2025-11-17T18:46:31-06:00 2024-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 46204 990 2024-01-01 237441353 MONONGALIA COUNTY GENERAL HOSPITAL CO MONO 3045981242 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 JEFF SANDENE EXECUTIVE VP AND CFO 3045981242 2025-11-17 1 1 ANGELA M MOORE P00244342 3174648600 2024 2025-03-06 01:10:19Z MON HEALTH MEDICAL CENTER DAVID S GOLDBERG 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 417679584 0 X WWW.MONHEALTHSYS.ORG X 1972 WV TO DELIVER THE BEST HEALTHCARE AND REMAIN THE PROVIDER OF CHOICE IN OUR REGIONAL SERVICE AREA BECAUSE OF OUR QUALITY, RESPECT, INTEGRITY, AND CREATIVITY, AS WELL AS OUR DEDICATION TO PATIENT SAFETY. 13 8 2819 8 948116 0 197257 520565 377781148 403573789 1869872 3810255 4399653 2165693 384247930 410070302 0 0 0 0 143556931 162382437 0 0 0 205974939 219112333 349531870 381494770 34716060 28575532 326526981 412242412 134205758 186992811 192321223 225249601 TO ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. 0 0 304034018 404176345 MONONGALIA GENERAL HOSPITAL (MGH) IS A 154-BED GENERAL, ACUTE CARE HOSPITAL IN MORGANTOWN, WV.MGH PROVIDES A WIDE ARRAY OF OUTPATIENT SERVICES INCLUDING OUTPATIENT SURGERY (11,508 SURGERIES), PHYSICIAN OFFICES (179,591 VISITS), AND MANY OTHER SERVICES. SOME OTHER SERVICES INCLUDE CARDIAC CATHETERIZATION, CT SCAN, MRI, NUCLEAR MEDICINE, AND ULTRASOUND. 304034018 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 0 0 0 1 128 0 1 2819 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 WV X GENE TOWNSEND - MANAGING ACCOUNTANT 3042853676 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 WILLIAM MCBEE MD DIRECTOR 50.00 0.00 X 2173655 0 57800 DAVID GOLDBERG DIRECTOR & MHS CEO 1.00 57.00 X X 532898 463686 51139 SHANE PRETTYMAN MD DIRECTOR/CHIEF OF STAFF 50.00 0.00 X 542369 0 58210 KRYSTAL ATKINSON DIRECTOR & MHMC CAO 1.00 50.00 X X 266591 183623 58305 KIMBERLY MOYERS CHAIRMAN 1.00 0.00 X X 0 0 0 NATALIE STONE VICE CHAIR 1.00 2.00 X X 0 0 0 SAM CHICO III SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 DEAN HATCHER DIRECTOR 1.00 0.00 X 0 0 0 DONALD ROBINSON DIRECTOR 1.00 0.00 X 0 0 0 PASTOR JUNIUS LEWIS DIRECTOR 1.00 0.00 X 0 0 0 PATTI HODGES DIRECTOR 1.00 0.00 X 0 0 0 RANDY BUZZO DIRECTOR 1.00 1.00 X 0 0 0 WESLEY DEADRICK DIRECTOR 1.00 0.00 X 0 0 0 MARY EDWARDS VICE PRESIDENT MEDICAL AFFAIRS 40.00 0.00 X 280741 177294 58306 KEVIN GESSLER VP FINANCE 10.00 40.00 X 168361 123519 21515 KAREN FRIGGENS VP PHYSICIAN SERVICES 50.00 0.00 X 163859 112817 32795 LUELLA GUNTER EXECUTIVE DIRECTOR PHILANTHROPY 10.00 40.00 X 129930 70269 32841 ALEXANDER NAGY PHYSICIAN 40.00 0.00 X 1081004 0 58210 KRISHNA BINGI PHYSICIAN 40.00 0.00 X 987692 0 58209 WISSAM GHARIB PHYSICIAN 40.00 0.00 X 958393 20185 58209 JOHN NASR PHYSICIAN 40.00 0.00 X 998509 0 25748 JASCHAR SHAKURI-RAD PHYSICIAN 50.00 0.00 X 922311 6488 56888 9206313 1157881 628175 240 0 1 0 QUALIVIS LLC PO BOX 674913 DALLAS TX 752674913 AGENCY SERVICES 7630918 NORTHSTAR ANESTHESIA OF WEST VIRGINIA PO BOX 226804 DALLAS TX 752226804 MEDICAL SERVICES 7507291 WEDGEWOOD PHYSICIANS INC 1197 VAN VOORHIS ROAD MORGANTOWN WV 26505 MEDICAL SERVICES 1868713 ASSOCIATED SPECIALISTS INC 527 