STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY: Form 990, tax year 2024
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- Organization
- STONEWALL JACKSON MEMORIAL HOSPITAL COMPANY (EIN 55-0422958)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-11-17
- IRS object ID
- 202523219349323232
- Schema version
- 2024v5.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-11-17T18:03:49-06:00 | ReturnTs |
| Tax Period End | 2024-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 MONUMENT CIRCLE SUITE 4200 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550422958 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STONEWALL JACKSON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STON | BusinessNameControlTxt |
| Phone | 3042698059 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 HOSPITAL PLAZA | AddressLine1Txt |
| City | WESTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26452 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFF SANDENE | PersonNm |
| Person Title | EXECUTIVE VP AND CFO | PersonTitleTxt |
| Phone | 3042698059 | PhoneNum |
| Signature | 2025-11-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANGELA M MOORE | PreparerPersonNm |
| PTIN | P00244342 | PTIN |
| Phone | 3174648600 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID GOLDBERG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 HOSPITAL PLAZA | AddressLine1Txt |
| City | WESTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26452 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $56,044,239 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MONHEALTH.COM/SJMH | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1959 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 482 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $17,261 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $47,579,940 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $52,833,552 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,248,668 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,293,197 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,317,566 | PYOtherRevenueAmt |
| CY Other Revenue | $1,901,016 | CYOtherRevenueAmt |
| PY Total Revenue | $50,163,435 | PYTotalRevenueAmt |
| CY Total Revenue | $56,027,765 | 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 | $25,876,272 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $30,452,710 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $27,870,138 | PYOtherExpensesAmt |
| CY Other Expenses | $28,728,006 | CYOtherExpensesAmt |
| PY Total Expenses | $53,746,410 | PYTotalExpensesAmt |
| CY Total Expenses | $59,180,716 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,582,975 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,152,951 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $65,998,448 | TotalAssetsBOYAmt |
| Total Assets EOY | $77,889,006 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,935,910 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $24,265,503 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $54,062,538 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $53,623,503 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $46,246,246 | ExpenseAmt |
| Revenue | $54,675,037 | RevenueAmt |
| Desc | STONEWALL JACKSON MEMORIAL HOSPITAL PROVIDES ACUTE MEDICAL AND OUTPATIENT SERVICES TO RESIDENTS OF WESTON, WEST VIRGINIA AND SURROUNDING COMMUNITIES WHICH COVERS 10 DIFFERENT COUNTIES. SERVICES INCLUDED 4,498 DAYS OF INPATIENT CARE, 244,092 OUTPATIENT VISITS, 12,059 EMERGENCY ROOM VISITS, AND 29,177 PHYSICIAN CLINIC VISITS. THE HOSPITAL HAD 109 DELIVERIES DURING THE YEAR IN WHICH APPROXIMATELY 71% WERE MEDICAID PATIENTS. MANY OF THESE BABIES HAD SIGNIFICANT SUBSTANCE ABUSE PROBLEMS. DUE TO THE DRUG ADDICTION PROBLEMS OF THE MOTHERS, VERY FEW OF THESE WOMEN HAVE RECEIVED PRENATAL CARE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ANNUAL BLOOD SCREENING: STONEWALL JACKSON MEMORIAL HOSPITAL PROVIDES ALL SUPPLIES AND STAFF TO OPERATE THE PROGRAM. A PORTION OF THE EXCESS REVENUE IS FORWARDED TO THE LOCAL ROTARY CLUB TO PROMOTE CHARITABLE SERVICES. OTHER PROGRAMS INCLUDE: SCOLIOSIS SCREENING AT COUNTY ELEMENTARY AND MIDDLE SCHOOLS, HEALTH FAIRS AT THE LOCAL SENIOR CITIZENS CENTER, FREE SPORTS PHYSICALS TO MIDDLE AND HIGH SCHOOL STUDENTS, CHILDREN'S SAFETY DAY TO