MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC: Form 990, tax year 2022
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- Organization
- MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC (EIN 85-3994078)
- Tax period
- 2022-07-01 to 2022-12-31
- Filed
- 2023-11-15
- IRS object ID
- 202313199349319666
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-15T15:08:57-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 SOUTH SIXTH STREET | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 853994078 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MON HEALTH MARION NEIGHBORHOOD | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MONH | BusinessNameControlTxt |
| Phone | 3045981242 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 JD ANDERSON DRIVE | AddressLine1Txt |
| City | MORGANTOWN | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26505 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFF SANDENE | PersonNm |
| Person Title | EXECUTIVE VP AND CFO | PersonTitleTxt |
| Phone | 3045981242 | PhoneNum |
| Signature | 2023-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JEFF | PersonFirstNm |
| Person Last | SANDENE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANNE FULTON | PreparerPersonNm |
| PTIN | P00941863 | PTIN |
| Phone | 6123974000 | PhoneNum |
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 | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID S GOLDBERG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 JD ANDERSON DRIVE | AddressLine1Txt |
| City | MORGANTOWN | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26505 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,174,197 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MONGENERAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2020 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | OUR GOAL IS TO OFFER THE QUALITY OF CARE WE WOULD EXPECT AND DEMAND FOR OUR OWN FAMILIES. STREAMLINED ADMITTING PROCEDURES, HIGHLY QUALIFIED PHYSICIANS AND MEDICAL SPECIALISTS AT EVERY LEVEL OF CARE AND THE LATEST DIAGNOSTIC EQUIPMENT ARE JUST A FEW OF THE DISTINCTIONS WE OFFER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 69 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,953,827 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,174,197 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,953,827 | PYTotalRevenueAmt |
| CY Total Revenue | $3,174,197 | 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 | $1,720,908 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,078,992 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,962,660 | PYOtherExpensesAmt |
| CY Other Expenses | $3,394,592 | CYOtherExpensesAmt |
| PY Total Expenses | $5,683,568 | PYTotalExpensesAmt |
| CY Total Expenses | $5,473,584 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,729,741 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,299,387 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,587,300 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,708,607 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $20,317,041 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,531,212 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$2,729,741 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$8,822,605 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,111,416 | ExpenseAmt |
| Revenue | $3,174,197 | RevenueAmt |
| Desc | MON HEALTH MARION NEIGHBORHOOD HOSPITAL OFFERS AROUND-THE-CLOCK EMERGENCY CARE, A COMPREHENSIVE INPATIENT WING FOR OVERNIGHT STAYS, ON-SITE LABORATORY TESTING AND IMAGING INCLUDING CT, ULTRASOUND AND X-RAY. | Desc |
| Total Program Service Expenses | $4,111,416 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 69 | 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GENE TOWNSEND - MANAGING ACCOUNTANT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3042853676 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 JD ANDERSON DRIVE | AddressLine1Txt |
