2024-11-14T03:13:16-06:00 2023-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 46204 990 2023-01-01 311097818 PRESTON MEMORIAL HOSPITAL CORPORATION PRES 3043291400 150 MEMORIAL DRIVE KINGWOOD WV 265371442 JEFF SANDENE EXECUTIVE VP AND CFO 3043291400 2024-11-13 1 0 ANGELA M MOORE P00244342 3174648600 2023 2024-10-15 13:58:12Z MELISSA LOCKWOOD 150 MEMORIAL DRIVE KINGWOOD WV 265371442 52979231 0 X WWW.PRESTONMEMORIAL.ORG X 1955 WV TO ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. 10 6 446 20 0 0 26629 600000 27423263 51041050 73326 472400 176291 865781 27699509 52979231 0 0 0 0 14043401 27628981 0 0 0 12877222 25320377 26920623 52949358 778886 29873 49013678 46376503 42882278 40287487 6131400 6089016 X TO ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. 0 0 46720667 51715252 THE HOSPITAL HAD 2,009 INPATIENT DAYS, CARED FOR 9,227 EMERGENCY PATIENTS AND TREATED 85,3382 PATIENTS IN ITS OUTPATIENT CLINICS. THE HOSPITAL PROVIDES CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. CHARGES FOREGONE FOR CHARITY CARE AMOUNTED TO $763,233. THE HOSPITAL PROMOTES AND PROVIDES ACTIVITIES SUCH AS HEALTH FAIRS, BLOOD DRIVES, AND A FITNESS CENTER TO IMPROVE THE HEALTH AND WELFARE OF ITS PATIENTS. THE HOSPITAL ALSO CONDUCTS COMMUNITY-WIDE SPEAKER BUREAUS TO HELP EDUCATE THE COMMUNITY ON SPECIFIC HEALTH AND WELLNESS MATTERS. THE HOSPITAL STRIVES TO PROVIDE AND PROMOTE NEEDED SERVICES IN THE COMMUNITY BY PARTNERING WITH LOCAL AGENCIES SUCH AS THE PRESTON COUNTY HEALTH DEPARTMENT, FAMILY RESOURCE NETWORK, PRESTON PREVENTION PARTNERSHIP, AND THE PRESTON COUNTY CHAMBER OF COMMERCE.THE ORGANIZATION SPONSORED HEALTH FAIRS, BLOOD DRIVES, CANCER SCREENINGS, CPR/FIRST AID CLASSES, CRISIS INTERVENTION, DIABETES INTERVENTION, FAMILY/PARENTING/SIBLING EDUCATION, FITNESS EDUCATION, FLU SHOTS, NUTRITION/WEIGHT MAINTENANCE, SCHOOL BASED PROGRAMS, SENIOR EDUCATION AND OUTREACH PROGRAMS, SPORTS INJURY PREVENTION, SUBSTANCE ABUSE AND TOBACCO/SMOKING CESSATION. 46720667 1 0 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 83 0 1 446 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WV X KEVIN GESSLER VP FINANCIAL SERVICE 3043291400 150 MEMORIAL DRIVE KINGWOOD WV 265371442 DAVID GOLDBERG DIRECTOR, MHS PRES/CEO 1.00 50.00 X X 0 853663 36373 MELISSA LOCKWOOD DIRECTOR/PMH CAO 30.00 20.00 X X 0 289328 52848 JASON MCNAIR DIRECTOR/CHIEF OF STAFF (START 05/23) 50.00 1.00 X 260385 0 10695 NICK TAYLOR CHAIR 1.00 1.00 X X 0 0 0 RAY THOMPSON VICE CHAIR 1.00 3.00 X X 0 0 0 TIM CALVERT SECRETARY/TREASURER, FINANCE CHAIR 1.00 1.00 X X 0 0 0 BONNIE J FORMAN CHIEF OF STAFF (END 05/23) 50.00 0.00 X 0 0 0 KATHY MCNEILL DIRECTOR 1.00 3.00 X 0 0 0 RITA MCCROBIE DIRECTOR 1.00 2.00 X 0 0 0 RONALD CRITES DIRECTOR 1.00 1.00 X 0 0 0 TARRELL RIES DIRECTOR 1.00 2.00 X 0 0 0 KEVIN GESSLER VP OF FINANCE 20.00 30.00 X 0 248249 1153 FRANK ABRAHAM PHYSICIAN 50.00 0.00 X 607024 0 67340 LORN WOLFE PHYSICIAN 50.00 0.00 X 449874 0 53703 MARISA DOWNEY PHYSICIAN 50.00 0.00 X 445624 0 40050 DAVID FOURQUREAN PHYSICIAN 50.00 0.00 X 409393 0 39231 MARAM HAKOUM PHYSICIAN 50.00 0.00 X 370233 0 25330 2542533 1391240 326723 38 0 1 0 QUALIVIS DEPARTMENT 3847 PO BOX 123847 DALLAS TX 753123847 RN STAFFING SERVICES 1935933 SYNERGY SURGICALISTS WV INC 12396 WORLD TRADE DRIVE SUITE 303 SAN DIEGO CA 92128 ORTHO SERVICES 1564529 RURAL PHYSICIANS GROUP 5575 DTC PARKWAY GREENWOOD VILLAGE CO 80111 HOSPITALIST SERVICES 813435 ALLIANCE