MEDICAL PARK DR SUITE 204 BRIDGEPORT WV 26330 MEDICAL SERVICES 1540800 ACCELERATED CONSTRUCTION SERVICES LLC 300 BUSINESS PARK DRIVE MORGANTOWN WV 26508 CONSTRUCTION SERVICES 1271142 34 319881 200684 200684 520565 PATIENT SERVICE REV 621990 400392357 399444241 948116 PHARMACY SALES 456110 3181432 3181432 403573789 1159057 1159057 592644 0 592644 592644 592644 2803489 7456991 0 7609282 2803489 -152291 2651198 2651198 CHILD CARE REV-TUITION 624410 495844 495844 MANAGEMENT FEES 541610 25868 25868 CAFETERIA SALES 722514 22377 22377 1028960 1028960 1573049 410070302 404176345 948116 4425276 X 1248591 1110488 138103 992070 882340 109730 123860027 110160241 13699786 3745742 3371168 374574 24296904 21609496 2687408 8239103 7415193 823910 3238 3238 280473 280473 42092528 36174046 5918482 7169 7169 1464087 1194580 269507 14124 11299 2825 8556601 6662772 1893829 318261 269047 49214 88346 70677 17669 3783769 3783769 10096251 8077001 2019250 3010143 3010143 MEDICAL SUPPLIES 83393946 83393946 MANAGEMENT FEES 43451011 43451011 MEDICAID TAX 13798307 13798307 REPAIRS AND MAINTENANCE 6152808 4922246 1230562 2601271 1893859 707412 381494770 304034018 77460752 0 3618804 8803 0 4062831 80558715 108385211 6233198 9412471 1006360 426151 150068210 16633378 138970954 133434832 41942949 152581 15248464 17439449 16348179 0 4612247 38947537 117959657 326526981 412242412 25668903 48853579 0 12129 88803221 85663736 0 265307 19733634 52198060 134205758 186992811 X 192321223 225249601 192321223 225249601 326526981 412242412 X 28575532 5258993 -906147 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6030000 6030000 100751423 7903700 92847723 525295 172452 352843 26289088 8348780 17940308 16472404 208446 16263958 133434832 AFFILIATE RECEIVABLES - VANDALIA HEALTH SUBSIDIARIES' 102158611 MALPRACTICE RECEIVABLE 8139661 BOND ACQUISITION FUND 1606604 RETIREMENT FUNDS 1428378 MALPRACTICE FUND 4626403 117959657 ESTIMATED MALPRACTICE CLAIMS 18311031 AFFILIATE PAYABLES - VANDALIA HEALTH SUBSIDIARIES' 25210257 ESTIMATED WORKERS COMPENSATION CLAIMS 1624042 SETTLEMENTS DUE TO 3RD PARTIES 401440 UMBRELLA TRUST AND SERP 6651290 52198060 X PART X, LINE 2: THE IRS HAS DETERMINED THAT THE SYSTEM ENTITIES ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE CODE AND APPLICABLE STATE STATUTES, EXCEPT FOR MHC, FHE, CMC, AND HFI, WHICH ARE CORPORATIONS SUBJECT TO INCOME TAX. THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2024. 1 1 1 X 0 1 1 0 0 806984 0 806984 0.00220 44760669 11810218 32950451 0.09040 0 45567653 11810218 33757435 0.09260 4194 0 4194 0.00000 1058063 0 1058063 0.00290 0 0 67349 0 67349 0.00020 1129606 1129606 0.00310 46697259 11810218 34887041 0.09570 0 17052992 0 55599681 74618037 -19018356 X 1 1 1 1 MONONGALIA COUNTY GENERAL HOSPITAL CO 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 HTTPS://WWW.MONHEALTH.COM/MAIN 35 X X X MONONGALIA COUNTY GENERAL HOSPITAL CO 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X HTTPS://WWW.MONHEALTH.COM/MAIN/COMMUNITY-WELLNESS X 1 23 1 HTTPS://WWW.MONHEALTH.COM/MAIN/COMMUNITY-WELLNESS 0 1 X 200.000000000000 X X X X 1 1 X X X 1 X HTTPS://WWW.MONHEALTH.COM/MAIN/FINANCIAL-ASSISTANCE X HTTPS://WWW.MONHEALTH.COM/MAIN/FINANCIAL-ASSISTANCE