PROMOTE HEALTHY CHOICES TO CHILDREN UNDER 12 YEARS OF AGE, EVENTS FOR FREE OSTEOPOROSIS SCREENINGS, EVENTS FOR FREE DERMASCANS TO SCREEN FOR SKIN CANCER, WESTON WALK-RUN TO PROMOTE EXERCISE AS A WAY TO IMPROVE CARDIAC HEALTH, FREE WOMEN'S HEALTH SCREENING FOR BREAST AND CERVICAL CANCER, FREE VEIN SCREENINGS AND FREE HEARING SCREENINGS. REVENUE AND EXPENSES ARE INCLUDED IN LINE 4A ABOVE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | WILLIAM ADLER SCHOLARSHIP FUND - STONEWALL JACKSON MEMORIAL HOSPITAL SPONSORED PROGRAM TO PROVIDE SCHOLARSHIPS TO LOCAL GRADUATING HIGH SCHOOL SENIORS WHO ARE PURSUING A CAREER IN THE HEALTH CARE FIELD. IT IS HOPED THAT THIS PROGRAM WILL ENCOURAGE MORE STUDENTS TO SEEK HEALTH CARE PROFESSIONS AND LESSON THE HEALTH CARE STAFFING SHORTAGE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $46,246,246 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 482 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RICK SCHERICH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3042698059 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 HOSPITAL PLAZA | AddressLine1Txt |
| City | WESTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 264528558 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 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 |
|---|---|---|---|---|---|---|---|---|
| DAVID GOLDBERG | ||||||||
| DIRECTOR & MHS CEO | 1.00 | 57.00 | Yes (X) | Yes (X) | $0 | $996,584 | $51,139 | |
| DOYLE SICKLES | ||||||||
| DIRECTOR AND PHYSICIAN | 40.00 | 0.00 | Yes (X) | $242,535 | $0 | $20,415 | ||
| GREGORY CUNNINGHAM | ||||||||
| VICE CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KIM GUM | ||||||||
| SECRETARY/TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBIN POLING | ||||||||
| CHAIRMAN | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ALISSA LAMBERT | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ALLISON BARDES MD | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GEORGE STANSBERRY | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GREGORY ST CLAIR | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN LAW CPA | ||||||||
| DIRECTOR | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH SNEAD MD | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LISA SONGER | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| R GERALD WOOD | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN STALNAKER | ||||||||
| CAO | 50.00 | 2.00 | Yes (X) | $83,191 | $213,964 | $53,177 | ||
| RICK SCHERICH | ||||||||
| VP FINANCE | 20.00 | 30.00 | Yes (X) | $37,043 | $242,090 | $50,854 | ||
| RONALD PEARSON | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $917,012 | $0 | $38,850 | Yes (X) | ||
| MICHAEL GREGORY | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $641,392 | $0 | $47,427 | Yes (X) | ||
| ROBERT SNUFFER | ||||||||
| DIRECTOR OF PHYSICIANS | 40.00 | 0.00 | $575,835 | $0 | $38,850 | Yes (X) | ||
| CAROLYN MOYERS | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $419,625 | $0 | $13,800 | Yes (X) | ||
| ERIN MILLER | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $418,900 | $0 | $13,800 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,335,533 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,452,638 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $328,312 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 45 | 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 |
|---|---|---|---|---|---|
| QUALIVIS LLC | |||||
| PO BOX 674913 | DALLAS | TX | 752674913 | AGENCY SERVICES | $1,847,504 |
| UNIFORMED PHYSICIANS | |||||
| 602 VIRGINIA STREET | CHARLESTON | WV | 25301 | MEDICAL SERVICES | $543,384 |
| CONTINENTAL REPUBLIC CAPITAL LLC | |||||
| PO BOX 650841 | DALLAS | TX | 752650841 | PROFESSIONAL SERVICES | $492,603 |
| MORRISON HEALTHCARE | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | MEDICAL SERVICES | $390,149 |
| ROGER ABRAHAMS | |||||
| 5002 WOODLAND COVE ROAD | MORGANTOWN | WV | 26508 | PROFESSIONAL SERVICES | $139,861 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICES | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $52,833,552 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $52,833,552 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $52,833,552 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $473,171 | TotalRevenueColumnAmt |
