MARIETTA MEMORIAL HOSPITAL OF TYLER COUNTY INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MARIETTA MEMORIAL HOSPITAL OF TYLER COUNTY INC (EIN 85-2862205)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-15
- IRS object ID
- 202342279349303314
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-08-15T13:39:53-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 271235638 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCM CPAS & ADVISORS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 S FIFTH STREET SUITE 2100 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 852862205 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARIETTA MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | OF TYLER COUNTY INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MARI | BusinessNameControlTxt |
| Phone | 3046522611 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 314 SOUTH WELLS STREET | AddressLine1Txt |
| City | SISTERSVILLE | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26175 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT SILVESTRI | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3046522611 | PhoneNum |
| Signature | 2023-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SCOTT | PersonFirstNm |
| Person Last | SILVESTRI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THERESA BATLINER CPA | PreparerPersonNm |
| PTIN | P00543162 | PTIN |
| Phone | 5027491900 | PhoneNum |
| Preparation | 2023-08-14 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Application Pending | Yes (X) | ApplicationPendingInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SISTERSVILLE GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | J SCOTT CANTLEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 MATTHEW ST | AddressLine1Txt |
| City | MARIETTA | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45750 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,992,592 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MHSYSTEM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2020 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | SISTERSVILLE GENERAL HOSPITAL IS A NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL WHERE SERVICE EXCELLENCE AND CLINICAL QUALITY CREATE THE REGION'S BEST EXPERIENCE FOR PATIENTS AND THEIR FAMILIES, PHYSICIANS, THE COMMUNITY AND OUR EMPLOYEES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 178 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,641,711 | PYContributionsGrantsAmt |
| CY Contributions Grants | $598,935 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,361,878 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $18,015,205 | CYProgramServiceRevenueAmt |
| PY Investment Income | $810 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,741 | CYInvestmentIncomeAmt |
| PY Other Revenue | $450,922 | PYOtherRevenueAmt |
| CY Other Revenue | $374,711 | CYOtherRevenueAmt |
| PY Total Revenue | $16,455,321 | PYTotalRevenueAmt |
| CY Total Revenue | $18,992,592 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,407,968 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,358,836 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,975,906 | PYOtherExpensesAmt |
| CY Other Expenses | $6,247,966 | CYOtherExpensesAmt |
| PY Total Expenses | $13,383,874 | PYTotalExpensesAmt |
| CY Total Expenses | $17,606,802 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,071,447 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,385,790 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,506,958 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,432,709 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,856,308 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,396,269 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,650,650 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,036,440 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE ARE 200 STRONG. WE ENHANCE THE QUALITY OF LIFE IN THE AREA. WE NURTURE AND CARE FOR OUR COMMUNITY BY CARING FOR YOU, YOUR FRIENDS, NEIGHBORS AND RELATIVES 24 HOURS