Taylor Community Health Center). There are no other designated medically underserved areas in the county. Part VI, Line 5: Preston Memorial Hospital has a governing body comprised of citizens of Preston County. They are not employees, contractors or family members thereof. They represent labor, elderly, the business community and the poor. The hospital extends privileges to qualified physicians in the community and beyond to help take care of the needs of its patients. The organization routinely does not have surplus funds available from operations. However, the hospital has identified resources through borrowing or fundraising to invest in new technologies for imaging services, electronic health records, facility improvements, patient care room upgrades and other clinical capital improvements (e.g., monitors, vents, surgical equipment, etc.). The hospital also provides 24 x 7 emergency services and a level 4 trauma center. The hospital's emergency department and all other clinical services where medical need is demonstrated is available to all patients regardless of ability to pay. The hospital's specialized services include: ENT, OB/Gyn care, general surgery, orthopedics, psychiatry, physical therapy, cardiology, laboratory, radiology, and neurology. If these services were not available, patients in the primary service area would have to travel more than 45 minutes to obtain these services elsewhere. The hospital works diligently to attract charitable support through its Foundation, and engages over 30 volunteers to support multiple activities at the hospital. Part VI, Line 6: As of 2/28/2014, Preston Memorial Hospital, collectively with Preston Memorial Foundation and Preston Memorial Medical Group, is part of the Monongalia Health System, Inc. The Monongalia Health System includes Monongalia County General Hospital Company, Mon Elder Services, Inc., Monongalia Emergency Medical Services, Inc., and Mon Health Care. All entities are under common governance and control, and collectively operate to serve the healthcare needs and charitable needs of the community. The medical group provides office rental space to other health care providers in the community. The Foundation serves as a fundraising arm of the Hospital to help provide support for capital improvements, maintenance costs for the radiology department, and to support community activities through charitable giving. 0 1 0 0 0 0 0 0 0 Melissa Lockwood President/CEO 0 200382 0 24105 0 633 0 3687 0 10581 0 239388 0 0 Kevin Gessler VP of Financial Services 0 127503 0 16178 0 189 0 2462 0 8149 0 154481 0 0 Darryl Duncan President/CEO Mon Health 0 583847 0 0 0 19932 0 126666 0 26750 0 757195 0 0 Daris Rosencrance Sr VP Finance/CFO Mon Health 0 321367 0 43607 0 38192 0 24984 0 32668 0 460818 0 0 Marisa Downey DO Physician 380650 0 0 0 0 0 7737 0 12959 0 401346 0 0 0 Theresa S Rutledge DO Physician 330327 0 0 0 8100 0 8235 0 25309 0 371971 0 0 0 Frank Abraham MD Physician 491943 0 0 0 23064 0 9100 0 25309 0 549416 0 0 0 James Holehouse MD Physician 210152 0 0 0 22892 0 6624 0 0 0 239668 0 0 0 Frederick Conley II MD Physician 189466 0 0 0 24000 0 6046 0 16031 0 235543 0 0 0 Part I, Line 3 The CEO's compensation is paid by Monongalia Health System. Monongalia Health System uses the following methods to establish the compensation of the CEO: salary survey or study; independent compensation consultants; compensation committee; and is approved by the board or compensation committee. Part I, Line 4b The following individuals deferred the following amounts under a 457(f) plan- Darryl Duncan ($121,266) and Daris Rosencrance ($19,584). Form 990, Part VI, Section A, line 6 The sole member of Preston Memorial Hospital is Monongalia Health System. Form 990, Part VI, Section A, line 7a Preston Memorial Hospital's board members are elected or appointed by Monongalia Health System. Form 990, Part VI, Section A, line 7b Preston 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 asksed 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 excutive committee to determine compensation for the individual. Form 990, Part VI, Section C, line 18 The organization makes its Form 990 available upon request. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements are kept onsite at Preston Memorial Hospital and are made available upon request. Form 990, Part XI, line 9: Transfer from PMMG 20,161. 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. Preston Memorial Medical Group 150 Memorial Drive Kingwood WV 26537 550717988 Provide primary and urgent care WV 501(c)(3) Line 3 Monongalia Health System Inc 0 Preston Memorial Foundation 150 Memorial Drive Kingwood WV 26537 550740121 Support activities of other charitable organizations WV 501(c)(3) Line 12b, II Monongalia Health System Inc 0 Monongalia County General Hospital Company 1200 JD Anderson Drive Morgantown WV 26505 237441353 Hospital WV 501(c)(3) Line 3 Monongalia Health System 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 System 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 System Inc 0 Monongalia Health System Inc 1200 JD Anderson Drive Morgantown WV 26505 550621551 Parent/management company WV 501(c)(3) Line 12b, II N/A 0 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 N/A 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 System 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 System Inc 0 Stonewall Jackson Memorial Hospital 230 Hospital Plaza Weston WV 26452 550422958 Hospital WV 501(c)(3) Line 3 Monongalia Health System Inc 0 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 26505 550570209 Office Rental WV Monongalia Health System Inc C 0 Stonewall Home Oxygen Therapy Inc 100 Market Place Mall Suite8 Weston WV 26452 550754278 Oxygen therapy services WV Stonewall Jackson Memorial Hospital C 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1