| Exclusion | $473,171 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $76,005 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $16,474 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $59,531 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59,531 | TotalRevenueColumnAmt |
| Exclusion | $59,531 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $820,026 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $820,026 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $820,026 | TotalRevenueColumnAmt |
| Exclusion | $820,026 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| 340B | 900099 | $1,631,216 | $1,631,216 |
| QUALITY INCENTIVE | 900099 | $156,054 | $156,054 |
| OTHER REVENUE | 900099 | $54,215 | $54,215 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,841,485 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $56,027,765 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $54,675,037 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,352,728 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,022,699 | TotalAmt |
| Program Services | $20,948,342 | ProgramServicesAmt |
| Management And General | $5,074,357 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $844,032 | TotalAmt |
| Program Services | $683,666 | ProgramServicesAmt |
| Management And General | $160,366 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,934,233 | TotalAmt |
| Program Services | $1,557,063 | ProgramServicesAmt |
| Management And General | $377,170 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,651,746 | TotalAmt |
| Program Services | $1,321,397 | ProgramServicesAmt |
| Management And General | $330,349 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,200 | TotalAmt |
| Management And General | $1,200 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,500 | TotalAmt |
| Management And General | $9,500 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,486 | TotalAmt |
| Management And General | $116,486 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,227,406 | TotalAmt |
| Program Services | $4,646,621 | ProgramServicesAmt |
| Management And General | $580,785 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,960 | TotalAmt |
| Program Services | $2,960 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $813,273 | TotalAmt |
| Program Services | $651,396 | ProgramServicesAmt |
| Management And General | $161,877 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,786 | TotalAmt |
| Program Services | $80,629 | ProgramServicesAmt |
| Management And General | $20,157 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,636,879 | TotalAmt |
| Program Services | $1,253,083 | ProgramServicesAmt |
| Management And General | $383,796 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,818 | TotalAmt |
| Program Services | $115,750 | ProgramServicesAmt |
| Management And General | $24,068 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,464 | TotalAmt |
| Program Services | $19,372 | ProgramServicesAmt |
| Management And General | $92 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,124 | TotalAmt |
| Management And General | $80,124 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $798,851 | TotalAmt |
| Program Services | $639,081 | ProgramServicesAmt |
| Management And General | $159,770 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,424,765 | TotalAmt |
| Program Services | $1,424,765 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $10,036,297 | $10,036,297 | |
| MANAGEMENT FEES | $4,839,586 | $4,839,586 | |
| REPAIRS AND MAINTENANCE | $1,379,766 | $1,103,813 | $275,953 |
| MEDICAID PROVIDER TAX | $1,305,868 | $1,305,868 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $794,977 | TotalAmt |
| Program Services | $456,143 | ProgramServicesAmt |
| Management And General | $338,834 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,180,716 | TotalAmt |
| Program Services | $46,246,246 | ProgramServicesAmt |
| Management And General | $12,934,470 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,219,744 | BOYAmt |
| EOY | $3,028 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,428,647 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,370,891 | BOYAmt |
| EOY | $7,291,702 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,307,551 | BOYAmt |
| EOY | $1,198,824 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,476 | BOYAmt |