A DAY, SEVEN DAYS A WEEK, 365 DAYS A YEAR. WE ARE QUALITY - WITH ACCREDITATIONS, CERTIFICATIONS AND DESIGNATIONS TO EXPRESS, UTILIZE AND DEMONSTRATE OUR EXPERTISE. WE ARE PART OF A SYSTEM THAT EXTENDS ACCESS TO SPECIALISTS AND NATIONALLY RECOGNIZED CARE. WE ARE A PILLAR IN THIS COMMUNITY WITH ROOTS FIRMLY PLANTED IN THE REGIONS WE SERVE. WE ARE AT YOUR DOORSTEP, WITH PROGRAMS AND EDUCATIONAL INFORMATION THAT PROMOTE GOOD HEALTH AND DISEASE PREVENTION. WE ARE VOLUNTEERS AT LOCAL COMMUNITY EVENTS. WE ARE ADVOCATES FOR SUPERIOR HEALTH CARE SYSTEMS. WE ARE TEACHERS, TRAINING FUTURE HEALTH CARE PROFESSIONALS. WE ARE COMPASSIONATE, CARING AND DEDICATED TO CREATING A HEALTH CARE SETTING IN WHICH QUALITY OF LIFE AND SERVICE EXCELLENCE ARE EXPERIENCED BY OUR PATIENTS, THEIR FAMILIES, THE MEDICAL STAFF AND THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,446,360 | ExpenseAmt |
| Revenue | $18,015,205 | RevenueAmt |
| Desc | DURING THE TWELVE MONTHS ENDING SEPTEMBER 30, 2022 THE HOSPITAL PROVIDED 1545 INPATIENT CARE DAYS, 82 DAYS OF OBSERVATION CARE, 8,697 DAYS OF HOSPICE CARE, 8,535 PHYSICAL THERAPY PROCEDURES, 5,472 EMERGENCY VISITS AND 6,818 IMAGING PROCEDURES. SISTERSVILLE BELIEVES IN MORE THAN PROVIDING THE BEST LOCAL HEALTHCARE. WE BELIEVE IN INVESTING IN OUR COMMUNITY, SUPPORTING OUR NEIGHBORS, OUR FAMILIES AND FRIENDS. OUR COMMITMENT IS TRULY TO OUR COMMUNITY - AS AN EMPLOYER, AS A CORPORATE CITIZEN AND AS A COMMUNITY RESOURCE AND AS A HEALTHCARE PROVIDER. TO THAT END, THE HOSPITAL, ITS PHYSICIANS, STAFF AND VOLUNTEERS EXTEND THEMSELVES WELL BEYOND PATIENT CARE. WE PROVIDE COMMUNITY CLINICAL SUPPORT SERVICES, WELLNESS EDUCATION, PROGRAMS, SUPPORT GROUPS, FINANCIAL SUPPORT TO LOCAL ORGANIZATIONS, AND OUR OWN PERSONAL TIME TO ENSURE THE HIGHEST QUALITY OF LIFE FOR EVERYONE WITHIN OUR COMMUNITY. WE CALL IT GIVING BACK. PART OF OUR MISSION EXTENDS TO WELLNESS EDUCATION AND HEALTH PREVENTION. WE SPEAK OUT IN OUR COMMUNITY, WE SPONSOR SUPPORT GROUPS, WE PROVIDE DOZENS OF WELLNESS PROGRAMS AND WE PROVIDE MONTHLY OPPORTUNITIES FOR FREE AND/OR LOW COST HEALTH SCREENINGS. THE HOSPITAL SUPPORTS PARTNERSHIPS, COMMUNITY HEALTH COALITIONS, AREA CHAMBERS OF COMMERCE, LOCAL NOT-FOR-PROFIT ORGANIZATIONS, LOCAL SCHOOLS AND GOVERNMENTS. ADDITIONALLY, MANY OF OUR STAFF MEMBERS, PHYSICIANS AND VOLUNTEERS DONATE THEIR TIME TO SERVE ON LOCAL BOARDS, COMMITTEES, AND ASSOCIATIONS. WE PROVIDE OPPORTUNITIES FOR LOCAL STUDENTS TO TRAIN WITHIN OUR HOSPITAL UNDER VARIOUS EDUCATIONAL PROGRAMS AND AGREEMENTS WITH AREA SCHOOL SYSTEMS. THIS SERVES BOTH THE STUDENTS AND THE COMMUNITY AS IT OFTEN INCREASES OUR SUPPLY OF LOCAL HEALTH CARE WORKERS. | Desc |
| Total Program Service Expenses | $10,446,360 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 178 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUG FULL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3046522611 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 314 SOUTH WELLS STREET | AddressLine1Txt |
| City | SISTERSVILLE | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26175 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JOSEPH COOPER MD | |||||||||
| SECRETARY | 1.00 | 42.00 | Yes (X) | Yes (X) | $0 | $450,163 | $43,839 | ||
| CHRISTOPHER COCKERHAM MD | |||||||||
| MEDICAL STAFF PRESIDENT | 1.00 | 42.00 | Yes (X) | $0 | $552,625 | $61,148 | |||
| MICHAEL IADEROSA | |||||||||
| BOARD MEMBER | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| COLLEEN COOK | |||||||||
| BOARD MEMBER | 1.00 | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| GREGG EMRICK | |||||||||
| BOARD MEMBER | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| CAROL SCHNEEBERGER | |||||||||
| BOARD MEMBER | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS DANFORD DDS | |||||||||
| BOARD MEMBER | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| TERRY RATAICZAK | |||||||||
| BOARD MEMBER | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| ANN HELMICK | |||||||||
| BOARD MEMBER | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| LARRY UNROE | |||||||||
