2025-11-17T18:03:49-06:00 2024-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 46204 990 2024-01-01 550422958 STONEWALL JACKSON MEMORIAL HOSPITAL STON 3042698059 230 HOSPITAL PLAZA WESTON WV 26452 JEFF SANDENE EXECUTIVE VP AND CFO 3042698059 2025-11-17 1 1 ANGELA M MOORE P00244342 3174648600 2024 2025-03-06 01:10:19Z DAVID GOLDBERG 230 HOSPITAL PLAZA WESTON WV 26452 56044239 0 X WWW.MONHEALTH.COM/SJMH X 1959 WV ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. 13 9 482 9 0 0 17261 0 47579940 52833552 1248668 1293197 1317566 1901016 50163435 56027765 0 0 0 0 25876272 30452710 0 0 0 27870138 28728006 53746410 59180716 -3582975 -3152951 65998448 77889006 11935910 24265503 54062538 53623503 X ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. 0 0 46246246 54675037 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. 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. 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. 46246246 1 0 0 1 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 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 24 0 1 482 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 9 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WV X RICK SCHERICH 3042698059 230 HOSPITAL PLAZA WESTON WV 264528558 DAVID GOLDBERG DIRECTOR & MHS CEO 1.00 57.00 X X 0 996584 51139 DOYLE SICKLES DIRECTOR AND PHYSICIAN 40.00 0.00 X 242535 0 20415 GREGORY CUNNINGHAM VICE CHAIR 1.00 2.00 X X 0 0 0 KIM GUM SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 ROBIN POLING CHAIRMAN 1.00 0.00 X X 0 0 0 ALISSA LAMBERT DIRECTOR 1.00 0.00 X 0 0 0 ALLISON BARDES MD DIRECTOR 1.00 0.00 X 0 0 0 GEORGE STANSBERRY DIRECTOR 1.00 0.00 X 0 0 0 GREGORY ST CLAIR DIRECTOR 1.00 0.00 X 0 0 0 JOHN LAW CPA DIRECTOR 2.00 2.00 X 0 0 0 JOSEPH SNEAD MD DIRECTOR 1.00 0.00 X 0 0 0 LISA SONGER DIRECTOR 1.00 0.00 X 0 0 0 R GERALD WOOD DIRECTOR 1.00 0.00 X 0 0 0 KEVIN STALNAKER CAO 50.00 2.00 X 83191 213964 53177 RICK SCHERICH VP FINANCE 20.00 30.00 X 37043 242090 50854 RONALD PEARSON PHYSICIAN 40.00 0.00 X 917012 0 38850 MICHAEL GREGORY PHYSICIAN 40.00 0.00 X 641392 0 47427 ROBERT SNUFFER DIRECTOR OF PHYSICIANS 40.00 0.00 X 575835 0 38850 CAROLYN MOYERS PHYSICIAN 40.00 0.00 X 419625 0 13800 ERIN MILLER PHYSICIAN 40.00 0.00 X 418900 0 13800 3335533 1452638 328312 45 0 1 0 QUALIVIS LLC PO BOX 674913 DALLAS TX 752674913 AGENCY SERVICES 1847504 UNIFORMED PHYSICIANS 602 VIRGINIA STREET CHARLESTON WV 25301 MEDICAL SERVICES 543384 CONTINENTAL REPUBLIC CAPITAL LLC PO BOX 650841 DALLAS TX 752650841 PROFESSIONAL SERVICES 492603 MORRISON HEALTHCARE PO BOX 102289 ATLANTA GA 30368 MEDICAL SERVICES 390149 ROGER ABRAHAMS 5002 WOODLAND COVE ROAD MORGANTOWN WV 26508 PROFESSIONAL SERVICES 139861 5 PATIENT SERVICES 622110 52833552 52833552 52833552 473171 473171 76005 16474 59531 59531 59531 820026 0 820026 820026 820026 340B 900099 1631216 1631216 QUALITY INCENTIVE 900099 156054 156054 OTHER REVENUE 900099 54215 54215 1841485 56027765 54675037 0 1352728 26022699 20948342 5074357 844032 683666 160366 1934233 1557063 377170 1651746 1321397 330349 1200 1200 9500 9500 116486 