| City | MORGANTOWN | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26505 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DAVID GOLDBERG | ||||||||
| SECRETARY/TREASURER/PRESIDENT/CEO | 1.00 | 49.00 | Yes (X) | Yes (X) | $0 | $911,058 | $131,451 | |
| CHRISTOPHER EDWARDS DO | ||||||||
| DIRECTOR/CAO | 1.00 | 40.00 | Yes (X) | $0 | $95,866 | $0 | ||
| DIXIE YANN | ||||||||
| VICE CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RONALD G STOVASH | ||||||||
| CHAIR | 1.00 | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DOYLE SICKLES | ||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| ED BOYLE 9122 START | ||||||||
| CHAIR | 1.00 | 6.50 | Yes (X) | $0 | $0 | $0 | ||
| SENATOR ROMAN PREZIOSO | ||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JEFF CRUDELE | ||||||||
| INTERIM CFO | 1.00 | 49.00 | Yes (X) | $0 | $480,000 | $0 | ||
| LISA SIMON CPA | ||||||||
| VP FINANCE/CFO | 1.00 | 50.00 | Yes (X) | $0 | $421,179 | $15,219 | ||
| ANNE WALLACE | ||||||||
| PHYSICIAN | 50.00 | 0.00 | $111,715 | $0 | $11,566 | Yes (X) | ||
| TERESA FAST | ||||||||
| PHYSICIAN | 50.00 | 0.00 | $110,874 | $0 | $7,854 | Yes (X) | ||
| TINA SLAUGHTER | ||||||||
| PHYSICIAN | 50.00 | 0.00 | $105,184 | $0 | $13,205 | Yes (X) | ||
| CRISTINA WAGONER | ||||||||
| PHYSICIAN | 50.00 | 0.00 | $110,488 | $0 | $6,962 | Yes (X) | ||
| LISA HINES | ||||||||
| PHYSICIAN | 50.00 | 0.00 | $101,889 | $0 | $8,462 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $540,150 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,908,103 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $194,719 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| QUALIVIS INC | |||||
| PO BOX 123847 DEPT 3847 | DALLAS | TX | 75312 | AGENCY SERVICES | $1,203,796 |
| ABC HEALTH | |||||
| 105 MARCO POLO DRIVE | MORGANTOWN | WV | 26508 | HOSPITALIST SERVICES | $395,417 |
| EMERUS DEVELOPMENT INC | |||||
| 8686 NEW TRAILS DR STE 100 | THE WOODLANDS | TX | 77381 | IMPLEMENTATION/MGMT SERVICES | $315,623 |
| CITY NEON INC | |||||
| PO BOX 40 | MORGANTOWN | WV | 26507 | SIGNAGE/FABRICATION/INSTALLATION | $109,645 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENU | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $3,174,197 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,174,197 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,174,197 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,174,197 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,174,197 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,634,504 | TotalAmt |
| Program Services | $1,246,083 | ProgramServicesAmt |
| Management And General | $388,421 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,984 | TotalAmt |
| Program Services | $24,690 | ProgramServicesAmt |
| Management And General | $13,294 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,547 | TotalAmt |
| Program Services | $187,555 | ProgramServicesAmt |
| Management And General | $100,992 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,957 | TotalAmt |
| Program Services | $76,672 | ProgramServicesAmt |
| Management And General | $41,285 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,556,085 | TotalAmt |
| Program Services | $838,785 | ProgramServicesAmt |
| Management And General | $717,300 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100 | TotalAmt |
| Management And General | $100 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,308 | TotalAmt |
| Program Services | $209,248 | ProgramServicesAmt |
| Management And General | $3,060 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,214 | TotalAmt |
| Program Services | $45,214 | ProgramServicesAmt |
| Management And General | $72,000 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,447 | TotalAmt |
| Program Services | $1,447 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,931 | TotalAmt |
| Program Services | $205,931 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $309,425 | TotalAmt |
| Program Services | $309,425 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| BAD DEBT | $520,087 | $520,087 |