| BOARD MEMBER | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| SHERYL HOLDREN | |||||||||
| BOARD MEMBER | 1.00 | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL ARCHER | |||||||||
| CHAIRPERSON | 1.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN KEISER | |||||||||
| VICE-CHAIRPERSON | 1.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JAMES BARENGO | |||||||||
| TREASURER | 1.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RICHARD HOYT MD | |||||||||
| BOARD MEMBER | 1.00 | 42.00 | Yes (X) | $0 | $459,108 | $58,265 | |||
| J SCOTT CANTLEY | |||||||||
| CEO - MARIETTA AREA HEALTH | 1.00 | 43.00 | Yes (X) | $0 | $1,281,437 | $63,803 | |||
| SCOTT SILVESTRI | |||||||||
| CFO - MARIETTA AREA HEALTH | 1.00 | 45.00 | Yes (X) | $0 | $596,177 | $70,850 | |||
| DAN BREECE MD | |||||||||
| VP PHYSICIAN SERVICES | 1.00 | 41.00 | $0 | $1,061,445 | $64,314 | Yes (X) | |||
| BRANDON CHADOCK | |||||||||
| CHIEF ADMINISTRATIVE OFFIC | 40.00 | $151,267 | $0 | $38,818 | Yes (X) | ||||
| KIMBERLY DOTY-ARRICK | |||||||||
| HOSPICE RN | 40.00 | $120,561 | $0 | $749 | Yes (X) | ||||
| WILLIAM REHL | |||||||||
| PHYSICIAN ASSISTANT | 40.00 | $109,299 | $0 | $42,297 | Yes (X) | ||||
| JESSICA OWENS | |||||||||
| NURSE PRACTITIONER | 40.00 | $113,168 | $0 | $38,189 | Yes (X) | ||||
| ALISHA PLACER | |||||||||
| NURSE PRACTITIONER | 40.00 | $114,268 | $0 | $1,279 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $608,563 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,400,955 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $483,551 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LUCID SOLUTIONS INC | |||||
| 100 E CAMPUS VIEW BLVD STE 100 | COLUMBUS | OH | 43235 | RADIOLOGY | $267,812 |
| PROLINK STAFFING | |||||
| 4600 MONTGOMERY RD STE 300 | CINCINNATI | OH | 45212 | NURSING STAFF | $225,343 |
| HEALOGICS WOUND CARE | |||||
| 5220 BELFORT ROAD 130 | JACKSONVILLE | FL | 32256 | WOUND CARE | $165,977 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $598,935 | GovernmentGrantsAmt |
| Total Contributions | $598,935 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $18,015,205 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,015,205 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $18,015,205 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,741 | TotalRevenueColumnAmt |
| Exclusion | $3,741 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| PHARMACY 340B | 900099 | $346,408 | $346,408 |
| OTHER REVENUE | 900099 | $28,303 | $28,303 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $374,711 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,992,592 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,015,205 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $378,452 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,860,764 | TotalAmt |
| Program Services | $6,389,929 | ProgramServicesAmt |
| Management And General | $3,470,835 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98 | TotalAmt |
| Management And General | $98 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $816,076 | TotalAmt |
| Program Services | $48,495 | ProgramServicesAmt |
| Management And General | $767,581 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $681,898 | TotalAmt |
| Program Services | $421,168 | ProgramServicesAmt |
| Management And General | $260,730 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,320 | TotalAmt |
| Management And General | $50,320 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,481 | TotalAmt |
| Management And General | $8,481 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $591 | TotalAmt |
| Management And General | $591 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,011 | TotalAmt |
| Program Services | $8,720 | ProgramServicesAmt |
| Management And General | $66,291 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,534 | TotalAmt |
| Program Services | $3,428 | ProgramServicesAmt |
| Management And General | $114,106 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,238 | TotalAmt |