| EOY | $31,206 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $20,635,992 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,227,196 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,323,318 | BOYAmt |
| EOY | $19,408,796 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,179,893 | BOYAmt |
| EOY | $41,123,838 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $607,804 | BOYAmt |
| EOY | $619,414 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,057 | BOYAmt |
| EOY | $143,758 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,859,714 | BOYAmt |
| EOY | $5,639,793 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,998,448 | BOYAmt |
| EOY | $77,889,006 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,029,688 | BOYAmt |
| EOY | $6,556,321 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,037 | BOYAmt |
| EOY | $2,033,647 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,895,185 | BOYAmt |
| EOY | $15,675,535 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,935,910 | BOYAmt |
| EOY | $24,265,503 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,596,096 | BOYAmt |
| EOY | $53,157,061 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $466,442 | BOYAmt |
| EOY | $466,442 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,062,538 | BOYAmt |
| EOY | $53,623,503 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,998,448 | BOYAmt |
| EOY | $77,889,006 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$3,152,951 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,713,916 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $395 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $395 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF DUES PAID BY THE HOSPITAL TO THE WEST VIRGINIA HOSPITAL ASSOCIATION IS ATTRIBUTABLE TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,640,000 | OtherCostOrOtherBasisAmt |
| Book Value | $10,640,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $849,302 | OtherCostOrOtherBasisAmt |
| Depreciation | $116,024 | DepreciationAmt |
| Book Value | $733,278 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $97,283 | OtherCostOrOtherBasisAmt |
| Depreciation | $34,955 | DepreciationAmt |
| Book Value | $62,328 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,537,228 | OtherCostOrOtherBasisAmt |
| Depreciation | $864,510 | DepreciationAmt |
| Book Value | $1,672,718 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,512,179 | OtherCostOrOtherBasisAmt |
| Depreciation | $211,707 | DepreciationAmt |
| Book Value | $6,300,472 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $19,408,796 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| AFFILIATE RECEIVABLES - VANDALIA HEALTH SUBSIDIARIES' | $1,166,505 |
| DUE FROM THIRD-PARTY PAYORS | $4,473,288 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,639,793 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | AFFILIATE PAYABLES - VANDALIA HEALTH SUBSIDIARIES' | Desc |
| Amt | $15,675,535 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $15,675,535 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE 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. TAX RETURNS FOR THE YEAR ENDED JUNE 30, 2020, ARE OPEN FOR THE MHS ENTITIES AND TAX RETURNS FOR THE YEAR ENDED DECEMBER 31, 2021, ARE OPEN FOR CAMC ENTITIES. | ExplanationTxt |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $666,120 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $666,120 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01170 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,028,308 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,346,725 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,681,583 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13520 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,694,428 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,346,725 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,347,703 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14690 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,180 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $36,180 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $554,238 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $554,238 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00980 