X HTTPS://WWW.MONHEALTH.COM/MAIN/FINANCIAL-ASSISTANCE X X X X 1 X 0 X X X X 1 X 0 0 MONONGALIA COUNTY GENERAL HOSPITAL CO. PART V, SECTION B, LINE 5: MON HEALTH PARTNERED WITH WEST VIRGINIA UNIVERSITY'S OFFICE OF HEALTH AFFAIRS (WVU OHA) TO COMPLETE THE CHNA USING A ROBUST COMMUNITY BASED PROCESS DESIGNED TO ENGAGE A BROAD REPRESENTATION OF COMMUNITY MEMBERS. A CHNA LEADERSIHP TEAM INCLUDING HOSPITAL AND COMMUNITY REPRESENTATION WAS CONVENED BY MHMC TO INFORM AND GUIDE THE PROCESS. FOR THE 2022 PROCESS, THREE ENTITIES WITHIN MONONGALIA COUNTY CAME TOGETHER TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSSESSMENT PROCESS TOGETHER FOR THE FIRST TIME. MON HEALTH MEDICAL CENTER, IN PARTNERSHIP WITH WVU MEDICINE RUBY MEMORIAL HOSPITAL AND THE MONONGALIA COUNTY HEALTH DEPARTMENT, COLLABORATED TO DEVELOP A COOPERATIVE DATA COLLECTION EFFORT THAT WOULD HELP COLLECTIVELY MEET REPORTING REQUIREMENTS FOR EACH. DUE TO CLINIC AND CAMPUS LOCATIONS IN MONONGALIA COUNTY, THIS TEAM DEFINED THE COMMUNITY SERVED AS MONONGALIA AND MARIONCOUNTIES IN WEST VIRGINIA. TWO PRIMARY SOURCES OF DATA WERE UTILIZED TO INFORM THE CHNA: 1) A PUBLIC INPUT SURVEY AND 2) A DATA PRESENTATION SESSION WHERE INFORMATION WAS GATHERED FROM ATTENDEES. MONONGALIA COUNTY GENERAL HOSPITAL CO. PART V, SECTION B, LINE 6A: WVU MEDICINE RUBY MEMORIAL HOSPITAL MONONGALIA COUNTY GENERAL HOSPITAL CO. PART V, SECTION B, LINE 6B: WEST VIRGINIA UNIVERSITY'S OFFICE OF HEALTH AFFAIRS (WVU OHA) AND MONONGALIA COUNTY HEALTH DEPARTMENT MONONGALIA COUNTY GENERAL HOSPITAL CO. PART V, SECTION B, LINE 11: THOUGH COMMUNITY HEALTH NEEDS WERE IDENTIFIED, MANY NEEDS ARE OUTSIDE OF THE SCOPE OF SERVICES OFFERED BY MONONGALIA GENERAL HOSPITAL. FOR NEEDS WITHIN THE SCOPE OF MONONGALIA GENERAL HOSPITAL, THE BOARD AND ADMINISTRATION HAVE DEVELOPED AN IMPLEMENTATION STRATEGY. PART I, LINE 7: THE HOSPITAL USED A COST-TO-CHARGE RATIO DERIVED FROM MEDICARE COST REPORT FOR TOTAL PROGRAM COSTS AND TOTAL PROGRAM CHARGES TO ESTIMATE THE OVERALL COST-TO-CHARGE RATIO (CCR). THIS CCR WAS USED IN COMPUTATIONS FOR UNREIMBURSED MEDICAID AND CHARITY CARE. 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 $ 17,052,992. PART III, LINE 4: 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 HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. 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 PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE 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 BAD DEBT EXPENSE WHEN RECEIVED. INTEREST IS NOT CHARGED ON PATIENT ACCOUNTS RECEIVABLE. PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. THE COSTS ARE ALLOCATED TO THE VARIOUS DEPARTMENTS USING A STEP DOWN APPROACH AND REMOVING ANY COSTS THAT ARE NOT ALLOWABLE UNDER MEDICARE RULES. THE ORGANIZATION IS A TAX EXEMPT, NOT-FOR-PROFIT ENTITY THAT SERVES MONONGALIA AND SURROUNDING COUNTIES PATIENT POPULATION REGARDLESS OF THEIR MEANS TO PAY OR HEALTH INSURANCE STATUS. MEDICARE PATIENTS IN OUR SERVICE AREA DEPEND ON THE ORGANIZATION TO DELIVER THEIR HEALTH CARE AND MEET THEIR MEDICAL NEEDS REGARDLESS OF MEDICARE COVERAGE OF COST FOR PROVIDING THE NEEDED SERVICE. SINCE THE ORGANIZATION