| Program Services | $25,093 | ProgramServicesAmt |
| Management And General | $14,145 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,901 | TotalAmt |
| Management And General | $7,901 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,488 | TotalAmt |
| Management And General | $159,488 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $456,072 | TotalAmt |
| Management And General | $456,072 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED SERVICES | $2,109,505 | $1,045,649 | $1,063,856 |
| SUPPLIES MEDICAL AND DR | $1,396,641 | $1,194,356 | $202,285 |
| BAD DEBT EXPENSE | $1,081,353 | $1,081,353 | |
| OTHER EXPENSES | $517,573 | $91,340 | $426,233 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,258 | TotalAmt |
| Program Services | $136,829 | ProgramServicesAmt |
| Management And General | $91,429 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,606,802 | TotalAmt |
| Program Services | $10,446,360 | ProgramServicesAmt |
| Management And General | $7,160,442 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,154 | BOYAmt |
| EOY | $45,328 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,888,787 | BOYAmt |
| EOY | $3,240,345 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $123,789 | BOYAmt |
| EOY | $232,652 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $437,928 | BOYAmt |
| EOY | $329,303 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,637,608 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,532,767 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,863,300 | BOYAmt |
| EOY | $2,104,841 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $480,240 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,506,958 | BOYAmt |
| EOY | $6,432,709 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $600,881 | BOYAmt |
| EOY | $648,847 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $129,188 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,255,427 | BOYAmt |
| EOY | $1,618,234 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,856,308 | BOYAmt |
| EOY | $2,396,269 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,650,650 | BOYAmt |
| EOY | $4,036,440 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,650,650 | BOYAmt |
| EOY | $4,036,440 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,506,958 | BOYAmt |
| EOY | $6,432,709 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,385,790 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,349 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,349 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PAYS DUES TO THE WEST VIRGINIA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. THE AMOUNT REPORTED REPRESENTS THE PORTION OF THOSE DUES USED BY THE NAMED ORGANIZATIONS FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $149,674 | OtherCostOrOtherBasisAmt |
| Book Value | $149,674 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,932,746 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,504,516 | DepreciationAmt |
| Book Value | $428,230 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,716,082 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,927,864 | DepreciationAmt |
| Book Value | $788,218 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $839,106 | OtherCostOrOtherBasisAmt |
| Depreciation | $100,387 | DepreciationAmt |
| Book Value | $738,719 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,104,841 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD PARTY SETTLEMENTS | Desc |
| Book Value | $480,240 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $480,240 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO RELATED ORGANIZATIONS | Desc |