HEALTHCARE SERVICES PO BOX 735714 DALLAS TX 753735714 DIAGNOSTIC IMAGING SERVICES 254882 NORTHSTAR ANESTHESIA 6225 N STATE HWY 161 INVING TX 75038 ANESTHESIA SERVICES 189402 8 600000 600000 NET PATIENT SERVICE RE 622110 50508768 50508768 340B DRUG PROGRAM 900099 532282 532282 51041050 152560 152560 319840 0 319840 319840 319840 SALES TAX REFUNDS 900099 316791 316791 CAFETERIA SALES 722514 191579 191579 EMPLOYEE DRUG REV 621990 68947 68947 288464 288464 865781 52979231 51715252 0 663979 X 21580137 21426966 153171 817519 817519 3773134 3770864 2270 1458191 1458191 6996 6996 19237 19237 7439064 7439064 13187 13187 1269879 1191710 78169 557128 557128 109856 101167 8689 997144 997144 1909427 1909427 20312 20312 MANAGEMENT FEES 5322557 0 5322557 MEDICAL SUPPLIES 4662612 4662417 195 REPAIRS & MAINTENANCE 951686 942582 9104 HEALTHCARE PROVIDER TAX 922745 922745 0 1118547 523743 594804 52949358 46720667 6228691 0 6961783 5310462 7754125 7427486 523838 385797 90733 107954 20326400 1990585 19188113 18335815 11265048 12725232 3230038 2083757 49013678 46376503 3664714 3064100 31845830 31354086 7371734 5869301 42882278 40287487 X 6121400 6079016 10000 10000 6131400 6089016 49013678 46376503 29873 1110524 -1182781 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 31782 31782 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP FEES TO THE WEST VIRGINIA HOSPITAL ASSOCIATION WHICH PARTICIPATES IN LOBBYING ACTIVITIES. 14802788 895337 13907451 3790517 861743 2928774 1733095 233505 1499590 18335815 FUNDED DEPRECIATION-PNC 12725232 F 12725232 DUE TO 3RD PARTY PAYORS 2576817 DUE TO RELATED PARTY 1600436 ESTIMATED PROFESSIONAL LIABILITY OBLIGATION 1700454 ACCRUED PENSION OBLIGATION -8406 5869301 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, 2023. TAX RETURNS FOR THE YEAR ENDED JUNE 30, 2019, ARE OPEN FOR THE MHS ENTITIES AND TAX RETURNS FOR THE YEAR ENDED DECEMBER 31, 2020, ARE OPEN FOR CAMC ENTITIES. 1 1 X 1 X 1 X 1 1 0 1 0 1352552 1352552 1949686 1949686 1224235 1224235 4526473 4526473 0 0.00000 459197 22221 436976 0.00880 409059 0 409059 0.00820 868256 22221 846035 0.01700 5394729 4548694 846035 0.01700 0 3191394 0 2923296 2923296 X 1 1 1 1 PRESTON MEMORIAL HOSPITAL 150 MEMORIAL DRIVE KINGWOOD WV 26537 HTTP://WWW.PRESTONMEMORIAL.ORG/ 205013 X X X X X 24X7 LAB AND RADIOLOGY. CENTER OF EXCELLENCE IN BARIATRIC SURGERY. PRESTON MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 1 0 1 X HTTPS://WWW.MONHEALTH.COM/PRESTON-MEMORIAL/WELLNESS-INITIATIVES X 1 21 1 HTTPS://WWW.MONHEALTH.COM/PRESTON-MEMORIAL/WELLNESS-INITIATIVES 0 1 X 200.000000000000 200.000000000000 X X X X 1 1 X X X 1 X HTTPS://WWW.MONHEALTH.COM/PRESTON-MEMORIAL/PATIENT-PAYMENTS X HTTPS://WWW.MONHEALTH.COM/PRESTON-MEMORIAL/PATIENT-PAYMENTS X HTTPS://WWW.MONHEALTH.COM/PRESTON-MEMORIAL/PATIENT-PAYMENTS X X X X X 1 X 0 X X X 1 X 0 0 PRESTON MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: THE 2022 CHNA INCLUDED QUANTITATIVE RESEARCH METHODS AND COMMUNITY CONVERSATIONS TO DETERMINE HEALTH TRENDS AND DISPARITIES AFFECTING PRESTON COUNTY RESIDENTS. THROUGH A COMPREHENSIVE VIEW OF STATISTICAL HEALTH INDICATORS AND COMMUNITY 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 PRESTON MEMORIAL HOSPITAL PART V, SECTION B, LINE 6A: GRAFTON CITY HOSPITAL PRESTON MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: PRESTON MEMORIAL HOSPITAL DEVELOPED AN IMPLEMENTATION PLAN THAT ADDRESSED ALL OF THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA. THE SIGNIFICANT NEEDS IDENTIFIED AND HOW PRESTON HAS RESPONDED:1. OBESITY: DIETITIAN ASSISTANCE FOR HEALTHY EATING AND PHYSICIAN GUIDED WEIGHT-LOSS PROGRAM; SPONSORED FITNESS CENTER; COMMUNITY EDUCATION2. CHRONIC LUNG DISEASE: TOBACCO PREVENTION AND CESSATION; SCHOOL- BASED YOUTH AND PARENT E-CIGARETTE AND VAPING PREVENTION EDUCATION; COMMUNITY-BASED EDUCATIONAL PRESENTATIONS; FREE TOBACCO CESSATION CLASSES; PULMONARY REHABILITATION CENTER SERVICES; PROVISION OF LOW-DOSE CT SCAN CARE PATHWAY FOR PATIENTS WITH QUALIFYING CRITERIA3. DIABETES AND CORONARY HEART DISEASE: FREE OR REDUCED COST COMMUNITY-BASED SCREENINGS, PARTICIPATION IN HEALTH FAIRS; EDUCATIONAL PRESENTATIONS; FIRST AID AND CPR COURSES FOR COMMUNITY MEMBERS AND HEALTHCARE PROVIDERS4. OPIOID USE DISORDER: SPEAKERS BUREAUS ON OPIOID PREVENTION AND ALTERNATIVES TO PAIN MANAGEMENT; PARTNERSHIP WITH MEDICATION-ASSISTED TREATMENT PROGRAM; PROVIDED SCHOOL-BASED YOUTH EDUCATION ON DRUG PREVENTION; IMPLEMENTATION OF THE RECOVERY CARE PROGRAM; IMPLEMENTATION OF PEER RECOVERY PROGRAM- REVERSE THE CYCLE;5. COVID 19 RESPONSE: SCREENINGS, COMMUNITY VACCINE CLINICS; STATE SPONSORED TESTING LOCATION UNTIL JUNE 2022; EXPANSION OF TELEHEALTH SERVICES; DEVELOPMENT OF VIRTUAL HEALTH EDUCATION MATERIALS PART I, LINE 3C: THE VP OF FINANCIAL SERVICES AND FINANCIAL COUNSELOR REVIEW ALL CHARITY APPLICATIONS. THE VP OF FINANCIAL SERVICES AND COUNSELOR THEN DETERMINE, BASED ON FINANCIAL INFORMATION GIVEN BY THE PATIENT (TAX RETURNS, PAY STUBS, HOUSEHOLD EXPENSES, AND OTHER FAMILY CONSIDERATIONS), IF DEEP DISCOUNTS CAN BE PROVIDED TO THE PATIENT, OR IF A COMPLETE WRITE-OFF TO FREE-CARE IS DEEMED APPROPRIATE. PART I, LINE 7: ACTUAL REVENUE AND COSTS WERE TAKEN FROM THE GENERAL LEDGER. REASONABLE ESTIMATES WERE USED WHERE APPROPRIATE. FINANCIAL ASSISTANCE AT COST WAS CALCULATED BASED ON THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. UNREIMBURSED MEDICAID AND UNREIMBURSED COST - OTHER MEANS-TESTED GOVERNMENT PROGRAMS WERE CALCULATED USING THE CALCULATED COST-TO-CHARGE RATIO. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS AND HEALTH PROFESSIONS EDUCATION WERE CALCULATED USING INTERNAL COST ACCOUNTING SYSTEMS THAT USE DIRECT AND INDIRECT COST REPORTING. PART I, LINE 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 $ 3,191,394. PART III, LINE 2: BAD DEBT EXPENSE AS REPORTED ON THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 4: PATIENTS SEEKING FINANCIAL ASSISTANCE COMPLETE FINANCIAL ASSISTANCE APPLICATIONS AND WORK WITH THE HOSPITAL'S FINANCIAL COUNSELOR TO DETERMINE APPROPRIATE LEVELS OF DISCOUNTS (OR COMPLETE FREE CARE) BASED ON INFORMATION SUPPLIED BY THE PATIENT. ALL SELF-PAY PATIENTS ARE OFFERED BASELINE DISCOUNTS OF 10% FROM CHARGES, AND AN ADDITIONAL 30% PROMPT PAYMENT DISCOUNT IF PAYMENT IS MADE WITHIN A CERTAIN TIME PERIOD AFTER RECEIVING A BILL. PATIENTS WHO REFUSE ASSISTANCE AND REFUSE PAYMENT OPTIONS ARE TURNED OVER TO A COLLECTION AGENCY AFTER 3 BILLS HAVE BEEN SUBMITTED, AND BAD DEBT IS RECOGNIZED AT THAT TIME. PART III, LINE 8: MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE HOSPITAL'S MEDICARE COST REPORT. PART III, LINE 9B: THE HOSPITAL FINANCIAL COUNSELING STAFF HELPS PATIENTS SEEK FINANCIAL ASSISTANCE THROUGH GOVERNMENT PROGRAMS OR OTHER PAYMENT SERVICES BEFORE APPLYING FOR CHARITY CARE. IF GOVERNMENT PROGRAMS OR OTHER SERVICES ARE DENIED, A FINANCIAL COUNSELOR WORKS WITH PATIENT TO OBTAIN FINANCIAL INFORMATION LIKE TAX RETURNS, HOUSEHOLD BILLS, BANK ACCOUNT INFORMATION, ETC. THE FINANCIAL COUNSELOR WORKS WITH THE VP OF FINANCIAL SERVICES TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FULL OR PARTIAL CHARITY CARE. ONCE THIS DETERMINATION IS MADE, THE FINANCIAL COUNSELOR COMMUNICATES RESULTS WITH THE PATIENT. IF PARTIAL PAYMENT IS DUE AFTER A DISCOUNT HAS BEEN RECOMMENDED, THE FINANCIAL COUNSELOR WORKS WITH THE PATIENT ON A PAYMENT ARRANGEMENT. IF A PATIENT, WHO HAS BEEN DEEMED ELIGIBLE FOR PARTIAL CHARITY CARE, AGREES TO A PAYMENT PLAN AND THEN FAILS TO PAY THE REMAINING BALANCE AGREED TO, THE REMAINING BALANCE WILL BE ADJUSTED OFF AS BAD DEBT. THE REMAINING BALANCE WILL BE TURNED OVER TO A COLLECTION AGENCY. PART VI, LINE 2: THE FOLLOWING RESEARCH METHODS WERE USED TO DETERMINE COMMUNITY HEALTH NEEDS:STATISTICAL ANALYSIS OF HEALTH AND SOCIOECONOMIC INDICATORS; A FULL LISTING OF DATA REFERENCES IS INCLUDED IN APPENDIX A PARTNER MEETING CONDUCTED WITH PRESTON COUNTY COMMUNITY AGENCY REPRESENTATIVES TO ENGAGE THEM IN THE CHNA AND GARNER INSIGHT ON COMMUNITY HEALTH CHALLENGES AND OPPORTUNITIES FOR PARTNERSHIP. TO WORK TOWARD HEALTH EQUITY, IT IS IMPERATIVE TO PRIORITIZE RESOURCES AND ACTIVITIES TOWARD THE MOST PRESSING AND CROSSCUTTING HEALTH NEEDS WITHIN THE COMMUNITY. PRIORITIES WERE DETERMINED BY THE PMH CHNA PLANNING COMMITTEE, TAKING INTO CONSIDERATION RESEARCH FINDINGS AND FEEDBACK FROM COMMUNITY STAKEHOLDERS. USING FEEDBACK FROM COMMUNITY PARTNERS AND STAKEHOLDERS AND TAKING INTO ACCOUNT THE HOSPITAL'S EXPERTISE AND RESOURCES.AS PART OF THE CHNA, PMH HOSTED A PARTNER MEETING ON MAY 23, 2022. A TOTAL OF 14 PEOPLE ATTENDED REPRESENTING HEALTH AND SOCIAL SERVICE AGENCIES, EDUCATION SECTORS, SENIOR SERVICES, AND CIVIC ORGANIZATIONS. THE OBJECTIVE OF THE FORUM WAS TO SHARE DATA FROM THE CHNA AND GARNER FEEDBACK ON COMMUNITY HEALTH PRIORITIES, AS WELL AS OPPORTUNITIES FOR COLLABORATION AMONG PARTNER AGENCIES. RESEARCH FROM THE CHNA WAS PRESENTED AT THE SESSION. GROUP DIALOGUE WAS FACILITATED TO DISCUSS RESEARCH FINDINGS, EXISTING RESOURCES AND INITIATIVES TO ADDRESS PRIORITY AREAS, THE IMPACT OF COVID19 ON COMMUNITIES AND SERVICES, AND NEW OR INNOVATIVE OPPORTUNITIES FOR CROSSSECTOR COLLABORATION.SOCIAL DETERMINANTS OF HEALTH (SDOH) ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE RANGE OF HEALTH RISKS AND OUTCOMES. HEALTHY PEOPLE 2030, THE CDC'S NATIONAL BENCHMARK FOR HEALTH, RECOGNIZES SDOH AS CENTRAL TO ITS FRAMEWORK, NAMING "SOCIAL AND PHYSICAL ENVIRONMENTS THAT PROMOTE GOOD HEALTH FOR ALL" AS ONE OF THE FOUR OVERARCHING GOALS FOR THE DECADE. HEALTHY PEOPLE 2030 OUTLINES FIVE KEY AREAS OF SDOH: ECONOMIC STABILITY, EDUCATION ACCESS AND QUALITY, HEALTHCARE ACCESS AND QUALITY, NEIGHBORHOOD AND BUILT ENVIRONMENT, AND SOCIAL AND COMMUNITY CONTEXT.THE MIX OF INGREDIENTS THAT INFLUENCE EACH PERSON'S OVERALL HEALTH PROFILE INCLUDE INDIVIDUAL BEHAVIORS, CLINICAL CARE, ENVIRONMENTAL FACTORS, AND SOCIAL CIRCUMSTANCE. WHILE HEALTH IMPROVEMENT EFFORTS HAVE HISTORICALLY TARGETED HEALTH BEHAVIORS AND CLINICAL CARE, PUBLIC HEALTH AGENCIES, INCLUDING THE US CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), WIDELY HOLD THAT AT LEAST 50% OF A PERSON'S HEALTH PROFILE IS DETERMINED BY SDOH.ADDRESSING SDOH IS A PRIMARY APPROACH TO ACHIEVING HEALTH EQUITY. HEALTH EQUITY ENCOMPASSES A WIDE RANGE OF SOCIAL, ECONOMIC, AND HEALTH MEASURES BUT CAN BE SIMPLY DEFINED AS "A FAIR OPPORTUNITY FOR EVERY PERSON TO BE AS HEALTHY AS POSSIBLE." IN ORDER TO ACHIEVE HEALTH EQUITY, WE NEED TO LOOK BEYOND THE HEALTHCARE SYSTEM TO DISMANTLE SYSTEMATIC INEQUITIES BORN THROUGH RACISM AND DISCRIMINATION LIKE POWER AND WEALTH DISTRIBUTION, EDUCATION ATTAINMENT, JOB OPPORTUNITIES, HOUSING, AND SAFE ENVIRONMENTS, TO BUILD A HEALTHIER COMMUNITY FOR ALL PEOPLE NOW AND IN THE FUTURE. PART VI, LINE 3: THE HOSPITAL PERSONNEL INSTRUCT PATIENTS DURING THE REGISTRATION PROCESS WHO DO NOT HAVE INSURANCE OR THE INABILITY TO PAY, TO COMPLETE AN APPLICATION FOR CHARITY CARE AFTER ALL OTHER SOURCES OF FINANCIAL ASSISTANCE HAVE BEEN DENIED. HOSPITAL PERSONNEL ASSIST PATIENTS WITH OBTAINING OTHER FINANCIAL ASSISTANCE BEFORE APPLYING FOR CHARITY CARE. THE FINANCIAL COUNSELING POLICY IS POSTED IN THE WAITING ROOMS AND AT THE FRONT-DESK. THE HOSPITAL ALSO HAS A FORMAL RESOLUTION IN PLACE WITH THE PRESTON COUNTY COMMISSION (LOCAL GOVERNMENT) INFORMING ALL LOCAL CITIZENS OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. PART VI, LINE 4: PRESTON COUNTY IS A RURAL COMMUNITY LOCATED IN WEST VIRGINIA'S SCENIC MOUNTAINEER COUNTRY. THE COUNTY HAD A TOTAL POPULATION OF 34,216 AS OF THE 2020 CENSUS, AND CONTRARY TO STATEWIDE POPULATION DECLINE, SAW SMALL POPULATION GROWTH OF +2.1% FROM THE 2010 CENSUS. WHILE MOST PRESTON COUNTY RESIDENTS (90%) IDENTIFY AS WHITE, CONSISTENT WITH THE STATE, POPULATION GROWTH OCCURRED EXCLUSIVELY AMONG NONWHITE INDIVIDUALS. THE BLACK/AFRICAN AMERICAN POPULATION MORE THAN QUADRUPLED FROM THE 2010 CENSUS. PRESTON COUNTY IS AN AGING COMMUNITY. APPROXIMATELY 20% OF RESIDENTS ARE AGED 65 OR OLDER, AN INCREASE FROM PRIOR YEARS, AND HIGHER THAN THE NATIONAL AVERAGE OF 16%. WHILE THE OLDER ADULT POPULATION INCREASED, YOUTH UNDER AGE 18 ALSO COMPRISE NEARLY 20% OF PRESTON COUNTY RESIDENTS, REINFORCING THE POTENTIAL IMPACT OF UPSTREAM, PREVENTATIVE INITIATIVES. POSITIVE SDOH INDICATORS WITHIN PRESTON COUNTY INCLUDE HOUSING AFFORDABILITY AND HOMEOWNERSHIP. MORE THAN 81% OF RESIDENTS OWN THEIR HOME AND 20% OF HOMEOWNERS ARE HOUSING COST BURDENED COMPARED TO 27% NATIONALLY. COST BURDEN IS DEFINED AS SPENDING 30% OR MORE OF HOUSEHOLD INCOME ON HOUSING. PRESTON COUNTY DIFFERS FROM THE STATE WITH A LOWER PROPORTION OF ALL RESIDENTS AND CHILDREN LIVING IN POVERTY, ALTHOUGH IT CONTINUES TO EXCEED NATIONAL TRENDS. ADDITIONALLY, MORE THAN 13% OF PRESTON COUNTY OLDER ADULTS LIVE IN POVERTY COMPARED TO 10% STATEWIDE AND NATIONALLY. THIS FINDING IS SIGNIFICANT DUE TO THE LARGE AND GROWING PROPORTION OF OLDER ADULT RESIDENTS.A ZIP CODE LEVEL ANALYSIS FOUND THAT RESIDENTS OF 26537, KINGWOOD EXPERIENCE MORE SOCIOECONOMIC BARRIERS THAN OTHER PRESTON COUNTY RESIDENTS. WITHIN KINGWOOD, APPROXIMATELY 1 IN 5 RESIDENTS AND 1 IN 4 CHILDREN LIVE IN POVERTY AND NEARLY 15% OF ADULTS HAVE NOT COMPLETED HIGH SCHOOL. THE HEALTH IMPACT OF THESE INDICATORS IS DEMONSTRATED IN LIFE EXPECTANCY DIFFERENCES. KINGWOOD HAS AN AVERAGE LIFE EXPECTANCY. FOR RESIDENTS OF 73.9 YEARS COMPARED TO 78.2 YEARS OR HIGHER IN OTHER PORTIONS OF THE COUNTY. PART VI, LINE 5: PRESTON MEMORIAL HOSPITAL HAS A GOVERNING BODY COMPRISED OF CITIZENS OF PRESTON COUNTY. THEY ARE NOT EMPLOYEES, CONTRACTORS OR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS PRIVILEGES TO QUALIFIED PHYSICIANS IN THE COMMUNITY AND BEYOND TO HELP TAKE CARE OF THE NEEDS OF ITS PATIENTS. THE ORGANIZATION