| MEDICAL SUPPLIES | $293,247 | $293,247 |
| BANK FEES | $57,655 | $57,655 |
| REPAIRS AND MAINTENANCE | $29,332 | $29,332 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,761 | TotalAmt |
| Program Services | $66,045 | ProgramServicesAmt |
| Management And General | $25,716 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,473,584 | TotalAmt |
| Program Services | $4,111,416 | ProgramServicesAmt |
| Management And General | $1,362,168 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $405,108 | BOYAmt |
| EOY | $206,698 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,838,897 | BOYAmt |
| EOY | $1,119,301 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $168,847 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,728 | BOYAmt |
| EOY | $63,988 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,473,718 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $155,098 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,157,720 | BOYAmt |
| EOY | $11,318,620 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,587,300 | BOYAmt |
| EOY | $12,708,607 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $289,575 | BOYAmt |
| EOY | $878,941 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,231,652 | BOYAmt |
| EOY | $13,871,192 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,795,814 | BOYAmt |
| EOY | $6,781,079 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,317,041 | BOYAmt |
| EOY | $21,531,212 | 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 | -$2,729,741 | BOYAmt |
| EOY | -$8,822,605 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,729,741 | BOYAmt |
| EOY | -$8,822,605 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,587,300 | BOYAmt |
| EOY | $12,708,607 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,299,387 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$3,793,477 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,667,003 | OtherCostOrOtherBasisAmt |
| Book Value | $2,667,003 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,003,060 | OtherCostOrOtherBasisAmt |
| Book Value | $7,003,060 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,803,655 | OtherCostOrOtherBasisAmt |
| Depreciation | $155,098 | DepreciationAmt |
| Book Value | $1,648,557 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,318,620 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $6,781,079 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,781,079 | 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 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 WHICH IS A CORPORATION SUBJECT TO INCOME TAX. THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 AND 2021. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| 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) |
|---|---|---|
| Total Community Benefit Expns | $130,238 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $130,238 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02630 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,832,549 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $470,358 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,362,191 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.27500 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,962,787 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $470,358 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,492,429 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.30130 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,962,787 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $470,358 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,492,429 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.30130 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $520,087 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $463,735 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $1,130,044 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$666,309 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| 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 | MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 JD ANDERSON DRIVE | AddressLine1Txt |