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $650 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $650 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $591,068 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $591,068 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01040 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,285,496 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,346,725 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,938,771 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15730 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,346,155 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,937,630 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,915,270 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,977,640 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STONEWALL JACKSON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 230 HOSPITAL PLAZA | AddressLine1Txt |
| City | WESTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26452 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MONHEALTH.COM/SJMH | WebsiteAddressTxt |
| State License | 7 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STONEWALL JACKSON MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | 0 | CHNAConductedInd |
| Organization Incur Excise Tax | Yes (1) | OrganizationIncurExciseTaxInd |
| Form4720 Filed | Yes (1) | Form4720FiledInd |
| Excise Report Form4720 For All | $50,000 | ExciseReportForm4720ForAllAmt |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.MONHEALTH.COM/SJMH/SJMH-FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.MONHEALTH.COM/SJMH/SJMH-FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.MONHEALTH.COM/SJMH/SJMH-FINANCIAL-ASSISTANCE | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | STONEWALL JACKSON MEMORIAL HOSPITAL | FormAndLineReferenceDesc |
| Explanation | PART V, SECTION B, LINE 3:STONEWALL JACKSON MEMORIAL HOSPITAL SHOULD HAVE CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING THE TAX YEAR ENDED DEC 31, 2024 BASED ON ITS EXISTING CHNA 3-YEAR CYCLE. THE HOSPITAL DID TAKE CERTAIN STEPS TO PERFORM THE CHNA DURING 2024, INCLUDING REACHING OUT TO COMMUNITY PARTNERS AND LOCAL PUBLIC HEALTH DEPARTMENTS. HOWEVER, THE HOSPITAL DID NOT COMPLETE A WRITTEN CHNA REPORT, NOR DID THE HOSPITAL BOARD ADOPT A CHNA BY DECEMBER 31, 2024. THIS LAPSE CAN BE ATTRIBUTED TO VARIOUS FACTORS WITHIN THE ORGANIZATION. THERE WAS ALSO A LEVEL OF UNCERTAINTY AMONG PERSONNEL ABOUT REGULATORY REQUIREMENTS. SPECIFICALLY, THERE WAS UNCERTAINTY REGARDING THE FACT THAT A SHORT TAX PERIOD REPRESENTS A FULL TAX YEAR IN THE CYCLE OF PROPERLY COMPLETING A CHNA EVERY THREE YEARS. THIS MISUNDERSTANDING OF THE TIMELINES AND REQUIREMENTS LED TO FURTHER DELAYS AND THE EVENTUAL FAILURE TO CONDUCT THE CHNA WITHIN THE PRESCRIBED TIMEFRAME. THE HOSPITAL RECOGNIZES THIS OVERSIGHT AND IS TAKING ACTIVE STEPS TO RECTIFY THE SITUATION. THIS INCLUDES ENSURING A CLEAR UNDERSTANDING OF THE REGULATORY REQUIREMENTS, AND PRIORITIZING THE CHNA PROCESS TO ALIGN WITH FEDERAL REGULATIONS. THESE MEASURES AIM TO PREVENT A RECURRENCE OF THIS LAPSE AND UPHOLD THE HOSPITAL'S COMMITMENT TO COMMUNITY HEALTH IMPROVEMENT AND REGULATORY COMPLIANCE. THE HOSPITAL BOARD OF DIRECTORS ADOPTED A NEW CHNA AND AN IMPLEMENTATION STRATEGY ON MAY 12, 2025. | ExplanationTxt |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE HEALTH RESOURCES AND SERVICES ADMINISTRATION ELIGIBILITY GUIDELINES ARE USED. WE ALSO EVALUATE THE PATIENT'S ASSETS AND THE AMOUNT OF MEDICAL DEBT. WE HAVE SIGNS POSTED AT REGISTRATION, AROUND AND IN THE EMERGENCY DEPARTMENT AND IN ALL PHYSICIAN CLINICS. WE SEND LETTERS TO PATIENTS WHO ARE NOT PAYING THEIR BILLS AND GIVE THE APPLICATION TO PRIVATE PAY INPATIENTS. WE ALSO TELL THE PATIENTS DURING TELEPHONE CONVERSATIONS IF THE PATIENT INDICATES HE/SHE IS NOT ABLE TO PAY THE BILL OR PAY ALL OF THE BILL. |
| PART I, LINE 7: | 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 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 $ 2,346,155. |
| PART III, LINE 2: | BAD DEBT EXPENSE AS REPORTED ON AUDITED FINANCIAL STATEMENTS |