ROUTINELY DOES NOT HAVE SURPLUS FUNDS AVAILABLE FROM OPERATIONS. HOWEVER, THE HOSPITAL HAS IDENTIFIED RESOURCES THROUGH BORROWING OR FUNDRAISING TO INVEST IN NEW TECHNOLOGIES FOR IMAGING SERVICES, ELECTRONIC HEALTH RECORDS, FACILITY IMPROVEMENTS, PATIENT CARE ROOM UPGRADES AND OTHER CLINICAL CAPITAL IMPROVEMENTS (E.G., MONITORS, VENTS, SURGICAL EQUIPMENT, ETC.). THE HOSPITAL ALSO PROVIDES 24 X 7 EMERGENCY SERVICES AND A LEVEL 4 TRAUMA CENTER. THE HOSPITAL'S EMERGENCY DEPARTMENT AND ALL OTHER CLINICAL SERVICES WHERE MEDICAL NEED IS DEMONSTRATED IS AVAILABLE TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL'S SPECIALIZED SERVICES INCLUDE: ENT, OB/GYN CARE, GENERAL SURGERY, ORTHOPEDICS, PSYCHIATRY, PHYSICAL THERAPY, CARDIOLOGY, LABORATORY, RADIOLOGY, AND NEUROLOGY. IF THESE SERVICES WERE NOT AVAILABLE, PATIENTS IN THE PRIMARY SERVICE AREA WOULD HAVE TO TRAVEL MORE THAN 45 MINUTES TO OBTAIN THESE SERVICES ELSEWHERE. THE HOSPITAL WORKS DILIGENTLY TO ATTRACT CHARITABLE SUPPORT THROUGH ITS FOUNDATION, AND ENGAGES OVER 20 VOLUNTEERS TO SUPPORT MULTIPLE ACTIVITIES AT THE HOSPITAL. PART VI, LINE 6: AS OF 2/28/2014, PRESTON MEMORIAL HOSPITAL, COLLECTIVELY WITH PRESTON MEMORIAL FOUNDATION AND PRESTON MEMORIAL MEDICAL GROUP, IS PART OF THE MON HEALTH SYSTEM, INC. THE MON HEALTH SYSTEM INCLUDES MONONGALIA COUNTY GENERAL HOSPITAL COMPANY, MON ELDER SERVICES, INC., MON HEALTH CARE AND STONEWALL JACKSON MEMORIAL HOSPITAL. ALL ENTITIES ARE UNDER COMMON GOVERNANCE AND CONTROL, AND COLLECTIVELY OPERATE TO SERVE THE HEALTHCARE NEEDS AND CHARITABLE NEEDS OF THE COMMUNITY. THE MEDICAL GROUP PROVIDES OFFICE RENTAL SPACE TO OTHER HEALTH CARE PROVIDERS IN THE COMMUNITY. THE FOUNDATION SERVES AS A FUNDRAISING ARM OF THE HOSPITAL TO HELP PROVIDE SUPPORT FOR CAPITAL IMPROVEMENTS, MAINTENANCE COSTS FOR THE RADIOLOGY DEPARTMENT, AND TO SUPPORT COMMUNITY ACTIVITIES THROUGH CHARITABLE GIVING. PART VI, LINE 7, REPORTS FILED WITH STATES WV 0 1 0 0 0 0 0 0 0 DAVID GOLDBERG DIRECTOR, MHS PRES/CEO 0 714488 0 139175 0 0 0 30000 0 6373 0 890036 0 0 FRANK ABRAHAM PHYSICIAN 607024 0 0 0 0 0 24390 0 42950 0 674364 0 0 0 LORN WOLFE PHYSICIAN 424384 0 25490 0 0 0 18128 0 35575 0 503577 0 0 0 MARISA DOWNEY PHYSICIAN 406970 0 38654 0 0 0 17898 0 22152 0 485674 0 0 0 DAVID FOURQUREAN PHYSICIAN 353893 0 55500 0 0 0 16529 0 22702 0 448624 0 0 0 MARAM HAKOUM PHYSICIAN 370233 0 0 0 0 0 14905 0 10425 0 395563 0 0 0 MELISSA LOCKWOOD DIRECTOR/PMH CAO 0 257560 0 31768 0 0 0 49500 0 3348 0 342176 0 0 JASON MCNAIR DIRECTOR/CHIEF OF STAFF (START 05/23 238468 0 21917 0 0 0 10404 0 291 0 271080 0 0 0 KEVIN GESSLER VP OF FINANCE 0 227811 0 20438 0 0 0 0 0 1153 0 249402 0 0 PART I, LINE 3: THE CEO'S COMPENSATION IS PAID BY MONONGALIA HEALTH SYSTEAM. MONONGALIA HEALTH SYSTEM USES THE FOLLOWING METHOD TO ESTABLISH THE COMPENSATION OF THE CEO: -COMPENSATION COMMITTEE; -INDEPENDENT COMPENSATION CONSULTANT; -COMPENSATION SURVEY OR STUDY; -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B: 457(F) INELIGIBLE DEFERRED COMPENSATION PLAN - A 457 F PLAN IS OFFERED TO CERTAIN MANAGEMENT AND/OR HIGHLY COMPENSATED EMPLOYEES TO OFFER THOSE EMPLOYEES A DEFERRED COMPENSATION OPPORTUNITY. THE PLAN IS INTENDED TO BE A "TOP-HAT PLAN", OR UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF EMPLOYEES. PARTICIPANTS MAY BECOME VESTED IN AMOUNTS CREDITED ON JANUARY 1 ELECTED BY THE PARTICIPANT AT THE TIME THE INITIAL DEFERRAL WAS ELECTED. A PARTICIPANT