CONSTANTLY WORK TO OPERATE AS COST EFFICIENT AS POSSIBLE, WE FEEL STRONGLY THAT MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. PART III, LINE 9B: THERE ARE PROVISIONS IN THE DEBT COLLECTION POLICY TO BE FOLLOWED FOR PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. THE POLICY STATES THAT FINANCIAL ASSISTANCE SHALL BE OFFERED TO THE HOSPITAL'S UNINSURED AND UNDERINSURED PATIENTS ON A NONDISCRIMINATORY BASIS TO MEET THE NEED OF THE COMMUNITY. CHARITY CARE REQUESTS WILL BE REVIEWED AND EVALUATED BY THE CFO AND DIRECTOR OF PATIENT ACCOUNTING FOR APPROVAL. PATIENTS THAT QUALIFY FOR 100% CHARITY CARE ARE NOT PURSUED FOR COLLECTION. PART VI, LINE 2: THE CHNA PROCESS BEGAN WITH A THOROUGH REVIEW OF THE PREVIOUS CYCLE'S NEEDS ASSESSMENT REPORT, AND INCLUDED A REVIEW OF PUBLICLY AVAILABLE SECONDARY DATA RELATED TO COUNTIES WITHIN MON GENERAL'S SERVICE AREA. THESE DATA INCLUDED THE ABOVE U.S. CENSUS DATA AND COUNTY HEALTH RANKINGS DATA. USING THESE REPORTS AS A SPRINGBOARD, THE LEADERSHIP TEAM STARTED THE INITIAL DISCUSSION AROUND CRITICAL HEALTH NEEDS, CHANGES IN THE COMMUNITY DEMOGRAPHICS OVER THE PREVIOUS FEW YEARS, AND LESSONS LEARNED FROM THE LAST CHNA CYCLE'S HEALTH TOPIC PRIORITIZATION AND DEVELOPMENT OF IMPLEMENTATION ACTIVITIES. PRIMARY DATA COLLECTION WAS COMPRISED OF SURVEYING COMMUNITY MEMBERS TO GATHER PERCEPTIONS OF HEALTH ISSUES, QUALITY OF LIFE, AND OTHER RELATED TOPICS. SURVEY DATA WAS ANALYZED AND PRESENTED BACK TO THE MHMC LEADERSHIP TEAM AS WELL AS THE MONONGALIA COUNTY COLLABORATIVE TEAM AT A DATA PRESENTATION HOSTED VIRTUALLY. THIS EVENT WAS FOCUSED ON REVIEWING THE SURVEY DATA, DISCUSSING COMMUNITY ASSETS THAT IMPACT POPULATION HEALTH IN MHMC'S SERVICE AREA, AS WELL AS DISCUSSING THE NEEDS OF THOSE NOT WELL REPRESENTED IN THE SURVEY DATA. AT THIS MEETING, THE GROUP WORKED TO DISCUSS POSSIBLE STRATEGIES FOR EACH AREA OF CONCERN, AS WELL AS EXISTING RESOURCES TO ADDRESS THESE NEEDS. EACH ENTITY OF THE COLLABORATIVE TEAM FOCUSED ON RESOURCES SPECIFIC TO THEIR ORGANIZATION, BUT MANY OF THE PROGRAMS SERVE THE SAME COMMUNITY. THE COLLABORATIVE TEAM INTENDS TO MOVE FORWARD WITH AT LEAST ONE JOINT IMPLEMENTATION STRATEGY TO SERVE THEIR COMMUNITY AS A WHOLE. PART VI, LINE 3: THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (FAP) AND FAP APPLICATION ARE AVAILABLE ON THE HOSPITAL'S WEBSITE. PAPER COPIES OF THE FAP, PLAIN LANGUAGE SUMMARY OF THE FAP, AND FAP APPLICATION ARE AVAILABLE UPON REQUEST AND COPIES ARE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. THE HOSPITAL HAS SIGNS THAT NOTIFY THE PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. UNINSURED PATIENTS ARE PROVIDED A PLAIN LANGUAGE SUMMARY AND FAP APPLICATION FORM. BILLING STATEMENTS INCLUDE A NOTICE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO OBTAIN INFORMATION. THE HOSPITAL HAS FINANCIAL COUNSELORS AVAILABLE TO EDUCATE PATIENTS ON THE ELIGIBILITY OF ASSISTANCE. PART VI, LINE 4: FOR THE 2022 PROCESS, THREE ENTITIES WITHIN MONONGALIA COUNTY CAME TOGETHER TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS TOGETHER FOR THE FIRST TIME. MON HEALTH MEDICAL CENTER, IN PARTNERSHIP WITH WVU MEDICINE RUBY MEMORIAL HOSPITAL AND THE