FURP.ORG / PUBLIC DATA EXPLORER

GRAFTON CITY HOSPITAL INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
GRAFTON CITY HOSPITAL INC (EIN 55-6000526)
Tax period
2022-07-01 to 2023-06-30
Filed
2024-05-15
IRS object ID
202431369349307773
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-05-15T12:00:46-05:00ReturnTs
Tax Period End2023-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1101 WASHINGTON STREET EASTAddressLine1Txt
CityCHARLESTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25301ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN556000526EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GRAFTON CITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGRAFBusinessNameControlTxt
Phone3042657152PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 HOSPITAL PLAZAAddressLine1Txt
CityGRAFTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26354ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMELISSA LOCKWOODPersonNm
Person TitleCAOPersonTitleTxt
Phone3042657152PhoneNum
Signature2024-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMELISSAPersonFirstNm
Person LastLOCKWOODPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDOLORES ROSEPreparerPersonNm
PTINP01286262PTIN
Phone3043460441PhoneNum
Preparation2024-05-09PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMELISSA LOCKWOODPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 HOSPITAL PLAZAAddressLine1Txt
CityGRAFTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26354ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$17,187,662GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MONHEALTH.COM/GRAFTON-HOSPITALWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1972FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionTO PROVIDE INPATIENT HOSPITAL CARE, OUTPATIENT SERVICES AND EMERGENCY ROOM SERVICES TO THE RESIDENTS OF TAYLOR COUNTY, WV AND SURROUNDING COMMUNITIES.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee213TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$408,919TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,174,950PYContributionsGrantsAmt
CY Contributions Grants$2,605CYContributionsGrantsAmt
PY Program Service Revenue$16,916,855PYProgramServiceRevenueAmt
CY Program Service Revenue$16,396,055CYProgramServiceRevenueAmt
PY Investment Income$40,461PYInvestmentIncomeAmt
CY Investment Income$19,381CYInvestmentIncomeAmt
PY Other Revenue$1,281,941PYOtherRevenueAmt
CY Other Revenue$769,621CYOtherRevenueAmt
PY Total Revenue$19,414,207PYTotalRevenueAmt
CY Total Revenue$17,187,662CYTotalRevenueAmt
PY Grants And Similar Paid$700PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$600CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,349,832PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,103,881CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,911,641PYOtherExpensesAmt
CY Other Expenses$7,804,286CYOtherExpensesAmt
PY Total Expenses$20,262,173PYTotalExpensesAmt
CY Total Expenses$18,908,767CYTotalExpensesAmt
PY Revenues Less Expenses-$847,966PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,721,105CYRevenuesLessExpensesAmt
Total Assets BOY$10,832,298TotalAssetsBOYAmt
Total Assets EOY$7,875,692TotalAssetsEOYAmt
Total Liabilities BOY$12,232,618TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,997,117TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$1,400,320NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$3,121,425NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE INPATIENT HOSPITAL CARE, OUTPATIENT SERVICES AND EMERGENCY ROOM SERVICES TO THE RESIDENTS OF TAYLOR COUNTY, WV AND SURROUNDING COMMUNITIES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$18,276,621ExpenseAmt
Revenue$16,750,219RevenueAmt
DescTHE HOSPITAL PROVIDED HEALTH CARE SERVICES INCLUDING 5,659 EMERGENCY ROOM VISITS, 604 ACUTE HOSPITAL DAYS, 0 LONG-TERM CARE DAYS, 620 SWING-BED DAYS, AND 205 SURGERIES. THE HOSPITAL PROVIDED CHARITY CARE WITHOUT CHARGE OR AT LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. CHARGES FOREGONE FOR CHARITY CARE DURING THE YEAR AMOUNTED TO $51,269.51. ADDITIONALLY, THE HOSPITAL'S RURAL HEALTH CLINIC RECORDED 11,369 VISITS FOR THE YEAR.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
DescTHE HOSPITAL SPONSORED COMMUNITY HEALTH IMPROVEMENT SERVICES THAT INCLUDED A HEALTH FAIR AND NEW YOU YOUTH FITNESS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$600ExpenseAmt
Grant$600GrantAmt
DescTHE ORGANIZATION PROVIDED GRANTS TO COMMUNITY ORGANIZATIONS INCLUDING A $500 SPONSORSHIP OF A FIVE MILE RUN AND A $100 DONATION TO HOSPICE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$18,277,221TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document12IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee213EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KEVIN GESSLERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3043294700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 HOSPITAL PLAZAAddressLine1Txt
CityGRAFTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP26354ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerInd
THOMAS STEVENS DO
PHYSICIAN40.00Yes (X)$426,433$0$0
ANDREW BERARDINELLI MD
PHYSICIAN40.00Yes (X)$419,883$0$2,569
JOSEPH DUVERT MD
PHYSICIAN40.00Yes (X)$390,492$0$3,093
DAVID BENDER MD
EXECUTIVE CREDENTIALS CHAIR40.00$364,152$0$7,441Yes (X)
THOMAS WILSHIRE DO
PHYSICIAN40.00Yes (X)$314,326$0$6,569
STEPHEN HARRIS PA
PHYSICIAN ASSISTANT40.00Yes (X)$146,695$0$0
MELISSA LOCKWOOD
CAO PRESTON MEMORIAL HOSPITAL16.00$0$0$0Yes (X)
JOHN L BORD
PRESIDENT2.00$0$0$0Yes (X)Yes (X)
ROBERT WEAVER
VICE PRESIDENT2.00$0$0$0Yes (X)Yes (X)
NANCY FOWLER
FINANCE CHAIR2.00$0$0$0Yes (X)
WAYNE MCDEVITT
TRUSTEE2.00$0$0$0Yes (X)
LARRY RICHMAN
TRUSTEE2.00$0$0$0Yes (X)
JENNY WEAVER
TRUSTEE2.00$0$0$0Yes (X)
JOHN WHITESCARVER
TRUSTEE2.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,061,981TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$19,672TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
XTEND HEALTHCARE LLC
90 VOLUNTEER DRIVE SUITE 200HENDERSONVILLETN37075PATIENT BILLING AND CODING$248,225
LABCORP
231 MAPLE AVEBURLINGTONNC27215LAB TESTING SERVICES$215,862
QUALIVIS
DEPT 3847 PO BOX 123847DALLASTX75312MEDICAL STAFFING SERVICES$188,453
JEFFREY SINCLAIR
4001 WEST RIDGE DRIVEMORGANTOWNWV26501EMERGENCY ROOM PHYSICAN SERVICE$135,100
ALLIANCE HEALTHCARE SERVICES
PO BOX 735714DALLASTX75373MRI SERVICES$132,394
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
All Other Contributions$2,605AllOtherContributionsAmt
Total Contributions$2,605TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICES622110$15,355,975$15,355,975
340B PROGRAM REVENUE900099$1,040,080$1,040,080
FieldValueIRS element (for citing)
Total Program Service Revenue$16,396,055TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,381TotalRevenueColumnAmt
Exclusion$19,381ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$6,538RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$6,538RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,538TotalRevenueColumnAmt
Exclusion$6,538ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NURSING HOME SERVICE REIMB900099$408,919$408,919
MISCELLANEOUS REVENUE900099$354,164$354,164
FieldValueIRS element (for citing)
Other Revenue Total$763,083OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,187,662TotalRevenueColumnAmt
Related Or Exempt Func Income$16,750,219RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$408,919UnrelatedBusinessRevenueAmt
Exclusion$25,919ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$600TotalAmt
Program Services$600ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$371,593TotalAmt
Program Services$359,182ProgramServicesAmt
Management And General$12,411ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,756,741TotalAmt
Program Services$8,464,266ProgramServicesAmt
Management And General$292,475ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,381,731TotalAmt
Program Services$1,335,581ProgramServicesAmt
Management And General$46,150ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$593,816TotalAmt
Program Services$573,983ProgramServicesAmt
Management And General$19,833ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$385,275TotalAmt
Program Services$372,407ProgramServicesAmt
Management And General$12,868ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$11,562TotalAmt
Management And General$11,562ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$55,581TotalAmt
Management And General$55,581ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,569,319TotalAmt
Program Services$1,516,904ProgramServicesAmt
Management And General$52,415ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,368,751TotalAmt
Program Services$1,323,127ProgramServicesAmt
Management And General$45,624ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$276,720TotalAmt
Program Services$267,478ProgramServicesAmt
Management And General$9,242ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$152,949TotalAmt
Program Services$147,841ProgramServicesAmt
Management And General$5,108ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,418TotalAmt
Program Services$6,204ProgramServicesAmt
Management And General$214ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$103,387TotalAmt
Program Services$99,934ProgramServicesAmt
Management And General$3,453ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$546,149TotalAmt
Program Services$527,908ProgramServicesAmt
Management And General$18,241ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$495,159TotalAmt
Program Services$478,621ProgramServicesAmt
Management And General$16,538ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$1,149,250$1,149,250
REPAIRS & MAINTENANCE$689,638$666,604$23,034
MEDICAID PROVIDER TAX$247,577$247,577
BAD DEBT EXPENSE$231,911$231,911

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$514,640TotalAmt
Program Services$507,843ProgramServicesAmt
Management And General$6,797ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$18,908,767TotalAmt
Program Services$18,277,221ProgramServicesAmt
Management And General$631,546ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,466,970BOYAmt
EOY$12,600EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,015,950BOYAmt
EOY$201,315EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,549,883BOYAmt
EOY$2,565,997EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$251,342BOYAmt
EOY$258,388EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$578,813BOYAmt
EOY$285,409EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$21,462,507LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$18,565,275LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,327,897BOYAmt
EOY$2,897,232EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,006,709BOYAmt
EOY$1,020,017EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$634,734BOYAmt
EOY$634,734EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,832,298BOYAmt
EOY$7,875,692EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,494,201BOYAmt
EOY$4,498,038EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$2,457,650BOYAmt
EOY$2,457,649EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,280,767BOYAmt
EOY$4,041,430EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,232,618BOYAmt
EOY$10,997,117EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$1,400,320BOYAmt
EOY-$3,121,425EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$1,400,320BOYAmt
EOY-$3,121,425EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,832,298BOYAmt
EOY$7,875,692EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,721,105ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$17,622OtherActivitiesAmt
Total Lobbying Expenditures$17,622TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationPART II-B, LINE(I), OTHER LOBBYING ACTIVITIES: GRAFTON CITY HOSPITAL PAYS DUES TO THE WEST VIRGINIA HOSPITAL ASSOCIATION. THE WEST VIRGINIA HOSPITAL ASSOCIATION REPRESENTS HOSPITALS AND HEALTH SYSTEMS. FOR THE YEAR ENDED 06/30/23, THE AMOUNT OF DUES RELATED TO LOBBYING ACTIVITIES WAS $17,622.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$26,597OtherCostOrOtherBasisAmt
Book Value$26,597BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,931,207OtherCostOrOtherBasisAmt
Depreciation$8,290,289DepreciationAmt
Book Value$640,918BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$388,268OtherCostOrOtherBasisAmt
Depreciation$169,326DepreciationAmt
Book Value$218,942BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,819,320OtherCostOrOtherBasisAmt
Depreciation$10,105,660DepreciationAmt
Book Value$1,713,660BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$297,115OtherCostOrOtherBasisAmt
Book Value$297,115BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,897,232TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescCHART RRG - INVESTMENTDesc
Book Value$1,020,017BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$1,020,017TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescRIGHT OF USE ASSETDesc
Book Value$634,734BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$634,734TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
CAPITAL LEASES$125,319
THIRD-PARTY PAYOR SETTLEMENTS$359,633
TAXABLE BONDS$2,912,207
OPERATING LEASE LIABILITY$634,734
ACCRUED PENSION$9,537
FieldValueIRS element (for citing)
Total Liability$4,041,430TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$16,955,751TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$16,955,751RevenueSubtotalAmt
Other Revenues Not Included$231,911OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$231,911RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$17,187,662TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$18,676,856TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$18,676,856ExpensesSubtotalAmt
Other Expenses Not Included$231,911OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$231,911ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$18,908,767TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIAL STATEMENTS 231,911.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE NETTED AGAINST REVENUE ON FINANCIAL STATEMENTS 231,911.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$302,710TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$302,710DirectOffsettingRevenueAmt

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$769,391TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$769,391DirectOffsettingRevenueAmt

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$102,195TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$102,195DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,174,296TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,174,296DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,491TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$16,491NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,491TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$16,491NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,190,787TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,174,296DirectOffsettingRevenueAmt
Net Community Benefit Expns$16,491NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$231,911BadDebtExpenseAmt
Reimbursed By Medicare$2,999,120ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$2,999,120CostOfCareReimbursedByMedcrAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GRAFTON CITY HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 MARKET STREETAddressLine1Txt
CityGRAFTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25354ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1GRAFTON CITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V SUPPLEMENTAL INFORMATIONOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTPS://WWW.MONHEALTH.COM/GRAFTON-HOSPITALStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care100.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTP://WWW.GRAFTONHOSPITAL.COM/PATIENTS---VISTORS.HTMLFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTP://WWW.GRAFTONHOSPITAL.COM/PATIENTS---VISTORS.HTMLFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTP://WWW.GRAFTONHOSPITAL.COM/PATIENTS---VISTORS.HTMLFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
GRAFTON CITY HOSPITALPART V, SECTION B, LINE 5: THE 2022 CHNA INCLUDED QUANTITATIVE RESEARCH METHODS AND COMMUNITY CONVERSATIONS TO DETERMINE HEALTH TRENDS AND DISPARITIES AFFECTING TAYLOR COUNTY RESIDENTS. THROUGH A COMPREHENSIVE VIEW OF STATISTICAL HEALTH INDICATORS AND COMMMUNITY STAKEHOLDER FEEDBACK, A PROFILE OF PRIORITY AREAS WAS DETERMINED. THE FINDINGS WILL GUIDE HEALTHCARE SERVICES AND HEALTH IMPROVEMENT EFFORTS, AS WELL AS SERVE AS A COMMUNITY RESOURCE FOR GRANT MAKING, ADVOCACY, AND TO SUPPORT THE MANY PROGRAMS PROVIDED BY HEALTH AND SOCIAL SERVICE PARTNERS.IN ASSESSING COMMUNITY HEALTH NEEDS, INPUT WAS SOLICITED AND RECEIVED FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, AS WELL AS UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. THESE INDIVIDUALS PROVIDED WIDE PERSPECTIVES ON HEALTH TRENDS, EXPERTISE ABOUT EXISTING COMMUNITY RESOURCES AVAILABLE TO MEET THOSE NEEDS, AND INSIGHTS INTO SERVICE DELIVERY GAPS THAT CONTRIBUTE TO HEALTH DISPARITIES AND INEQUITIES.
GRAFTON CITY HOSPITALPART V, SECTION B, LINE 6A: PRESTON MEMORIAL HOSPITAL
GRAFTON CITY HOSPITALPART V, SECTION B, LINE 11: GRAFTON CITY HOSPITAL ADDRESSED THE FOLLOWING SIGNIFICANT NEEDS IDENTIFIED:ACCESS TO CARE: EXPANSION OF TELEHEALTH PROGRAM; FREE OR REDUCED-COST COMMUNITY-BASED HEALTH SCREENINGS; BLOOD PRESSURE CLINICS; EXPANSION OF SPECIALTY CLINICS WITH THE ADDITION OF CARDIOLOGY AND ORTHOPEDICS SERVICESBEHAVIORAL HEALTH AND DRUG AND ALCOHOL USE DISORDER: EXPANSION OF TELEHEALTH IN THE GRAFTON RECOVERY CENTER; ADULT INPATIENT SHORT-STAY PROGRAM OFFERING 24-HOUR SUPPORT, SUPERVISION, AND NURSING CARE; EVIDENCE-BASED PROGRAMS FOR PEOPLE WITH OPIOID USE DISORDER; SCREENINGS AND FOLLOW UP CARE TO SUPPORT PEOPLE EXPERIENCING MENTAL HEALTH AND SUBSTANCE USE DISORDERSCOVID-19 RESPONSE: DURING THE PANDEMIC PROVIDED TESTING IN THE PARKING LOT OR FREE-STANDING LAB BUILDING; ADMINISTERED VACCINATIONS; SUPPORTED COVID-19 DISEASE AND VACCINATION EDUCATION IN PARTNERSHIP WITH COMMUNITY AGENCIES
GRAFTON CITY HOSPITALPART V, SECTION B, LINE 16J: THE ADMISSION DEPARTMENT HAS SIGNS POSTED THAT OFFER FINANCIAL ASSISTANCE INFORMATION. PRIVATE PAY PATIENTS ARE OFFERED FINANCIAL ASSISTANCE INFORMATION AT THE TIME OF ADMISSION.
GRAFTON CITY HOSPITALPART V, SECTION B, LINE 20E: EVERY 30 DAYS PATIENTS RECEIVE A STATEMENT AND AFTER 4 STATEMENTS EACH PATIENT RECEIVES A LETTER ASKING IF THE ARE ANY CONCERNS WITH THE BILL AND TO PLEASE CALL THE HOSPITAL. IF THE ACCOUNT IS NOT PAID THE PATIENT IS EITHER CALLED OR RECEIVES A LETTER INDICATING THAT COLLECTION EFFORTS WILL START. AT THE POINT OF CALLING, THE PATIENT IS OFFERED CHARITY CARE, ASSISTANCE WITH THE MEDICAID APPLICATION, OR A DISCOUNT IF THE BILL IS PAID IN FULL.
PART V, SECTION B, LINE 7ATHE URL LINK FOR THE CHNA:HTTPS://WWW.MONHEALTH.COM/UPLOADS/PUBLIC/DOCUMENTS/GRAFTON/2022%20CHNA%20REPORT.PDF

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE COST OF CHARITY CARE WAS ESTIMATED USING A COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS.AS A WV CAH, GCH IS REIMBURSED 100% OF COSTS FROM MEDICAID FOR HOSPITAL LEVEL SERVICES (THE EXCEPTION TO THIS COST REIMBURSEMENT IS FOR THE RHC). THE ONLY COMPONENT THAT WOULD HAVE A MEDICAID COMMUNITY BENEFIT EXPENSE RELATES TO THE RHC.
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 $ 231,911.
PART III, LINE 2:BAD DEBT EXPENSE AS REPORTED ON AUDITED FINANCIAL STATEMENTS.
PART III, LINE 4:PATIENT ACCOUNTS RECEIVABLE: PATIENT ACCOUNTS RECEIVABLE ARE CARRIED AT THE ORIGINAL CHARGE LESS AN ESTIMATE MADE FOR DOUBTFUL OR UNCOLLECTABLE ACCOUNTS. THE ALLOWANCE IS BASED UPON A REVIEW OF THE OUTSTANDING BALANCES AGED BY FINANCIAL CLASS. MANAGEMENT USES COLLECTION PERCENTAGES BASED UPON HISTORICAL COLLECTION EXPERIENCE TO DETERMINE COLLECTABILITY. MANAGEMENT ALSO REVIEWS TROUBLED, AGED ACCOUNTS TO DETERMINE COLLECTION POTENTIAL. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF ACCOUNTS PREVIOUSLY WRITTEN OFF ARE RECORDED AS REDUCTION TO BAD DEBT EXPENSE WHEN RECEIVED. INTEREST IS NOT CHARGED ON PATIENT ACCOUNTS RECEIVABLE.