SHALL BECOME FULLY VESTED UPON DEATH, DISABILITY, ATTAINMENT OF AGE 60, OR SEPARATION OF SERVICE, AS DEFINED BY THE PLAN. ANY UNVESTED CONTRIBUTIONS SHALL BE FORFEITED TO THE PLAN OR EMPLOYER. FOR 2023: PER BENEFITS - NO DISTRIBUTIONS / PAYMENTS WERE MADE FROM THE PLAN; DAVID GOLDBERG WAS THE ONLY PARTICIPANT. ALISA MARTIN FAMILY MEMBER OF NICK TAYLOR, TRUSTEE 38075 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF PRESTON MEMORIAL HOSPITAL CORPORATION IS MONONGALIA HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A PRESTON MEMORIAL HOSPITAL'S BOARD MEMBERS ARE ELECTED OR APPOINTED BY MONONGALIA HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B PRESTON MEMORIAL HOSPITAL'S BOARD SHALL GIVE NOTICE TO MONONGALIA HEALTH SYSTEM AND RECEIVE ITS APPROVAL BEFORE ACTING ON ANY OF THE FOLLOWING MATTERS: (A) AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE HOSPITAL OR THE BYLAWS; (B) SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF THE HOSPITAL AND ANY EXPENDITURE IN EXCESS OF $750,000; (C) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION; (D) ELECTION TO DISSOLVE THE HOSPITAL ENTITY; (E) APPROVAL OF THE BUDGET OF THE HOSPITAL; (F) APPROVAL IN ADVANCE OF THE HIRING OF THE PRESIDENT OF THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B THE GOVERNING BODY IS PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW PRIOR TO SUBMISSION. THE MEMBERS ARE ASKED TO INFORM MANAGEMENT OF ANY QUESTIONS OR REVISIONS THEY MAY HAVE. IF CHANGES ARE MADE, BASED ON 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 REVIEWS ALL RESPONSES FOR POSSIBLE CONFLICTS OF INTEREST AND DETERMINES WHAT TYPES OF DECISIONS THAT A MEMBER IS PROHIBITED FROM PARTICIPATING. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY, A CONSULTANT COMPILES A MARKET DATA REPORT ON CEO COMPENSATION. THIS REPORT IS THEN REVIEWED BY THE EXECUTIVE COMMITTEE OF MON HEALTH SYSTEM TO DETERMINE COMPENSATION FOR THE INDIVIDUAL. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE THROUGH PUBLIC DISCLOSURE WITH THE WV HEALTH CARE AUTHORITY. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,861,629. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,861,629. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 3,509,318. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,509,318. ACUTE CARE SERVICES: PROGRAM SERVICE EXPENSES 68,117. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 68,117. VANDALIA HEALTH INC PO BOX 1547 CHARLESTON WV 253261547 550664138 PARENT COMPANY WV 501(C)(3) 12C, III-FI N/A 0 CAMC FOUNDATION INC PO BOX 1547 CHARLESTON WV 253261547 310887133 FUNDRAISING WV 501(C)(3) 12A, I CHARLESTON AREA MEDICAL CENTER INC 1 CHARLESTON AREA MEDICAL CENTER INC PO BOX 1547 CHARLESTON WV 253261547 550526150 HOSPITAL WV 501(C)(3) 3 VANDALIA HEALTH INC 0 MONONGALIA HEALTH SYSTEM INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550621551 PARENT COMPANY WV 501(C)(3) 12C, III-FI VANDALIA HEALTH INC 0 MONONGALIA COUNTY GENERAL HOSPITAL COMPANY 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 237441353 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 MON ELDER SERVICES INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 311520863 CONTINUING CARE RETIREMENT CENTER WV 501(C)(3) 10 MONONGALIA HEALTH SYSTEM INC 1 THE FOUNDATION OF MONONGALIA GENERAL HOSPITAL 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550570338 RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL WV 501(C)(3) 7 MONONGALIA COUNTY GENERAL HOSPITAL CO 1 PRESTON MEMORIAL MEDICAL GROUP 300 SOUTH PRICE STREET KINGWOOD WV 26537 550717988 PRIMARY AND URGENT CARE WV 501(C)(3) 3 PRESTON MEMORIAL HOSPITAL 1 PRESTON MEMORIAL HOSPITAL FOUNDATION 300 SOUTH PRICE STREET KINGWOOD WV 26537 550740121 RAISE FUNDS FOR PRESTON HOSPITAL WV 501(C)(3) 12B, II PRESTON MEMORIAL HOSPITAL 1 AUXILIARY OF MONONGALIA GENERAL HOSPITAL INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550362965 RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL WV 501(C)(3) 12A, I MONONGALIA COUNTY GENERAL HOSPITAL CO 1 LIABILITY INSURANCE TRUST FOR MONONGALIA HEALTH SYSTEM 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550689535 LIABILITY INSURANCE TRUST WV 501(C)(3) 12A, I MONONGALIA HEALTH SYSTEM INC 1 STONEWALL JACKSON MEMORIAL HOSPITAL 230 HOSPITAL PLAZA WESTON WV 26452 550422958 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC 140 MIDDLETOWN LOOP WHITEHALL WV 26554 853994078 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 CAMC GREENBRIER VALLEY MEDICAL CENTER INC 1320 MAPLEWOOD AVENUE RONCEVERTE WV 24970 884128022 HOSPITAL WV 501(C)(3) 3 CHARLESTON AREA MEDICAL CENTER INC 1 CAMC PLATEAU MEDICAL CENTER INC 430 MAIN STREET OAK HILL WV 25901 921715117 HOSPITAL WV 501(C)(3) 3 CHARLESTON AREA MEDICAL CENTER INC 1 CAMC HEALTH EDUCATION AND RESEARCH INSTITUTE INC PO BOX 1547 CHARLESTON WV 253261547 550753754 MEDICAL EDUCATIONAL RESEARCH WV 501(C)(3) 12A, I CHARLESTON AREA MEDICAL CENTER INC 1 BROADDUS HOSPITAL ASSOCIATION INC PO BOX 930 PHILLIPI WV 26416 550379108 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM INC 1 DAVIS HEALTH SYSTEM INC PO BOX 1484 ELKINS WV 26241 550737655 HEALTH SYSTEM WV 501(C)(3) 12B, II MONONGALIA HEALTH SYSTEM INC 1 DAVIS MEMORIAL HOSPITAL INC PO BOX 1484 ELKINS WV 26241 550375433 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM INC 1 DAVIS HEALTH SYSTEM FOUNDATION INC PO BOX 1188 ELKINS WV 26241 320185772 PROVIDES SUPPORT TO DAVIS HEALTH SYSTEM ENTITIES WV 501(C)(3) 10 DAVIS HEALTH SYSTEM INC 1 WEBSTER MEMORIAL HOSPITAL 812 GORMAN AVENUE ELKINS WV 26241 871759588 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM INC 1 WOMEN AND CHILDREN'S MEDICAL OFFICE BUILDING LLC PO BOX 1547 CHARLESTON WV 253261547 550669065 MEDICAL OFFICE BUILDING WV N/A 0 0 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 VANDALIA INSURANCE COMPANY 76 ST PAUL STREET STE 500 BURLINGTON VT 05401 030308754 INSURANCE VT N/A C 1 MON HEALTH CARE INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550654973 MEDICAL EQUIPMENT WV N/A C 1 STONEWALL HOME OXYGEN THERAPY INC 100 MARKET PLACE MALL SUITE 8 WESTON WV 26452 550754278 OXYGEN THERAPY SERVICES WV N/A C 1 FAIRMONT HOME EQUIPMENT AND SUPPLY 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550763259 EQUIPMENT RENT & SVC WV N/A C 1 MORGANTOWN PHYSICAL THERAPY ASSOC INC 943 MAPLE DRIVE MORGANTOWN WV 26505 550614636 REHABILITATION SERVICES WV N/A C 1 HEALTH FACILITIES INC 909 GORMAN AVENUE ELKINS WV 26241 550516937 HEALTH CARE WV N/A C 1 CENTRAL WV MEDCORP INC PO BOX 2630 ELKINS WV 26241 550739314 PHYSICIAN SERVICES WV N/A C 1 DAVIS REGIONAL HEALTH PARTNERS INC PO BOX 2632 ELKINS WV 26241 550746206 CONTRACT NEGOTIATIONS WV N/A C 1 ZERCOR RE SEGREGATED PORTFOLIO #2 DAVIS 18 FORUM LANE 2ND FLOOR GRAND CAYMAN CAYMAN ISLANDS CJ KY1-1102 CAPTIVE INSURANCE CJ N/A C 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1