| PART III, LINE 4: | PATIENT RECEIVABLES, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH WE HAVE THE UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF OUR RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. THE ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT ACCOUNTS RECEIVABLE. FOR CHANGES IN CREDIT ISSUES NOT ASSESSED AT THE DATE OF SERVICE, THE SYSTEM WILL PROSPECTIVELY RECOGNIZE THOSE AMOUNTS IN NET PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS. THE PROVISION FOR DOUBTFUL ACCOUNTS WAS IMMATERIAL AS OF DECEMBER 31, 2024 AND 2023. |
| PART III, LINE 8: | THE MEDICARE COST REPORT WAS USED TO DETERMINE REVENUE ALLOWABLE COSTS ASSOCIATED WITH THE REVENUE. |
| PART III, LINE 9B: | OUR COLLECTIONS POLICY APPLIES TO ALL PATIENTS REGARDLESS OF FINANCIAL CLASS OR ANY OTHER CLASSIFICATION. DURING OUR COLLECTIONS PROCESS, IF THE PATIENT INDICATES THEY DO NOT HAVE THE ABILITY TO PAY THEIR BILL, THE CREDIT STAFF OFFERS EXONERATION. |
| PART VI, LINE 2: | THE ASSESSMENT WAS CONDUCTED IN THREE PHASES: THE FIRST PHASE WAS ATTAINING BACKGROUND INFORMATION ON THE HEALTHCARE PROBLEMS OF THE LOCAL AREA AND STATE. THE SECOND PHASE WAS A SURVEY CONDUCTED ONLINE AND BY PAPER. THE LAST PHASE WAS A FOCUS GROUP CONDUCTED BY AN EXPERIENCED MEDIATOR. |
| PART VI, LINE 3: | WE HAVE SIGNS POSTED AT REGISTRATION, AROUND AND IN THE EMERGENCY DEPARTMENT, AND IN ALL PHYSICIAN CLINICS. WE SEND LETTERS TO PATIENTS WHO ARE NOT PAYING THEIR BILLS. WE GIVE THE APPLICATION TO PRIVATE PAY INPATIENTS. WE TELL THE PATIENTS DURING TELEPHONE CONVERSATIONS, IF THE PATIENT INDICATES HE/SHE IS NOT ABLE TO PAY THE BILL OR PAY ALL OF THE BILL. |
| PART VI, LINE 4: | STONEWALL JACKSON MEMORIAL HOSPITAL SERVES A RELATIVELY LARGE RURAL POPULATION OF ABOUT 65,000 PEOPLE WITH AN AVERAGE HOUSEHOLD INCOME OF $32,000. 16% OF THE POPULATION IS DISABLED. APPROXIMATELY 30% ARE MEDICAID ELIGIBLE OR ARE UNINSURED. WE ARE THE LARGEST HOSPITAL IN OUR SERVICE AREA, WHICH INCLUDES TWO OTHER HOSPITALS, ONE BEING A CRITICAL ACCESS HOSPITAL. WE ARE LOCATED IN A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. LOCATED IN NORTH CENTRAL WEST VIRGINIA, LEWIS COUNTY HAS A TOTAL AREA OF 390 SQUARE MILES, OF WHICH 382 IS LAND AND 8 SQUARE MILES IS WATER. THE COUNTY WAS CREATED FROM PART OF HARRISON COUNTY BY AN ACT OF THE VIRGINIA GENERAL ASSEMBLY ON DECEMBER 18, 1816. (WIKIPEDIA, 2012) MON HEALTH STONEWALL JACKSON MEMORIAL HOSPITAL AND THE LEWIS COUNTY HEALTH DEPARTMENT ARE BOTH LOCATED WITHIN THE CITY LIMITS OF WESTON, WV. THE COMMUNITY HEALTH NEEDS ASSESSMENT REPRESENTS RESIDENTS FROM THIS COMMUNITY. |
| PART VI, LINE 5: | STONEWALL JACKSON MEMORIAL HOSPITAL (SJMH) IS A 70 BED RURAL ACUTE CARE HOSPITAL LOCATED IN LEWIS COUNTY WEST VIRGINIA. SJMH IS THE ONLY HOSPITAL LOCATED IN THE COUNTY AS SUCH IT IS SOLELY RESPONSIBLE FOR THE HEALTHCARE OF THIS RURAL COMMUNITY. SJMH PROVIDES A 24 HOUR EMERGENCY ROOM AND OBSTETRICS SERVICES AND PROVIDES CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE MAJORITY OF THE GOVERNING BODY IS COMPRISED OF COMMUNITY MEMBERS. MEDICAL PRIVILEGES ARE OFFERED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY AND SJMH HAS WORKED DILIGENTLY TO PROVIDE OTHER PHYSICIAN SERVICES BY EXPANDING THE SERVICES THEY PROVIDE. SJMH CONTINUES TO MAKE CAPITAL IMPROVEMENT TO THE FACILITY AND EXPAND PATIENT CARE SERVICES TO MEET THE NEEDS OF THE COMMUNITY. |
| PART VI, LINE 6: | THE HOSPITAL IS PART OF MONONGALIA HEALTH SYSTEM, INC. WHICH INCLUDES THE FOLLOWING OTHER HEALTH CARE ENTITIES IN THE COMMUNITY: MONONGALIA COUNTY GENERAL HOSPITAL, MON HEALTH MARION NEIGHBORHOOD HOSPITAL, MON ELDER SERVICES, INC. DBA THE VILLAGE AT HERITAGE POINT, MON HEALTH CARE, INC., PRESTON MEMORIAL HOSPITAL, AND PRESTON MEMORIAL MEDICAL GROUP, 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. MONONGALIA COUNTY GENERAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL. ON 9/1/22 MON HEALTH SYSTEM AND CAMC HEALTH SYSTEM COMBINED TO CREATE A SINGLE HEALTHCARE SYSTEM CALLED VANDALIA HEALTH. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID GOLDBERG | ||||||||||||||
| DIRECTOR & MHS CEO | $0 | $736,828 | $0 | $241,048 | $0 | $18,708 | $0 | $13,800 | $0 | $37,339 | $0 | $1,047,723 | $0 | $0 |
| RONALD PEARSON | ||||||||||||||
| PHYSICIAN | $891,355 | $0 | $8,000 | $0 | $17,657 | $0 | $13,800 | $0 | $25,050 | $0 | $955,862 | $0 | $0 | $0 |
| MICHAEL GREGORY | ||||||||||||||
| PHYSICIAN | $630,151 | $0 | $0 | $0 | $11,241 | $0 | $13,800 | $0 | $33,627 | $0 | $688,819 | $0 | $0 | $0 |
| ROBERT SNUFFER | ||||||||||||||