| Amt | $1,618,234 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,618,234 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE SYSTEM, EXCLUDING MSC, MOHP AND THE INNOVATION CENTER, IS ORGANIZED AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE UNITED STATES INTERNAL REVENUE CODE. MSC, MOHP AND THE INNOVATION CENTER ARE ORGANIZED AS LIMITED LIABILITY COMPANIES, WHEREBY, NET TAXABLE INCOME IS TAXED DIRECTLY TO THE MEMBERS AND NOT MSC, MOHP OR THE INNOVATION CENTER. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM, AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2022 AND 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. AS SUCH, THE SYSTEM IS GENERALLY EXEMPT FROM INCOME TAXES. HOWEVER, THE SYSTEM, EXCLUDING MSC, MOHP AND THE INNOVATION CENTER, IS REQUIRED TO FILE FEDERAL FORM 990 - RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX WHICH IS AN INFORMATIONAL RETURN ONLY. THE SYSTEM, MSC, AND MOHP HAVE FILED THEIR TAX RETURNS FOR PERIODS THROUGH 2019. THE RETURNS FOR MSC AND MOHP ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). THE SYSTEM, MSC AND MOHP ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. HOWEVER, AS OF THE DATE THE CONSOLIDATED FINANCIAL STATEMENTS WERE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 282 | PersonsServedCnt |
| Total Community Benefit Expns | $145,837 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $145,837 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00830 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7418 | PersonsServedCnt |
| Total Community Benefit Expns | $4,695,110 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,626,053 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7700 | PersonsServedCnt |
| Total Community Benefit Expns | $4,840,947 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,626,053 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $145,837 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00830 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 219 | PersonsServedCnt |
| Total Community Benefit Expns | $2,094 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,750 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 219 | PersonsServedCnt |
| Total Community Benefit Expns | $2,094 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,750 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7919 | PersonsServedCnt |
| Total Community Benefit Expns | $4,843,041 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,629,803 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $145,837 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00830 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,081,353 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $3,490,704 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,809,080 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$318,376 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SISTERSVILLE GENERAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 314 SOUTH WELLS STREET | AddressLine1Txt |
| City | SISTERSVILLE | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26175 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MHSYSTEM.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SISTERSVILLE GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 20 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.MHSYSTEM.ORG/HEALTHASSESSMENT/ | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.MHSYSTEM.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://MHSYSTEM.ORG/FINANCIALASSISTANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://MHSYSTEM.ORG/FINANCIALASSISTANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://MHSYSTEM.ORG/FINANCIALASSISTANCE/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SISTERSVILLE GENERAL HOSPITAL | PART V, SECTION B, LINE 5: THIS ASSESSMENT INCORPORATES DATA FROM MULTIPLE SOURCES, INCLUDING PRIMARY RESEARCH (THROUGH THE PRC COMMUNITY HEALTH SURVEY AND PRC ONLINE KEY INFORMANT SURVEY), AS WELL AS SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). IT ALSO ALLOWS FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. THE SURVEY INSTRUMENT USED FOR THIS STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. THE FINAL SURVEY INSTRUMENT WAS DEVELOPED BY SISTERSVILLE GENERAL HOSPITAL AND PRC. THE STUDY AREA FOR THE SURVEY EFFORT (REFERRED TO AS THE "TOTAL SERVICE AREA" IN THIS REPORT) IS DEFINED AS EACH OF THE RESIDENTIAL ZIP CODES COMPRISING WETZEL, TYLER, AND PLEASANTS COUNTIES IN WEST VIRGINIA. THE SURVEY WAS ADMINISTERED AS AN ONLINE SURVEY. PRC HOSTED THE ONLINE SURVEY INSTRUMENT, AND SISTERSVILLE GENERAL HOSPITAL AND LOCAL PARTNERS USED A VARIETY OF COMMUNICATION TOOLS TO DRIVE RESIDENTS TO TAKE THE SURVEY ONLINE. EXAMPLES INCLUDE PRESS RELEASES, SOCIAL MEDIA ADVERTISING, POSTING ON ORGANIZATIONAL WEBSITES, AND EMAIL CAMPAIGNS TO COMMUNITY MEMBERS AND COMMUNITY PARTNERS. IN ALL, A TOTAL OF 201 SURVEYS IN THE TOTAL SERVICE AREA WERE ACHIEVED.TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY ALSO WAS IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY SISTERSVILLE GENERAL HOSPITAL; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 10 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY.FINAL PARTICIPATION INCLUDED REPRESENTATIVES OF THE ORGANIZATIONS OUTLINED BELOW. MID-OHIO VALLEY HEALTH DEPARTMENT MOMENTIVE PERFORMANCE MATERIALS NEW MARTINSVILLE SCHOOL SISTERSVILLE ELEMENTARY SCHOOL SISTERSVILLE GENERAL HOSPITAL SISTERSVILLE POLICE DEPARTMENT TYLER COUNTY EMERGENCY MANAGEMENT WETZEL TYLER HEALTH DEPARTMENT WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES |
| SISTERSVILLE GENERAL HOSPITAL | PART V, SECTION B, LINE 11: THE FOLLOWING "AREAS OF OPPORTUNITY" REPRESENT THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY, BASED ON THE INFORMATION GATHERED THROUGH THIS COMMUNITY HEALTH NEEDS ASSESSMENT. FROM THESE DATA, OPPORTUNITIES FOR HEALTH IMPROVEMENT EXIST IN THE AREA WITH REGARD TO THE FOLLOWING HEALTH ISSUES.THE AREAS OF OPPORTUNITY WERE DETERMINED AFTER CONSIDERATION OF VARIOUS CRITERIA, INCLUDING: STANDING IN COMPARISON WITH BENCHMARK DATA (PARTICULARLY NATIONAL DATA); IDENTIFIED TRENDS; THE PREPONDERANCE OF SIGNIFICANT FINDINGS WITHIN TOPIC AREAS; THE MAGNITUDE OF THE ISSUE IN TERMS OF THE NUMBER OF PERSONS AFFECTED; AND THE POTENTIAL HEALTH IMPACT OF A GIVEN ISSUE. THESE ALSO TAKE INTO ACCOUNT THOSE ISSUES OF GREATEST CONCERN TO THE COMMUNITY STAKEHOLDERS (KEY INFORMANTS) GIVING INPUT TO THIS PROCESS.AREAS OF OPPORTUNITY IDENTIFIED THROUGH THIS ASSESSMENT: 1. TOBACCO USE 2. MENTAL HEALTH 3. NUTRITION, PHYSICAL ACTIVITY & WEIGHT 4. SUBSTANCE ABUSE 5. DIABETES 6. HEART DISEASE & STROKE 7. ACCESS TO HEALTHCARE SERVICES 8. CANCER 9. POTENTIALLY DISABLING CONDITIONS 10. ORAL HEALTH 11. RESPIRATORY DISEASE 12. INFANT HEALTH & FAMILY PLANNING 13. INJURY & VIOLENCE SISTERSVILLE GENERAL HOSPITAL WILL USE THE INFORMATION FROM THIS COMMUNITY HEALTH NEEDS ASSESSMENT TO DEVELOP AN IMPLEMENTATION STRATEGY TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY. WHILE THE HOSPITAL WILL LIKELY NOT IMPLEMENT STRATEGIES FOR ALL OF THE HEALTH ISSUES LISTED ABOVE, THE RESULTS OF THIS PRIORITIZATION EXERCISE WILL BE USED TO INFORM THE DEVELOPMENT OF THE HOSPITAL'S ACTION PLAN TO GUIDE COMMUNITY HEALTH IMPROVEMENT EFFORTS IN THE COMING YEARS. |
| SISTERSVILLE GENERAL HOSPITAL | PART V, SECTION B, LINE 16J: APPLICATION IS ON THE BACK OF THE ACCOUNT STATEMENT MAILER. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 2: | ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE SYSTEM'S EVALUATION OF ITS MAJOR PAYOR SOURCES OF REVENUE, THE AGING OF THE ACCOUNTS, HISTORICAL LOSSES, CURRENT ECONOMIC CONDITIONS, AND OTHER FACTORS UNIQUE TO THEIR SERVICE AREA AND THE HEALTHCARE INDUSTRY. |
| PART III, LINE 3: | THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN CHARITY CARE CANDIDATES MUST COOPERATE FULLY. IN ADDITION THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THIS REASON THE ORGANIZATION BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY AND THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS NEGLIGIBLE. |
| PART III, LINE 4: | THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| PART III, LINE 8: | THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED 9/30/22 REPORT: HOSPITAL STATEMENT OF REIMBURSABLE COST. |
| PART III, LINE 9B: | PATIENTS ARE ENCOURAGED BY THE FINANCIAL ADVOCATES TO COMPLETE A CHARITY APPLICATION AND THUS AVOID THE COLLECTION PROCEDURE. THIS IS WRITTEN ON THE PATIENT BILLING STATEMENT. |
| PART VI, LINE 2: | SEE THE COMMUNITY NEEDS ASSESSMENT.THIS ASSESSMENT INCORPORATES DATA FROM MULTIPLE SOURCES, INCLUDING PRIMARY RESEARCH (THROUGH THE PRC COMMUNITY HEALTH SURVEY AND PRC ONLINE KEY INFORMANT SURVEY), AS WELL AS SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). IT ALSO ALLOWS FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. THE SURVEY INSTRUMENT USED FOR THIS STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. THE FINAL SURVEY INSTRUMENT WAS DEVELOPED BY SISTERSVILLE GENERAL HOSPITAL AND PRC. THE STUDY AREA FOR THE SURVEY EFFORT (REFERRED TO AS THE "TOTAL SERVICE AREA" IN THIS REPORT) IS DEFINED AS EACH OF THE RESIDENTIAL ZIP CODES COMPRISING WETZEL, TYLER, AND PLEASANTS COUNTIES IN WEST VIRGINIA. THE SURVEY WAS ADMINISTERED AS AN ONLINE SURVEY. PRC HOSTED THE ONLINE SURVEY INSTRUMENT, AND SISTERSVILLE GENERAL HOSPITAL AND LOCAL PARTNERS USED A VARIETY OF COMMUNICATION TOOLS TO DRIVE RESIDENTS TO TAKE THE SURVEY ONLINE. EXAMPLES INCLUDE PRESS RELEASES, SOCIAL MEDIA ADVERTISING, POSTING ON ORGANIZATIONAL WEBSITES, AND EMAIL CAMPAIGNS TO COMMUNITY MEMBERS AND COMMUNITY PARTNERS. IN ALL, A TOTAL OF 201 SURVEYS IN THE TOTAL SERVICE AREA WERE ACHIEVED.TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY ALSO WAS IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY SISTERSVILLE GENERAL HOSPITAL; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 10 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. |
| PART VI, LINE 3: | HTTPS://MHSYSTEM.ORG/FINANCIALASSISTANCE/ |
| PART VI, LINE 4: | TYLER COUNTY HAS A SIGNIFICANT SENIOR POPULATION AND HIGH POVERTY LEVEL. |
| PART VI, LINE 5: | WE ENHANCE THE QUALITY OF LIFE IN THE AREA. WE NURTURE AND CARE FOR OUR COMMUNITY BY CARING FOR YOU, YOUR FRIENDS, NEIGHBORS AND RELATIVES 24 HOURS A DAY, SEVEN DAYS A WEEK, 365 DAYS A YEAR. WE ARE QUALITY - WITH ACCREDITATIONS, CERTIFICATIONS AND DESIGNATIONS TO EXPRESS, UTILIZE AND DEMONSTRATE OUR EXPERTISE. WE ARE PART OF A SYSTEM THAT EXTENDS ACCESS TO SPECIALISTS AND NATIONALLY RECOGNIZED CARE. WE ARE A PILLAR IN THIS COMMUNITY WITH ROOTS FIRMLY PLANTED IN THE REGIONS WE SERVE. WE ARE AT YOUR DOORSTEP, WITH PROGRAMS AND EDUCATIONAL INFORMATION THAT PROMOTE GOOD HEALTH AND DISEASE PREVENTION. WE ARE VOLUNTEERS AT LOCAL COMMUNITY EVENTS. WE ARE ADVOCATES FOR SUPERIOR HEALTH CARE SYSTEMS. WE ARE TEACHERS, TRAINING FUTURE HEALTH CARE PROFESSIONALS. WE ARE COMPASSIONATE, CARING AND DEDICATED TO CREATING A HEALTH CARE SETTING IN WHICH QUALITY OF LIFE AND SERVICE EXCELLENCE ARE EXPERIENCED BY OUR PATIENTS THEIR FAMILIES, THE MEDICAL STAFF AND THE COMMUNITY. WE ARE SISTERSVILLE GENERAL HOSPITAL. |
| PART VI, LINE 6: | SEE THE COMMUNITY NEEDS ASSESSMENT. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | OH,WV |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| J SCOTT CANTLEY | ||||||||||||||
| CEO - MARIETTA AREA HEALTH | $0 | $938,822 | $0 | $342,615 | $0 | $0 | $0 | $19,500 | $0 | $44,303 | $0 | $1,345,240 | $0 | $0 |
| DAN BREECE MD | ||||||||||||||
| VP PHYSICIAN SERVICES | $0 | $824,726 | $0 | $236,719 | $0 | $0 | $0 | $19,500 | $0 | $44,814 | $0 | $1,125,759 | $0 | $0 |
| SCOTT SILVESTRI | ||||||||||||||
| CFO - MARIETTA AREA HEALTH | $0 | $468,677 | $0 | $127,500 | $0 | $0 | $0 | $19,500 | $0 | $51,350 | $0 | $667,027 | $0 | $0 |
| CHRISTOPHER COCKERHAM MD | ||||||||||||||
| MEDICAL STAFF PRESIDENT | $0 | $552,625 | $0 | $0 | $0 | $0 | $0 | $19,000 | $0 | $42,148 | $0 | $613,773 | $0 | $0 |
| RICHARD HOYT MD | ||||||||||||||
| BOARD MEMBER | $0 | $380,661 | $0 | $78,447 | $0 | $0 | $0 | $19,000 | $0 | $39,265 | $0 | $517,373 | $0 | $0 |
| JOSEPH COOPER MD | ||||||||||||||
| SECRETARY | $0 | $450,163 | $0 | $0 | $0 | $0 | $0 | $19,500 | $0 | $24,339 | $0 | $494,002 | $0 | $0 |
| BRANDON CHADOCK | ||||||||||||||
| CHIEF ADMINISTRATIVE OFFIC | $144,091 | $0 | $7,176 | $0 | $0 | $0 | $0 | $0 | $38,818 | $0 | $190,085 | $0 | $0 | $0 |
| WILLIAM REHL | ||||||||||||||
| PHYSICIAN ASSISTANT | $109,299 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $42,297 | $0 | $151,596 | $0 | $0 | $0 |