| City | MORGANTOWN | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 26505 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MON HEALTH MARION NEIGHBORHOOD HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | Yes (1) | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | 0 | CHNAConductedInd |
| 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 | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| 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 | MONGENERAL.COM/MAIN/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | MONGENERAL.COM/MAIN/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | MONGENERAL.COM/MAIN/FINANCIAL-ASSISTANCE | 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 |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| None Made | Yes (X) | NoneMadeInd |
| 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 Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE HOSPITAL USED A COST-TO-CHARGE RATIO DERIVED FROM MEDICARE COST REPORT FOR TOTAL PROGRAM COSTS AND TOTAL PROGRAM CHARGES TO ESTIMATE THE OVERALL COST-TO-CHARGE RATIO (CCR). THIS CCR WAS USED IN COMPUTATIONS FOR UNREIMBURSED MEDICAID AND CHARITY CARE. |
| 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 $ 520,087. |
| PART III, LINE 4: | PATIENT ACCOUNTS RECEIVABLE ARE CARRIED AT THE ORIGINAL CHARGE LESS AN ESTIMATE MADE FOR DOUBTFUL OR UNCOLLECTIBLE 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. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS MGH RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE BASED ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. RECOVERIES OF ACCOUNTS PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION TO THE PROVISION FOR BAD DEBT EXPENSE WHEN RECEIVED. INTEREST IS NOT CHARGED ON PATIENT ACCOUNTS RECEIVABLE. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. THE COSTS ARE ALLOCATED TO THE VARIOUS DEPARTMENTS USING A STEP DOWN APPROACH AND REMOVING ANY COSTS THAT ARE NOT ALLOWABLE UNDER MEDICARE RULES. THE ORGANIZATION IS A TAX EXEMPT, NOT-FOR-PROFIT ENTITY THAT SERVES MONONGALIA AND SURROUNDING COUNTIES PATIENT POPULATION REGARDLESS OF THEIR MEANS TO PAY OR HEALTH INSURANCE STATUS. MEDICARE PATIENTS IN OUR SERVICE AREA DEPEND ON THE ORGANIZATION TO DELIVER THEIR HEALTH CARE AND MEET THEIR MEDICAL NEEDS REGARDLESS OF MEDICARE COVERAGE OF COST FOR PROVIDING THE NEEDED SERVICE. SINCE THE ORGANIZATION CONSTANTLY WORK TO OPERATE AS COST EFFICIENT AS POSSIBLE, WE FEEL STRONGLY THAT MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. |
| PART III, LINE 9B: | THERE ARE PROVISIONS IN THE DEBT COLLECTION POLICY TO BE FOLLOWED FOR PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. THE POLICY STATES THAT FINANCIAL ASSISTANCE SHALL BE OFFERED TO THE HOSPITAL'S UNINSURED AND UNDERINSURED PATIENTS ON A NONDISCRIMINATORY BASIS TO MEET THE NEED OF THE COMMUNITY. CHARITY CARE REQUESTS WILL BE REVIEWED AND EVALUATED BY THE CFO AND DIRECTOR OF PATIENT ACCOUNTING FOR APPROVAL. PATIENTS THAT QUALIFY FOR 100% CHARITY CARE ARE NOT PURSUED FOR COLLECTION. |
| PART VI, LINE 2: | THE NEEDS OF THE COMMUNITY WERE ASSESSED BASED ON DISCUSSIONS AMONGST MANAGEMENT AND CROSS-SECTION OF COMMUNITY MEMBERS, WHICH PROVIDES OPINIONS FROM VARYING DEMOGRAPHICS. |
| PART VI, LINE 3: | THE PLAIN LANGUAGE SUMMARY OF THE FAP AND FAP APPLICATION ARE AVAILABLE ON THE HOSPITAL'S WEBSITE. PAPER COPIES OF THE FAP, PLAIN LANGUAGE SUMMARY OF THE FAP, AND FAP APPLICATION ARE AVAILABLE UPON REQUEST AND COPIES ARE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. THE HOSPITAL HAS SIGNS THAT NOTIFY THE PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. UNINSURED PATIENTS ARE PROVIDED A PLAIN LANGUAGE SUMMARY AND FAP APPLICATION FORM. BILLING STATEMENTS INCLUDE A NOTICE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO OBTAIN INFORMATION. THE HOSPITAL HAS FINANCIAL COUNSELORS AVAILABLE TO EDUCATE PATIENTS ON THE ELIGIBILITY OF ASSISTANCE. |