| DIRECTOR OF PHYSICIANS | $574,029 | $0 | $0 | $0 | $1,806 | $0 | $13,800 | $0 | $25,050 | $0 | $614,685 | $0 | $0 | $0 |
| CAROLYN MOYERS | ||||||||||||||
| PHYSICIAN | $412,500 | $0 | $0 | $0 | $7,125 | $0 | $13,800 | $0 | $0 | $0 | $433,425 | $0 | $0 | $0 |
| ERIN MILLER | ||||||||||||||
| PHYSICIAN | $418,900 | $0 | $0 | $0 | $0 | $0 | $13,800 | $0 | $0 | $0 | $432,700 | $0 | $0 | $0 |
| KEVIN STALNAKER | ||||||||||||||
| CAO | $82,380 | $160,537 | $0 | $52,990 | $811 | $437 | $5,545 | $6,664 | $14,365 | $26,603 | $103,101 | $247,231 | $0 | $0 |
| RICK SCHERICH | ||||||||||||||
| VP FINANCE | $37,043 | $204,766 | $0 | $36,110 | $0 | $1,214 | $1,336 | $10,049 | $6,100 | $33,369 | $44,479 | $285,508 | $0 | $0 |
| DOYLE SICKLES | ||||||||||||||
| DIRECTOR AND PHYSICIAN | $239,726 | $0 | $0 | $0 | $2,809 | $0 | $9,728 | $0 | $10,687 | $0 | $262,950 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | 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 | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RALPH GERALD WOOD JR | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY MEMBER | RelationshipDescriptionTxt |
| Transaction | $30,145 | TransactionAmt |
| Transaction | EMPLOYMENT | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | DAVID GOLDBERG AND JOHN LAW HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 3 | MANAGEMENT DUTIES CUSTOMARILY ARE PERFORMED UNDER THE DIRECT SUPERVISION OF OFFICERS, DIRECTORS, TRUSTEES OR KEY EMPLOYEES, BUT THE HOSPITAL HAS CONTRACTED OUT THE MANAGEMENT DUTIES OF THE DIETARY DEPARTMENT (ALSO CONSIDERED A DEPARTMENT HEAD) AND IS EMPLOYED BY THE DIETARY COMPANY. THE CERTIFIED DIETARY MANAGER AND THE DIETITIAN ARE ALSO THE EMPLOYEES OF THE DIETARY COMPANY. ALL OTHER DIETARY STAFF ARE EMPLOYEES OF THE HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 6 | MONONGALIA HEALTH SYSTEM, INC., A WEST VIRGINIA NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | STONEWALL JACKSON MEMORIAL HOSPITAL BOARD MEMBERS ARE ELECTED OR APPOINTED BY MONONGALIA HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7B | STONEWALL JACKSON MEMORIAL HOSPITAL'S BOARD SHALL GIVE NOTICE TO MONONGALIA HEALTH SYSTEM AND RECEIVE ITS APPROVAL BEFORE ACTING ON ANY OF THE FOLLOWING MATTERS: (A) AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE HOSPITAL OR THE BYLAWS; (B) SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF THE HOSPITAL AND ANY EXPENDITURE IN EXCESS OF $750,000; (C) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION; (D) ELECTION TO DISSOLVE THE HOSPITAL ENTITY; (E) APPROVAL OF THE BUDGET OF THE HOSPITAL; (F) APPROVAL IN ADVANCE OF THE HIRING OF THE PRESIDENT OF THE HOSPITAL. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE GOVERNING BODY IS PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW PRIOR TO SUBMISSION. THE BOARD MEMBERS ARE ASKED TO INFORM MANAGEMENT OF ANY QUESTIONS OR REVISIONS THEY MAY HAVE. IF CHANGES ARE MADE, BASED ON BOARD MEMBER'S REVISIONS, MANAGEMENT REDISTRIBUTES A FINAL VERSION TO ALL BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, A CONFLICT OF INTEREST QUESTIONNAIRE IS SENT OUT TO ALL BOARD MEMBERS. THE BOARD THEN REVIEWS ALL RESPONSES FOR POSSIBLE CONFLICTS OF INTEREST. IF A CONFLICT IS NOTED, THE BOARD MEMBERS DETERMINE WHICH DECISIONS THE CONFLICTED MEMBERS SHALL NOT PARTICIPATE IN. |
| FORM 990, PART VI, SECTION B, LINE 15 | ANNUALLY, A CONSULTANT COMPILES A MARKET DATA REPORT ON EXECUTIVE CEO COMPENSATION. THIS REPORT IS THEN REVIEWED BY THE EXECUTIVE COMMITTEE TO DETERMINE COMPENSATION FOR THE INDIVIDUAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL PLACES A PUBLICATION IN THE LOCAL NEWSPAPER STATING THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | Yes (1) | CHARLESTON AREA MEDICAL CENTER INC | |
| CHARLESTON AREA MEDICAL CENTER INC | |||||||||||
| PO BOX 1547 | CHARLESTON | WV | 253261547 | 550526150 | HOSPITAL | WV | 501(C)(3) | 3 | 0 | VANDALIA HEALTH INC | |
| MONONGALIA HEALTH SYSTEM INC | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550621551 | PARENT COMPANY | WV | 501(C)(3) | 12C, III-FI | 0 | VANDALIA HEALTH INC | |