| JESSICA OWENS | ||||||||||||||
| NURSE PRACTITIONER | $113,168 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $38,189 | $0 | $151,357 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE SHALL HAVE ALL THE POWERS AND DUTIES OF THE BOARD OF DIRECTORS IN THE INTERIM BETWEEN MEETINGS OF THE LATTER, EXCEPT AS LIMITED BY THIS CODE OF REGULATIONS OR BY SPECIFIC INSTRUCTION OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL NOT HAVE POWER TO ELECT DIRECTORS. A SUMMARY OF THE PROCEEDINGS OF THE EXECUTIVE COMMITTEE SHALL BE REPORTED TO THE BOARD AT ITS NEXT MEETING. THE EXECUTIVE COMMITTEE SHALL MAINTAIN THE COMPENSATION COMMITTEE AND NOMINATING COMMITTEE. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S ACCOUNTING DEPARTMENT. THE GOVERNING BODY RECEIVES AN ELECTRONIC COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVAL PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE ENFORCED BY THE CORPORATE INTEGRITY COMMITTEE. THE SCOPE OF THIS POLICY INCLUDES THE DIRECTORS, OFFICERS AND SENIOR EXECUTIVES. THE PURPOSE OF THE POLICY IS TO PROTECT THE HOSPITAL'S INTEREST WHEN IT IS CONNTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN INTERESTED OFFICER, DIRECTOR OR PERSON. ANY CONFLICT RESULTING IN INELIGIBILITY FOR OR REMOVAL FROM THE BOARD OR SPECIFIC COMMITTEES INCLUDE THE THE FOLLOWING: A. REPEATED, INTENTIONAL FAILURE TO DISCLOSE A CONFLICT OF INTEREST. B.HAVING A FAMILY MEMBER WHO IS A SENIOR EXECUTIVE FOR THE HOSPITAL. C. A MATERIAL INVESTMENT OR EMPLOYMENT RELATIONSHIP INVOLVING AN INTERESTED PERSON IN AN ASC, A PROPRIETARY HOSPITAL, OR NURSING FACILTIY WITHIN THE HOSPITAL'S SERVICE AREA THAT IS NOT OWNED BY THE HOSPITAL. ANNUAL DISCLOSURES ARE REQUIRED SETTING FORTH ALL BUSINESS AND OTHER AFFILIATIONS, WHICH RELATE IN ANY WAY TO THE HOSPITAL. THE COMMITTEE RECOMMENDS THE DISQUALIFICATION OR REMOVAL OF INTERESTED PERSONS WHEN NECESSARY AND REPORTS TO THE BOARD THOSE DIRECTORS WHICH THE COMMITTEE HAS DETERMINED MEET THE DEFINITION OF INDEPENDENT DIRECTOR. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION COMMITTEE REVIEWS FAIR MARKET WAGE DATA. SPECIFIC APPROVAL OF BOARD MUST BE SOUGHT IF PHYSICIAN COMPENSATION IS 75% OR GREATER OF MEDIAN IN THE ANNUAL MGMA STUDY. EXECUTIVE AND ALL OTHER HOSPITAL STAFF COMPENSATION IS SET AT MEDIAN. AN EXECUTIVE COMPENSATION FIRM IS UTILIZED (YAFFE & COMPANY). A SEPERATE INDEPENDENT CONSULTANT (VMG) IS RETAINED FOR PHYSICIAN COMPENSATION STUDIES AS NEEDED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE DOCUMENTS CAN BE VIEWED IN THE ADMINISTRATION OFFICE. |
| FORM 990, PART XII, LINE 2C | THE PROCESS IS THE SAME AS MARIETTA MEMORIAL HOSPITAL. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|
| MARIETTA AREA HEALTH CARE INC | ||||||||||
| 401 MATTHEW STREET | MARIETTA | OH | 45750 | 311126451 | MANAGEMENT | OH | 501(C)(3) | LINE 10 | 0 | |
| MARIETTA HEALTHCARE PHYSICIANS INC | ||||||||||
| 401 MATTHEW STREET | MARIETTA | OH | 45750 | 311375125 | PHYSICIAN GROUP | OH | 501(C)(3) | LINE 10 | 0 | MARIETTA AREA HEALTH CARE INC |
| MEMORIAL HEALTH FOUNDATION | ||||||||||
| 401 MATTHEW STREET | MARIETTA | OH | 45750 | 311011321 | SUPPORTING ORG | OH | 501(C)(3) | LINE 12B, II | 0 | MARIETTA AREA HEALTH CARE INC |
| MARIETTA MEMORIAL HOSPITAL | ||||||||||
| 401 MATTHEW STREET | MARIETTA | OH | 45750 | 314379509 | HOSPITAL | OH | 501(C)(3) | LINE 3 | 0 | MARIETTA AREA HEALTH CARE INC |
| SELBY GENERAL HOSPITAL | ||||||||||
| 1106 COLEGATE DR | MARIETTA | OH | 45750 | 314413259 | HOSPITAL | OH | 501(C)(3) | LINE 3 | 0 | MARIETTA AREA HEALTH CARE INC |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| MARIETTA OCCUPTIONAL HEALTH PARTNERS LLC | |||||||||
| 401 MATTHEW ST | MARIETTA | OH | 45750 | 043587132 | OCCUPATIONAL HEALTH | OH | N/A | 0 | 0 |
| MARIETTA SURGERY CENTER LLC | |||||||||
| 611 2ND ST | MARIETTA | OH | 45750 | 311684367 | SURGERY | OH | N/A | 0 | 0 |
| MARIETTA HOME HEALTH AND HOSPICE | |||||||||
| 5959 S SHERWOOD | BATON ROUGE | LA | 70816 | 261480799 | HOME HEALTH | LA | N/A | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Comments