| PART VI, LINE 4: | THE HOSPITAL SERVES PRIMARILY MARION COUNTY, HOWEVER, THERE IS UTILIZATION BY MANY SURROUNDING COUNTIES AS WELL. MARION COUNTY HAS APPROXIMATELY 56,000 RESIDENTS. MARION COUNTY HAS A POVERTY RATE OF 14.6%. MEDIAN HOUSEHOLD INCOME IS $55,094 WHICH IS 20% BELOW THE NATIONAL AVERAGE. |
| PART VI, LINE 5: | THE HOSPITAL HAS AN OPEN MEDICAL STAFF SERVING A MULTITUDE OF SPECIALTIES. THE BOARD OF DIRECTORS IS COMPRISED OF VARIOUS MEMBERS OF THE COMMUNITY AS REQUIRED UNDER ITS BYLAWS. THE ORGANIZATION SPONSORS AN ANNUAL HEALTH FAIR AT THE LOCAL MALL, IN WHICH THOUSANDS OF CITIZENS FROM THE LOCAL COMMUNITY COME TO LEARN ABOUT SERVICES OFFERED AND ARE PROVIDED THE OPPORTUNITY TO RECEIVE MULTIPHASIC BLOODWORK FOR A NOMINAL FEE. |
| PART VI, LINE 6: | THE HOSPITAL IS PART OF MONONGALIA HEALTH SYSTEM, INC. WHICH INCLUDES THE FOLLOWING OTHER HEALTH CARE ENTITIES IN THE COMMUNITY: MONONGALIA COUNTY GENERAL HOSPITAL, MON ELDER SERVICES, INC. DBA THE VILLAGE AT HERITAGE POINT, MON HEALTH CARE, INC., PRESTON MEMORIAL HOSPITAL, PRESTON MEMORIAL MEDICAL GROUP, AND STONEWALL JACKSON MEMORIAL HOSPITAL. MONONGALIA COUNTY GENERAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL. MON ELDER SERVICES, INC. IS A NOT-FOR-PROFIT RESIDENTIAL AND ASSISTED LIVING PROVIDER. MON HEALTH CARE, INC. IS A FOR-PROFIT DURABLE MEDICAL EQUIPMENT RETAILER. PRESTON MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL. PRESTON MEMORIAL MEDICAL CENTER GROUP IS A NOT-FOR-PROFIT ENTITY WHICH PROVIDES PRIMARY AND URGERT CARE. STONEWALL JACKSON MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WV |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID GOLDBERG | ||||||||||||||
| SECRETARY/TREASURER/PRESIDENT/CEO | $0 | $576,356 | $0 | $237,960 | $0 | $96,742 | $0 | $128,124 | $0 | $3,327 | $0 | $1,042,509 | $0 | $0 |
| JEFF CRUDELE | ||||||||||||||
| INTERIM CFO | $0 | $480,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $480,000 | $0 | $0 |
| LISA SIMON CPA | ||||||||||||||
| VP FINANCE/CFO | $0 | $35,487 | $0 | $46,842 | $0 | $338,850 | $0 | $14,673 | $0 | $546 | $0 | $436,398 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE CEO'S COMPENSATION IS PAID BY MONONGALIA HEALTH SYSTEM. MONONGALIA HEALTH SYSTEM USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF - COMPENSATION COMMITTEE - COMPENSATION SURVEY OR STUDY THE CEO - INDEPENDENT COMPENSATION CONSULTANT - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINES 4A-B | LISA SIMON RECEIVED SEVERANCE PAYMENT IN 2022 OF $338,707. THE FOLLOWING INDIVIDUALS PARTICIPATED IN 457(F) PLAN: DAVID GOLDBERG AND LISA SIMON. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF MON HEALTH MARION NEIGHBORHOOD HOSPITAL IS MONONGALIA HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7A | MON HEALTH MARION NEIGHBORHOOD HOSPITAL'S BOARD MEMBERS ARE ELECTED OR APPOINTED BY MONONGALIA HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7B | MON HEALTH MARION NEIGHBORHOOD 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 TO THE HOSPITAL. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE GOVERNING BODY IS PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW PRIOR TO SUBMISSION. THE BOARD MEMBERS ARE ASKED TO INFORM MANAGEMENT OF ANY QUESTIONS OR REVISIONS THEY MAY HAVE. IF CHANGES ARE MADE, BASED ON BOARD MEMBER'S REVISIONS, MANAGEMENT REDISTRIBUTES A FINAL VERSION TO ALL BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY A CONFLICT OF INTEREST QUESTIONNAIRE IS SENT OUT TO ALL BOARD MEMBERS. THE BOARD THEN REVIEWS ALL RESPONSES FOR POSSIBLE CONFLICTS OF INTEREST. IF A CONFLICT IS NOTED, THE BOARD MEMBERS DETERMINE WHICH DECISIONS THE CONFLICTED MEMBER SHALL NOT PARTICIPATE IN. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO'S COMPENSATION IS PAID BY MONONGALIA HEALTH SYSTEM. ANNUALLY, A CONSULTANT COMPILES A MARKET DATA REPORT ON EXECUTIVE CEO COMPENSATION. THIS REPORT IS THEN REVIEWED BY THE EXECUTIVE COMMITTEE TO DETERMINE COMPENSATION FOR THE INDIVIDUAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE KEPT ONSITE AT MONONGALIA GENERAL HOSPITAL AND ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER FEES: PROGRAM SERVICE EXPENSES 838,785. MANAGEMENT AND GENERAL EXPENSES 717,300. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,556,085. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | Yes (1) | CHARLESTON AREA MEDICAL CENTER INC | |