PART III, LINE 8:THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE HOSPITAL'S MEDICARE COST REPORT.
PART VI, LINE 2:TO ASSESS THE HEALTH CARE NEEDS OF THE POPULATION BASE OF GRAFTON CITY HOSPITAL, THE FACILITY IS HEAVILY INVOLVED WITH THE AREAS COMMUNITY FORUMS. THROUGH THIS VENUE THE HOSPITAL TAKES THE INQUIRIES THAT ARE VOICED AND APPLIES AN ECONOMIC FORECAST TO THE PROGRAM TO VERIFY ITS STABILITY. THE FACILITY ALSO USES THE BUREAU FOR PUBLIC HEALTH, FOR RISK FACTORS THAT WOULD HAVE AN IMPACT ON THE LIVES OF THE POPULATION THAT GRAFTON CITY HOSPITAL SERVES.
PART VI, LINE 3:THE PATIENT POPULATION IS EDUCATED AND INFORMED OF THE FINANCIAL ASSISTANCE PROGRAMS THROUGH THE FINANCIAL COUNSELORS AND ADMISSION PERSONNEL. THE HOSPITAL ALSO HAS THIS INFORMATION PUBLISHED IN THE PUBLIC AREAS WITHIN THE HOSPITAL.
PART VI, LINE 4:GRAFTON CITY HOSPITAL IS A CRITICAL ACCESS FACILITY LOCATED WITHIN THE CITY OF GRAFTON, WEST VIRGINIA, OPERATING A 25-BED ACUTE CARE FLOOR, AN EMERGENCY ROOM OPEN 24/7, A REHABILITATION AND FITNESS CENTER, AND A TOTAL CARE CLINIC. THE HOSPITAL'S SERVICE AREA HAS BEEN DEFINED BASED ON PATIENT DAYS, DISCHARGES AND CHARGES COMPILED BY ZIP CODE DURING THE PREPARATION OF THE LATEST COMMUNITY HEALTH NEEDS ASSESSMENT (2022). THE SERVICE AREA IS CONCENTRATED IN GRAFTON, WV AND SPANS THE COUNTIES OF TAYLOR, PRESTON AND BARBOUR, WEST VIRGINIA. THERE ARE TWO OTHER RURAL 25-BED CRITICAL ACCESS HOSPITALS LOCATED WITHIN THE SERVICE AREA, THE PRESTON MEMORIAL HOSPITAL IN KINGWOOD, WV, AND THE BROADDUS HOSPITAL IN PHILIPPI, WV. THE POPULATION COVERAGE BY THE SERVICE AREA IS APPROXIMATELY 67,000. THE HOSPITAL'S SERVICE AREA DEMOGRAPHICS CARRY A COMMUNITY NEED INDEX (CNI) RANGE OF 2.4 TO 2.8, INDICATING A MODERATE COMMUNITY SOCIOECONOMIC NEED. THE VAST MAJORITY OF THE POPULATION IS US-BORN, WITH A SMALL PERCENTAGE OF NON-US-BORN RESIDENTS. THE RACIAL COMPOSITION IS PREDOMINANTLY WHITE (NON-HISPANIC), WITH A SIGNIFICANT PORTION OF THE POPULATION LIVING BELOW THE POVERTY LINE. THE COMBINED MEDICARE AND MEDICAID POPULATION IS APPROXIMATELY 20% FOR BOTH PRESTON AND BARBOUR COUNTIES. ALL THREE COUNTIES IN THE HOSPITAL'S PRIMARY SERVICE AREA ARE DESIGNATED "SHORTAGE AREAS" BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE COUNTIES ARE DESIGNATED HPSA'S (HEALTH PROFESSIONAL SHORTAGE AREA) FOR PRIMARY CARE, DENTAL AND MENTAL HEALTH SERVICES. ALL THREE COUNTIES ARE ALSO DESIGNATED AS MUA'S AND/OR MUP'S (MEDICALLY UNDERSERVED AREAS/POPULATIONS).