| MONONGALIA COUNTY GENERAL HOSPITAL COMPANY | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 237441353 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| MON ELDER SERVICES INC | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 311520863 | CONTINUING CARE RETIREMENT CENTER | WV | 501(C)(3) | 10 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| 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 | Yes (1) | MONONGALIA COUNTY GENERAL HOSPITAL CO | |
| PRESTON MEMORIAL HOSPITAL | |||||||||||
| 150 MEMORIAL DRIVE | KINGWOOD | WV | 26537 | 311097818 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| PRESTON MEMORIAL MEDICAL GROUP | |||||||||||
| 300 SOUTH PRICE STREET | KINGWOOD | WV | 26537 | 550717988 | PRIMARY AND URGENT CARE | WV | 501(C)(3) | 3 | Yes (1) | PRESTON MEMORIAL HOSPITAL CORPORATION | |
| PRESTON MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 300 SOUTH PRICE STREET | KINGWOOD | WV | 26537 | 550740121 | RAISE FUNDS FOR PRESTON HOSPITAL | WV | 501(C)(3) | 12B, II | Yes (1) | PRESTON MEMORIAL HOSPITAL CORPORATION | |
| LIABILITY INSURANCE TRUST FOR MONONGALIA HEALTH SYSTEM | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550689535 | LIABILITY INSURANCE TRUST | WV | 501(C)(3) | 12A, I | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC | |||||||||||
| 140 MIDDLETOWN LOOP | WHITEHALL | WV | 26554 | 853994078 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| CAMC GREENBRIER VALLEY MEDICAL CENTER INC | |||||||||||
| 1320 MAPLEWOOD AVENUE | RONCEVERTE | WV | 24970 | 884128022 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | CHARLESTON AREA MEDICAL CENTER INC | |
| CAMC PLATEAU MEDICAL CENTER INC | |||||||||||
| 430 MAIN STREET | OAK HILL | WV | 25901 | 921715117 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | CHARLESTON AREA MEDICAL CENTER INC | |
| CAMC HEALTH EDUCATION AND RESEARCH INSTITUTE INC | |||||||||||
| PO BOX 1547 | CHARLESTON | WV | 253261547 | 550753754 | MEDICAL EDUCATIONAL RESEARCH | WV | 501(C)(3) | 12A, I | Yes (1) | CHARLESTON AREA MEDICAL CENTER INC | |
| DAVIS HEALTH SYSTEM INC | |||||||||||
| PO BOX 1484 | ELKINS | WV | 26241 | 550737655 | HEALTH SYSTEM | WV | 501(C)(3) | 12B, II | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| DAVIS MEMORIAL HOSPITAL INC | |||||||||||
| PO BOX 1484 | ELKINS | WV | 26241 | 550375433 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | DAVIS HEALTH SYSTEM INC | |
| BROADDUS HOSPITAL ASSOCIATION INC | |||||||||||
| PO BOX 930 | PHILLIPI | WV | 26416 | 550379108 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | DAVIS HEALTH SYSTEM INC | |
| DAVIS HEALTH SYSTEM FOUNDATION INC | |||||||||||
| PO BOX 1188 | ELKINS | WV | 26241 | 320185772 | PROVIDES SUPPORT TO DAVIS HEALTH SYSTEM ENTITIES | WV | 501(C)(3) | 10 | Yes (1) | DAVIS HEALTH SYSTEM INC | |
| WEBSTER MEMORIAL HOSPITAL | |||||||||||
| 812 GORMAN AVENUE | ELKINS | WV | 26241 | 871759588 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | DAVIS HEALTH SYSTEM INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 | N/A | 0 | 0 |
| 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VANDALIA INSURANCE COMPANY | |||||||||||||||||||
| 76 ST PAUL STREET STE 500 | BURLINGTON | VT | 05401 | 030308754 | INSURANCE | VT | N/A | C | Yes (1) | ||||||||||
| MON HEALTH CARE INC | |||||||||||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550654973 | MEDICAL EQUIPMENT | WV | N/A | C | Yes (1) | ||||||||||
| STONEWALL HOME OXYGEN THERAPY INC | |||||||||||||||||||
| 100 MARKET PLACE MALL SUITE 8 | WESTON | WV | 26452 | 550754278 | OXYGEN THERAPY SERVICES | WV | C | Yes (1) | STONEWALL JACKSON MEMORIAL HOSPITAL | $13,626 | $186,987 | 1.00000 | |||||||
| HEALTH FACILITIES INC | |||||||||||||||||||
| 909 GORMAN AVENUE | ELKINS | WV | 26241 | 550516937 | HEALTH CARE | WV | N/A | C | Yes (1) | ||||||||||
| CENTRAL WV MEDCORP INC | |||||||||||||||||||
| PO BOX 2630 | ELKINS | WV | 26241 | 550739314 | PHYSICIAN SERVICES | WV | N/A | C | Yes (1) | ||||||||||
| DAVIS REGIONAL HEALTH PARTNERS INC | |||||||||||||||||||
| PO BOX 2632 | ELKINS | WV | 26241 | 550746206 | CONTRACT NEGOTIATIONS | WV | N/A | C | Yes (1) | ||||||||||
| XERCOR RE SEGREGATED PORTFOLIO #2 DAVIS | |||||||||||||||||||
| CAPTIVE INSURANCE | N/A | C | Yes (1) | 18 FORUM LANE 2ND FLOOR | GRAND CAYMAN | CAYMAN ISLANDS | CJ | KY1-1102 | CJ | ||||||||||
| FAIRMONT HOME EQUIPMENT AND SUPPLY | |||||||||||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550763259 | EQUIPMENT RENT & SVC | WV | N/A | C | Yes (1) | ||||||||||
| 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |