2023-05-15T08:47:22-05:00 2022-06-30 390859910 Baker Tilly US LLP 101 Washington Street East Charleston WV 25301 990 2021-07-01 556000526 Grafton City Hospital GRAF 3042657152 1 Hospital Plaza Grafton WV 26354 Kevin Gessler Chief Financial Officer 3042657152 2023-05-10 1 Kevin Gessler 999009999 Dolores Rose P01286262 3043460441 2023-05-10 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z Kevin Gessler 1 Hospital Plaza Grafton WV 26354 19414207 0 X www.monhealth.com/grafton-hospital X 1972 WV To provide inpatient hospital care, outpatient services and emergency room services to the residents of Taylor County, WV and surrounding communities. 7 6 229 6 723960 0 970940 1174950 16530794 16916855 39639 40461 2569960 1281941 20111333 19414207 1350 700 0 0 10022069 10349832 0 0 0 8220649 9911641 18244068 20262173 1867265 -847966 12579232 10832298 13131586 12232618 -552354 -1400320 To provide inpatient hospital care, outpatient services and emergency room services to the residents of Taylor County, WV and surrounding communities. 0 0 15195930 17368458 The Hospital provided health care services including 5,976 emergency room visits, 970 acute hospital days, 0 long-term care days, 865 swing-bed days, and 237 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 $38,405. Additionally, the Hospital's Rural Health Clinic recorded 11,370 visits for the year. The hospital sponsored community health improvement services that included a health fair and New You Youth Fitness. 700 700 The organization provided grants to community organizations including a $500 sponsorship of a five mile run, $100 donation to Hospice and a $100 Christmas Toy Drive. 15196630 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 26 0 229 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 7 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Kevin Gessler 3043294700 1 Hospital Plaza Grafton WV 26354 John L Bord President 2.00 X X 0 0 0 John Whitescarver Vice President 2.00 X X 0 0 0 Nancy Fowler Finance Chair 2.00 X 0 0 0 David Bender MD Executive Credentials Chair 40.00 X 401989 0 6750 Wayne McDevitt Trustee 2.00 X 0 0 0 Larry Richman Trustee 2.00 X 0 0 0 Orville Wright Trustee 2.00 X 0 0 0 George Boyles termed 103121 CAO 40.00 X 131129 0 0 Kevin Gessler CAO/CFO 20.00 X 0 0 0 Joseph Duvert MD Physician 40.00 X 407548 0 3093 Andrew Berardinelli MD Physician 40.00 X 376822 0 2569 Thomas Wilshire DO Physician 40.00 X 321731 0 6569 Thomas Stevens DO Physician 40.00 X 425391 0 2141 Stephen Harris PA Physician Assistant 40.00 X 159880 0 2020 2224490 0 23142 10 0 1 1 Labcorp 231 Maple Ave Burlington NC 27215 Lab testing services 138792 TTG Healthcare LLC 2403 Sidney Street Suite 220-B Pittsburgh PA 15203 Nuclear Medicine Services 107519 2 1173185 1765 1174950 Net patient services 622110 16617019 16617019 340B program revenue 900099 299836 299836 16916855 40461 40461 6378 0 6378 6378 6378 Nursing Home Service Reimb 900099 723960 723960 Miscellaneous Revenue 900099 451603 451603 CHART Dividend 900099 100000 100000 1275563 19414207 17368458 723960 146839 700 700 539868 369594 170274 8013926 5486334 2527592 1235504 845826 389678 560534 383742 176792 410912 281310 129602 35133 35133 37469 37469 1568337 1073685 494652 1146781 785178 361603 215659 147640 68019 121543 83208 38335 3530 2417 1113 121771 83364 38407 604628 413928 190700 479457 328236 151221 Bad Debt and Charity Ex 2504779 2504779 Medical supplies 1492653 1492653 Repairs & maintenance 673227 460891 212336 Medicaid provider tax 251547 251547 244215 201598 42617 20262173 15196630 5065543 0 2701898 1466970 2758722 1015950 2099775 2549883 239323 251342 336482 578813 21347024 18019127 3475215 3327897 967817 1006709 0 634734 12579232 10832298 2211228 3494201 2657650 2457650 8262708 6280767 13131586 12232618 X -552354 -1400320 -552354 -1400320 12579232 10832298 -847966 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 17740 17740 0 Part II-B, Line 1: Part 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 06/30/22, the amount of dues related to lobbying activities was $17,740.25. 26597 26597 8906249 8112200 794049 388268 157594 230674 11728795 9749333 1979462 297115 297115 3327897 CHART RRG - Investment 1006709 C 1006709 Right of Use Asset 634734 634734 Capital leases 206111 Third-party payor settlements 2433049 Taxable bonds 3006873 Operating Lease Liability 634734 6280767 16909428 0 16909428 2504779 2504779 19414207 17757394 0 17757394 2504779 2504779 20262173 Part XI, Line 4b - Other Adjustments: Bad debt expense netted against revenue on financial statements 2,504,779. Part XII, Line 4b - Other Adjustments: Bad debt expense netted against revenue on financial statements 2,504,779. 