PART VI, LINE 5:THE ORGANIZATION'S HEALTH CARE FACILITIES FURTHER ITS EXEMPT PURPOSE IN THE FOLLOWING WAYS: THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND ARE NOT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PROVIDERS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. THE ORGANIZATION OPERATES AN EMERGENCY ROOM AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY. SPECIALIZED SERVICES OFFERED BY THE ORGANIZATION THAT ARE NOT AVAILABLE ELSEWHERE INCLUDE PULMONOLOGY, CRITICAL CARE MEDICINE, GENERAL SURGERY, INTERNAL MEDICINE, AND FAMILY MEDICINE. THE ORGANIZATION SERVES AS A VEHICLE FOR ATTRACTING CHARITABLE SUPPORT, AS WELL AS A SOURCE OF COMMUNITY VOLUNTEER ACTIVITIES.
PART VI, LINE 6:GRAFTON CITY HOSPITAL IS MANAGED BY MON HEALTH SYSTEM, INC., LOCATED IN MORGANTOWN, WV. THROUGH THAT MANAGEMENT AGREEMENT, AFFILIATES OF THE MON HEALTH SYSTEM DO PROVIDE RESOURCES TO PROMOTE HEALTH IN THE GRAFTON COMMUNITY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
THOMAS STEVENS DO
PHYSICIAN$317,467$0$93,293$0$15,673$0$0$0$0$0$426,433$0$0$0
ANDREW BERARDINELLI MD
PHYSICIAN$338,071$0$66,812$0$15,000$0$0$0$2,569$0$422,452$0$0$0
JOSEPH DUVERT MD
PHYSICIAN$390,492$0$0$0$0$0$0$0$3,093$0$393,585$0$0$0
DAVID BENDER MD
EXECUTIVE CREDENTIALS CHAIR$305,533$0$49,562$0$9,057$0$0$0$7,441$0$371,593$0$0$0
THOMAS WILSHIRE DO
PHYSICIAN$314,326$0$0$0$0$0$0$0$6,569$0$320,895$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, PART IV, LINE 23FormAndLineReferenceDesc
ExplanationGRAFTON CITY HOSPITAL HAS A MANAGEMENT AGREEMENT WITH MONONGALIA HEALTH SYSTEM. MELISSA LOCKWOOD IS THE CONTRACTED CAO THROUGH THIS AGREEMENT. THE PORTION OF HER 2022 COMPENSATION AND BENEFITS ALLOCATED TO GRAFTON CITY HOSPITAL FOR HER CAO SERVICES WAS $103,361.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WILL BE REVIEWED BY THE CHIEF ADMINISTRATIVE OFFICER AND CFO BEFORE IT IS FILED. A COPY OF THE FINAL FORM 990 WILL BE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTRUSTEES ARE MADE AWARE OF THE CONFLICT OF INTEREST POLICY. SHOULD A TRUSTEE FEEL THERE IS A SUBJECT IN WHICH THEY HAVE A CONFLICT, THEY RECUSE THEMSELVES FROM THE DISCUSSION AND ANY POSSIBLE ACTION.
FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION COMMITTEE DETERMINES THE COMPENSATION OF THE CEO AND OTHER OFFICERS BY COMPARING SALARIES WITH OTHER HOSPITALS LOCATED IN THE WEST VIRGINIA CRITICAL ACCESS HOSPITAL NETWORK WITH BOARD APPROVAL.
FORM 990, PART VI, SECTION C, LINE 18THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION'S FINANCE COMMITTEE OF THE BOARD OF DIRECTORS SELECTS THE INDEPENDENT ACCOUNTANT. THIS PROCESS REMAINS UNCHANGED FROM PRIOR YEARS.