116486 5227406 4646621 580785 2960 2960 813273 651396 161877 100786 80629 20157 1636879 1253083 383796 139818 115750 24068 19464 19372 92 80124 80124 798851 639081 159770 1424765 1424765 MEDICAL SUPPLIES 10036297 10036297 MANAGEMENT FEES 4839586 4839586 REPAIRS AND MAINTENANCE 1379766 1103813 275953 MEDICAID PROVIDER TAX 1305868 1305868 794977 456143 338834 59180716 46246246 12934470 0 1219744 3028 0 2428647 5370891 7291702 1307551 1198824 11476 31206 20635992 1227196 13323318 19408796 37179893 41123838 607804 619414 118057 143758 6859714 5639793 65998448 77889006 6029688 6556321 11037 2033647 5895185 15675535 11935910 24265503 X 53596096 53157061 466442 466442 54062538 53623503 65998448 77889006 -3152951 2713916 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 395 395 0 PART II-B, LINE 1: A PORTION OF DUES PAID BY THE HOSPITAL TO THE WEST VIRGINIA HOSPITAL ASSOCIATION IS ATTRIBUTABLE TO LOBBYING. 10640000 10640000 849302 116024 733278 97283 34955 62328 2537228 864510 1672718 6512179 211707 6300472 19408796 AFFILIATE RECEIVABLES - VANDALIA HEALTH SUBSIDIARIES' 1166505 DUE FROM THIRD-PARTY PAYORS 4473288 5639793 AFFILIATE PAYABLES - VANDALIA HEALTH SUBSIDIARIES' 15675535 15675535 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. 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. 1 1 X 1 X 0 1 1 1 0 0 666120 0 666120 0.01170 14028308 6346725 7681583 0.13520 14694428 6346725 8347703 0.14690 36180 0 36180 0.00060 554238 0 554238 0.00980 650 0 650 0.00000 591068 591068 0.01040 15285496 6346725 8938771 0.15730 0 2346155 0 6937630 8915270 -1977640 X 1 1 1 1 STONEWALL JACKSON MEMORIAL HOSPITAL 230 HOSPITAL PLAZA WESTON WV 26452 WWW.MONHEALTH.COM/SJMH 7 X X X STONEWALL JACKSON MEMORIAL HOSPITAL 1 0 0 0 1 1 50000 1 X 200.000000000000 X X X X 1 1 X X X 1 X HTTPS://WWW.MONHEALTH.COM/SJMH/SJMH-FINANCIAL-ASSISTANCE X HTTPS://WWW.MONHEALTH.COM/SJMH/SJMH-FINANCIAL-ASSISTANCE X HTTPS://WWW.MONHEALTH.COM/SJMH/SJMH-FINANCIAL-ASSISTANCE X X X X 1 X 0 X X X X 1 X 0 0 STONEWALL JACKSON MEMORIAL HOSPITAL 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. 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. 0 1 0 0 0 0 0 0 0 DAVID GOLDBERG DIRECTOR & MHS CEO 0 736828 0 241048 0 18708 0 13800 0 37339 0 1047723 0 0 RONALD PEARSON PHYSICIAN 891355 0 8000 0 17657 0 13800 0 25050 0 955862 0 0 0 MICHAEL GREGORY PHYSICIAN 630151 0 0 0 11241 0 13800 0 33627 0 688819 0 0 0 ROBERT SNUFFER DIRECTOR OF PHYSICIANS 574029 0 0 0 1806 0 13800 0 25050 0 614685 0 0 0 CAROLYN MOYERS PHYSICIAN 412500 0 0 0 7125 0 13800 0 0 0 433425 0 0 0 ERIN MILLER PHYSICIAN 418900 0 0 0 0 0 13800 0 0 0 432700 0 0 0 KEVIN STALNAKER CAO 82380 160537 0 52990 811 437 5545 6664 14365 26603 103101 247231 0 0 RICK SCHERICH VP FINANCE 37043 204766 0 36110 0 1214 1336 10049 6100 33369 44479 285508 0 0 DOYLE SICKLES DIRECTOR AND PHYSICIAN 239726 0 0 0 2809 0 9728 0 10687 0 262950 0 0 0 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 RALPH GERALD WOOD JR FAMILY MEMBER 30145 EMPLOYMENT 0 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. 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