1 1 X 1 X 0 1 1 0 0 290842 290842 36882 36882 327724 327724 0 0.00000 327724 327724 0 0.00000 1 2504779 3162674 3162674 X 1 1 1 1 Grafton City Hospital Inc 500 Market Street Grafton WV 25354 X X X X Grafton City Hospital 1 0 0 1 X X X X X X X X X 21 1 1 0 1 X See Part V Supplemental Information X 1 21 1 https://www.monhealth.com/grafton-hospital 0 1 X 100.000000000000 100.000000000000 X X X 1 1 X X X 1 X http://www.graftonhospital.com/patients---vistors.html X http://www.graftonhospital.com/patients---vistors.html X http://www.graftonhospital.com/patients---vistors.html X X X X X X 1 X 0 X X X X 1 X 0 0 Grafton City Hospital Part 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 Hospital Part V, Section B, Line 6a: Preston Memorial Hospital Grafton City Hospital Part 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 Hospital Part 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 Hospital Part 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 7a The URL link for the CHNA:https://www.monhealth.com/Uploads/Public/Documents/Grafton/2022%20CHNA%20Report.pdf 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 $ 2,504,779. 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 area's 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 and on the website. Part VI, Line 4: The facility is a rural 25-bed Critical Access Hospital located in Grafton, WV. The 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 (2019). The service area is concentrated in Grafton, WV and spans the counties of Taylor, Preston and Barbour. There are two other hospitals located within the service area. These are Preston Memorial Hospital and Broaddus Hospital. Both of these hospitals are rural 25-bed Critical Access Hospitals. The population coverage by the service area is approximately 67,000 based on the 2010 Census information. 2014 data from Health Indicators.gov: 17.20% of Taylor county residents, 17.0% for Preston county residents and 21.4% of Barbour county residents are living in poverty. The median household income for Taylor, Preston and Barbour counties is $39,536, $45,413 and $37,327, respectively. The Median household income for the State of WV is $41,043 (based on 2013 data). 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 neither employees or 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 has a management services agreement with Mon Health, an integrated health system, in neighboring Monongalia County. Grafton City Hospital works with hospitals within Mon Health to gain access to specific specialties, including cardiology, to help promote gaps identified in the Taylor County community. X X X 0 0 0 0 0 0 0 0 0 Thomas Stevens DO Physician 370326 0 50418 0 4647 0 0 0 2141 0 427532 0 0 0 Joseph Duvert MD Physician 407548 0 0 0 0 0 0 0 3093 0 410641 0 0 0 David Bender MD Executive Credentials Chair 337598 0 61641 0 2750 0 0 0 6750 0 408739 0 0 0 Andrew Berardinelli MD Physician 339254 0 34669 0 2899 0 0 0 2569 0 379391 0 0 0 Thomas Wilshire DO Physician 321731 0 0 0 0 0 0 0 6569 0 328300 0 0 0 Stephen Harris PA Physician Assistant 132192 0 3338 0 24350 0 0 0 2020 0 161900 0 0 0 Form 990, Part IV, Line 23 Grafton City Hospital has a management agreement with Monongalia Health System. Kevin Gessler is the contracted CFO through this agreement. The portion of his 2022 compensation and benefits allocated to his time as Grafton's CFO was $105,864. David BenderMD Physician/Board Member 40023 Dr. Bender is compensated for his services to the Hospital through payroll compensation. Grafton Medical Associates, of which Dr. Bender is an owner, also supplies services to the Hospital for which the Hospital is billed through invoices from the company. In FY 2022, moneys paid through accounts payable to Grafton Medical Associates amounted to $40,023. 0 Form 990, Part VI, Section B, line 11b The 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 12c Trustees 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 15 A 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 18 The 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 19 The 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.