MONONGALIA COUNTY HEALTH DEPARTMENT, COLLABORATED TO DEVELOP A COOPERATIVE DATA COLLECTION EFFORT THAT WOULD HELP COLLECTIVELY MEET REPORTING REQUIREMENTS FOR EACH. DUE TO CLINIC AND CAMPUS LOCATIONS BEYOND MONONGALIA COUNTY, THIS TEAM DEFINED THE COMMUNITY SERVED AS MONONGALIA AND MARION COUNTIES IN WEST VIRGINIA. PART VI, LINE 5: THE HOSPITAL HAS AN OPEN MEDICAL STAFF SERVING A MULTITUDE OF SPECIALTIES. THE BOARD OF DIRECTORS IS COMPRISED OF VARIOUS MEMBERS OF THE COMMUNITY AS REQUIRED UNDER ITS BYLAWS. THE ORGANIZATION SPONSORS AN ANNUAL HEALTH FAIR AT THE LOCAL MALL, IN WHICH THOUSANDS OF CITIZENS FROM THE LOCAL COMMUNITY COME TO LEARN ABOUT SERVICES OFFERED AND ARE PROVIDED THE OPPORTUNITY TO RECEIVE MULTIPHASIC BLOODWORK FOR A NOMINAL FEE. PART VI, LINE 6: THE HOSPITAL IS PART OF MONONGALIA HEALTH SYSTEM, INC. WHICH INCLUDES THE FOLLOWING OTHER HEALTH CARE ENTITIES IN THE COMMUNITY: MON HEALTH MARION NEIGHBORHOOD HOSPITAL, MON ELDER SERVICES, INC. DBA THE VILLAGE AT HERITAGE POINT, MON HEALTH CARE, INC., PRESTON MEMORIAL HOSPITAL, PRESTON MEMORIAL MEDICAL GROUP, AND STONEWALL JACKSON MEMORIAL HOSPITAL. MON HEALTH MARION NEIGHBORHOOD HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL. MON ELDER SERVICES, INC. IS A NOT-FOR-PROFIT RESIDENTIAL AND ASSISTED LIVING PROVIDER. MON HEALTH CARE, INC. IS A FOR-PROFIT DURABLE MEDICAL EQUIPMENT RETAILER. PRESTON MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL. PRESTON MEMORIAL MEDICAL CENTER GROUP IS A NOT-FOR-PROFIT ENTITY WHICH PROVIDES PRIMARY AND URGENT CARE. STONEWALL JACKSON MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL. IN 2022 THE MON HEALTH SYSTEM AND CHARLESTON AREA MEDICAL CENTER HEALTH SYSTEM MERGED TO FORM A NEW SYSTEM NAMED VANDALIA HEALTH. PART VI, LINE 7, REPORTS FILED WITH STATES WV 0 1 0 0 0 0 0 0 0 WILLIAM MCBEE MD DIRECTOR 2173021 0 0 0 634 0 13800 0 44000 0 2231455 0 0 0 ALEXANDER NAGY PHYSICIAN 995841 0 80000 0 5163 0 13800 0 44410 0 1139214 0 0 0 DAVID GOLDBERG DIRECTOR & MHS CEO 517871 218957 0 241048 15027 3681 4847 8953 25813 11526 563558 484165 0 0 KRISHNA BINGI PHYSICIAN 987269 0 0 0 423 0 13800 0 44409 0 1045901 0 0 0 WISSAM GHARIB PHYSICIAN 757421 20185 200000 0 972 0 13800 0 44409 0 1016602 20185 0 0 JOHN NASR PHYSICIAN 955178 0 38500 0 4831 0 13800 0 11948 0 1024257 0 0 0 JASCHAR SHAKURI-RAD PHYSICIAN 917888 6488 4000 0 423 0 13800 0 43088 0 979199 6488 0 0 SHANE PRETTYMAN MD DIRECTOR/CHIEF OF STAFF 512946 0 29000 0 423 0 13800 0 44410 0 600579 0 0 0 MARY EDWARDS VICE PRESIDENT MEDICAL AFFAIRS 280212 117975 0 59034 529 285 8956 4844 29878 14628 319575 196766 0 0 KRYSTAL ATKINSON DIRECTOR & MHMC CAO 265073 182804 0 0 1518 819 9426 4373 30816 13690 306833 201686 0 0 KEVIN GESSLER VP FINANCE 167193 72797 0 50560 1168 162 6437 2928 8450 3700 183248 130147 0 0 KAREN FRIGGENS VP PHYSICIAN SERVICES 162281 66026 0 46414 1578 377 8439 2688 14313 7355 186611 122860 0 0 LUELLA GUNTER EXECUTIVE DIRECTOR PHILANTHROPY 129486 56660 0 13378 444 231 5321 2352 16694 8474 151945 81095 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: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B 457(F) INELIGIBLE DEFERRED COMPENSATION PLAN - A 457 F PLAN IS OFFERED TO CERTAIN MANAGEMENT AND/OR HIGHLY COMPENSATED EMPLOYEES TO OFFER THOSE EMPLOYEES A DEFERRED COMPENSATION OPPORTUNITY. THE PLAN IS INTENDED TO BE A "TOP-HAT PLAN", OR UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF EMPLOYEES. PARTICIPANTS MAY BECOME VESTED IN AMOUNTS CREDITED ON JANUARY 1 ELECTED BY THE PARTICIPANT AT THE TIME THE INITIAL DEFERRAL WAS ELECTED. A PARTICIPANT SHALL BECOME FULLY VESTED UPON DEATH, DISABILITY, ATTAINMENT OF AGE 60, OR SEPARATION OF SERVICE, AS DEFINED BY THE PLAN. ANY UNVESTED CONTRIBUTIONS SHALL BE FORFEITED TO THE PLAN OR EMPLOYER. FOR 2024: PER BENEFITS - NO DISTRIBUTIONS / PAYMENTS WERE MADE FROM THE PLAN; DAVID GOLDBERG WAS THE ONLY PARTICIPANT A MONONGALIA COUNTY BUILDING COMMISSION 550714648 000000000 2021-06-30 6649397 REFUND BONDS ISSUED 4/20/2011 0 0 0 B MONONGALIA COUNTY BUILDING COMMISSION 550714648 000000000 2019-07-01 34250000 REFUND BONDS ISSUED 3/28/12 0 0 0 C MONONGALIA COUNTY BUILDING COMMISSION 550714648 610218BN8 2015-04-28 55725495 REFUND BONDS ISSUED 6/15/2005 AND TO FINANCE CERTAIN CAPITAL PROJECTS 0 0 0 A 961645 6649397 66991 6582406 1 0 1 1 B 520000 34250000 34250000 1 0 1 1 C 14860000 51450000 776600 5198733 49750162 2016 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 1 0 0 0 0 B 0 0 0 0 1 0 0 0 0 C 0 0 0 1 0 0 0 0 0 A 0 B 0 C 0 EARNINGS FOR 2015 PROJECT FUND COLUMN C: DIFFERENCES BETWEEN THE ISSUE PRICE (PART 1) AND THE TOTAL PROCEEDS (PART II, LINE 3) ARE DUE TO INVESTMENT EARNINGS REBATE CALCULATION DATE OF REBATE CALCULATION FOR 2015 BONDS IS SAMANTHA HATCHER DAUGHTER OF BOARD MEMBER 65952 FAMILY MEMBER COMPENSATION 0 JESSICA MCBEE WIFE OF WILLIAM MCBEE MD 151039 FAMILY MEMBER COMPENSATION 0 MARCIE PRETTYMAN WIFE OF SHANE PRETTYMAN MD 76440 FAMILY MEMBER COMPENSATION 0 CHRISTOPHER EDWARDS HUSBAND OF MARY EDWARDS 657418 FAMILY MEMBER COMPENSATION 0 TAMMY STRAUB SISTER OF KAREN FRIGGENS 41221 FAMILY MEMBER COMPENSATION 0 X PULSE OXIMETRY SENSORS 1 200684 COST OR SELLING PRIC 0 0 0 PART I, COLUMN (B): SCHEDULE M, PART I, COLUMN (B): THE NUMBERS ABOVE REPRESENT THE NUMBER OF CONTRIBUTORS THAT CONTRIBUTED THE ITEMS TO MON COUNTY GENERAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 2 DAVID GOLDBERG AND KEVIN GESSLER HAVE A BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MONONGALIA COUNTY GENERAL HOSPITAL IS MONONGALIA HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A MONONGALIA COUNTY GENERAL HOSPITAL'S BOARD MEMBERS ARE ELECTED OR APPOINTED BY MONONGALIA HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B MONONGALIA COUNTY GENERAL 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 TO THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B THE GOVERNING BODY IS PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW PRIOR TO SUBMISSION. THE BOARD MEMBERS ARE ASKED TO INFORM MANAGEMENT OF ANY QUESTIONS OR REVISIONS THEY MAY HAVE. IF CHANGES ARE MADE, BASED ON BOARD MEMBER'S REVISIONS, MANAGEMENT REDISTRIBUTES A FINAL VERSION TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY A CONFLICT OF INTEREST QUESTIONNAIRE IS SENT OUT TO ALL BOARD MEMBERS. THE BOARD THEN REVIEWS ALL RESPONSES FOR POSSIBLE CONFLICTS OF INTEREST. IF A CONFLICT IS NOTED, THE BOARD MEMBERS DETERMINE WHICH DECISIONS THE CONFLICTED MEMBER SHALL NOT PARTICIPATE IN. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS PAID BY MONONGALIA HEALTH SYSTEM AND MONONGALIA COUNTY GENERAL HOSPITAL CO. ANNUALLY, A CONSULTANT COMPILES A MARKET DATA REPORT ON EXECUTIVE CEO COMPENSATION. THIS REPORT IS THEN REVIEWED BY THE EXECUTIVE COMMITTEE OF MONONGALIA HEALTH SYSTEM TO DETERMINE COMPENSATION FOR THE INDIVIDUAL. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE KEPT ONSITE AT MONONGALIA GENERAL HOSPITAL AND ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 36,174,046. MANAGEMENT AND GENERAL EXPENSES 5,918,482. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,092,528. FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY -906,147. CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS TRANSFERS VANDALIA HEALTH INC PO BOX 1547 CHARLESTON WV 253261547 550664138 PARENT COMPANY WV 501(C)(3) 12C, III-FI N/A 0 CAMC FOUNDATION INC PO BOX 1547 CHARLESTON WV 253261547 310887133 FUNDRAISING WV 501(C)(3) 12A, I CHARLESTON AREA MEDICAL CENTER INC 1 CHARLESTON AREA MEDICAL CENTER INC PO BOX 1547 CHARLESTON WV 253261547 550526150 HOSPITAL WV 501(C)(3) 3 VANDALIA HEALTH INC 0 MONONGALIA HEALTH SYSTEM INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550621551 PARENT COMPANY WV 501(C)(3) 12C, III-FI VANDALIA HEALTH INC 0 MON ELDER SERVICES INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 311520863 CONTINUING CARE RETIREMENT CENTER WV 501(C)(3) 10 MONONGALIA HEALTH SYSTEM INC 1 THE FOUNDATION OF MONONGALIA GENERAL HOSPITAL 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550570338 RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL WV 501(C)(3) 7 MONONGALIA COUNTY GENERAL HOSPITAL CO 1 PRESTON MEMORIAL HOSPITAL 150 MEMORIAL DRIVE KINGWOOD WV 26537 311097818 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 PRESTON MEMORIAL MEDICAL GROUP 300 SOUTH PRICE STREET KINGWOOD WV 26537 550717988 PRIMARY AND URGENT CARE WV 501(C)(3) 3 PRESTON MEMORIAL HOSPITAL CORPORATION 1 PRESTON MEMORIAL HOSPITAL FOUNDATION 300 SOUTH PRICE STREET KINGWOOD WV 26537 550740121 RAISE FUNDS FOR PRESTON HOSPITAL WV 501(C)(3) 12B, II PRESTON MEMORIAL HOSPITAL CORPORATION 1 AUXILIARY OF MONONGALIA GENERAL HOSPITAL INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550362965 RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL WV 501(C)(3) 12A, I MONONGALIA COUNTY GENERAL HOSPITAL CO 1 LIABILITY INSURANCE TRUST FOR MONONGALIA HEALTH SYSTEM 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550689535 LIABILITY INSURANCE TRUST WV 501(C)(3) 12A, I MONONGALIA HEALTH SYSTEM INC 1 STONEWALL JACKSON MEMORIAL HOSPITAL 230 HOSPITAL PLAZA WESTON WV 26452 550422958 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC 140 MIDDLETOWN LOOP WHITEHALL WV 26554 853994078 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 CAMC GREENBRIER VALLEY MEDICAL CENTER INC 1320 MAPLEWOOD AVENUE RONCEVERTE WV 24970 884128022 HOSPITAL WV 501(C)(3) 3 CHARLESTON AREA MEDICAL CENTER INC 1 CAMC PLATEAU MEDICAL CENTER INC 430 MAIN STREET OAK HILL WV 25901 921715117 HOSPITAL WV 501(C)(3) 3 CHARLESTON AREA MEDICAL CENTER INC 1 CAMC HEALTH EDUCATION AND RESEARCH INSTITUTE INC PO BOX 1547 CHARLESTON WV 253261547 550753754 MEDICAL EDUCATIONAL RESEARCH WV 501(C)(3) 12A, I CHARLESTON AREA MEDICAL CENTER INC 1 DAVIS HEALTH SYSTEM INC PO BOX 1484 ELKINS WV 26241 550737655 HEALTH SYSTEM WV 501(C)(3) 12B, II MONONGALIA HEALTH SYSTEM INC 1 DAVIS MEMORIAL HOSPITAL INC PO BOX 1484 ELKINS WV 26241 550375433 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM INC 1 BROADDUS HOSPITAL ASSOCIATION INC PO BOX 930 PHILLIPI WV 26416 550379108 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM INC 1 DAVIS HEALTH SYSTEM FOUNDATION INC PO BOX 1188 ELKINS WV 26241 320185772 PROVIDES SUPPORT TO DAVIS HEALTH SYSTEM ENTITIES WV 501(C)(3) 10 DAVIS HEALTH SYSTEM INC 1 WEBSTER MEMORIAL HOSPITAL 812 GORMAN AVENUE ELKINS WV 26241 871759588 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM INC 1 GENERAL DIVISION MEDICAL OFFICE BUILDING LLC PO BOX 1547 CHARLESTON WV 253261547 550623949 MEDICAL OFFICE BUILDING WV N/A 0 0 DASCO-CAMC HOME MEDICAL EQUIPMENT LLC 501 MORRIS STREET CHARLESTON WV 25301 844487189 HOME MEDICAL EQUIPMENT WV N/A 0 0 MGH SURGERY LLC 2000 MON HEALTH MEDICAL PARK DRIVE MORGANTOWN WV 26505 472736896 SURGERY CENTER WV MONONGALIA COUNTY GENERAL HOSPITAL CO RELATED 2672520 2470320 0 0 0.51000 MON HEALTH-DASCO HOME MEDICAL EQUIPMENT LLC 375 N WEST ST WESTERVILLE OH 43082 871577276 HOME MEDICAL EQUIPMENT OH N/A 0 0 CHARLESTON SURGICAL HOSPITAL LLC 1306 KANAWHA BLVD E CHARLESTON WV 25301 550526191 SURGERY CENTER WV N/A 0 0 VANDALIA INSURANCE COMPANY 76 ST PAUL STREET STE 500 BURLINGTON VT 05401 030308754 INSURANCE VT N/A C 1 MON HEALTH CARE INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550654973 MEDICAL EQUIPMENT WV N/A C 1 STONEWALL HOME OXYGEN THERAPY INC 100 MARKET PLACE MALL SUITE 8 WESTON WV 26452 550754278 OXYGEN THERAPY SERVICES WV N/A C 1 HEALTH FACILITIES INC 909 GORMAN AVENUE ELKINS WV 26241 550516937 HEALTH CARE WV N/A C 1 CENTRAL WV MEDCORP INC PO BOX 2630 ELKINS WV 26241 550739314 PHYSICIAN SERVICES WV N/A C 1 DAVIS REGIONAL HEALTH PARTNERS INC PO BOX 2632 ELKINS WV 26241 550746206 CONTRACT NEGOTIATIONS WV N/A C 1 XERCOR RE SEGREGATED PORTFOLIO #2 DAVIS 18 FORUM LANE 2ND FLOOR GRAND CAYMAN CAYMAN ISLANDS CJ KY1-1102 CAPTIVE INSURANCE CJ N/A C 1 FAIRMONT HOME EQUIPMENT AND SUPPLY 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550763259 EQUIPMENT RENT & SVC WV N/A C 1 0 0 1 0 0 0 0 0 0 1 1 0 1 0 1 1 1 0 0 MON ELDER SERVICES INC P 1064159 FAIR MARKET VALUE STONEWALL JACKSON MEMORIAL HOSPITAL P 484064 FAIR MARKET VALUE PRESTON MEMORIAL HOSPITAL P 361618 FAIR MARKET VALUE MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC P 152827 FAIR MARKET VALUE MON ELDER SERVICES INC Q 1559286 FAIR MARKET VALUE STONEWALL JACKSON MEMORIAL HOSPITAL Q 7789640 FAIR MARKET VALUE PRESTON MEMORIAL HOSPITAL Q 8422342 FAIR MARKET VALUE THE FOUNDATION OF MONONGALIA GENERAL HOSPITAL Q 106134 FAIR MARKET VALUE MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC Q 11867876 FAIR MARKET VALUE MON HEALTH CARE INC Q 120801 FAIR MARKET VALUE DAVIS MEMORIAL HOSPITAL INC Q 16898001 FAIR MARKET VALUE THE FOUNDATION OF MONONGALIA GENERAL HOSPITAL C 319881 FAIR MARKET VALUE