| CHARLESTON AREA MEDICAL CENTER INC | |||||||||||
| PO BOX 1547 | CHARLESTON | WV | 253261547 | 550526150 | HOSPITAL | WV | 501(C)(3) | 3 | 0 | VANDALIA HEALTH INC | |
| MONONGALIA HEALTH SYSTEM INC | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550621551 | PARENT COMPANY | WV | 501(C)(3) | 12C, III-FI | 0 | VANDALIA HEALTH INC | |
| MONONGALIA COUNTY GENERAL HOSPITAL COMPANY | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 237441353 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| MON ELDER SERVICES INC | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 311520863 | CONTINUING CARE RETIREMENT CENTER | WV | 501(C)(3) | 10 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| 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 | Yes (1) | MONONGALIA COUNTY GENERAL HOSPITAL CO | |
| PRESTON MEMORIAL HOSPITAL | |||||||||||
| 150 MEMORIAL DRIVE | KINGWOOD | WV | 26537 | 311097818 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| PRESTON MEMORIAL MEDICAL GROUP | |||||||||||
| 300 SOUTH PRICE STREET | KINGWOOD | WV | 26537 | 550717988 | PRIMARY AND URGENT CARE | WV | 501(C)(3) | 3 | Yes (1) | PRESTON MEMORIAL HOSPITAL | |
| PRESTON MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 300 SOUTH PRICE STREET | KINGWOOD | WV | 26537 | 550740121 | RAISE FUNDS FOR PRESTON HOSPITAL | WV | 501(C)(3) | 12B, II | Yes (1) | PRESTON MEMORIAL HOSPITAL | |
| AUXILIARY OF MONONGALIA GENERAL HOSPITAL | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550362965 | RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL | WV | 501(C)(3) | 12A, I | Yes (1) | MONONGALIA COUNTY GENERAL HOSPITAL CO | |
| LIABILITY INSURANCE TRUST FOR MONONGALIA HEALTH SYSTEM | |||||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550689535 | LIABILITY INSURANCE TRUST | WV | 501(C)(3) | 12A, I | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| STONEWALL JACKSON MEMORIAL HOSPITAL | |||||||||||
| 230 HOSPITAL PLAZA | WESTON | WV | 26452 | 550422958 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | MONONGALIA HEALTH SYSTEM INC | |
| CAMC GREENBRIER VALLEY MEDICAL CENTER INC | |||||||||||
| 1320 MAPLEWOOD AVENUE | RONCEVERTE | WV | 24970 | 884128022 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | CHARLESTON AREA MEDICAL CENTER INC | |
| CAMC PLATEAU MEDICAL CENTER INC | |||||||||||
| 430 MAIN STREET | OAK HILL | WV | 25901 | 921715117 | HOSPITAL | WV | 501(C)(3) | 3 | Yes (1) | CHARLESTON AREA MEDICAL CENTER INC | |
| CAMC HEALTH EDUCATION AND RESEARCH INSTITUTE INC | |||||||||||
| PO BOX 1547 | CHARLESTON | WV | 253261547 | 550753754 | MEDICAL EDUCATIONAL RESEARCH | WV | 501(C)(3) | 12A, I | Yes (1) | CHARLESTON AREA MEDICAL CENTER INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 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 |
|---|---|---|---|---|---|---|---|---|---|
| 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| VANDALIA INSURANCE COMPANY | |||||||||
| 76 ST PAUL STREET STE 500 | BURLINGTON | VT | 05401 | 030308754 | INSURANCE | VT | N/A | C | Yes (1) |
| MON HEALTH CARE INC | |||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550654973 | MEDICAL EQUIPMENT | WV | N/A | C | Yes (1) |
| STONEWALL HOME OXYGEN THERAPY INC | |||||||||
| 100 MARKET PLACE MALL SUITE 8 | WESTON | WV | 26452 | 550754278 | OXYGEN THERAPY SERVICES | WV | N/A | C | Yes (1) |
| FAIRMONT HOME EQUIPMENT AND SUPPLY | |||||||||
| 1200 JD ANDERSON DRIVE | MORGANTOWN | WV | 26505 | 550763259 | EQUIPMENT RENT & SVC | WV | N/A | C | Yes (1) |
| MORGANTOWN PHYSICAL THERAPY ASSOC INC | |||||||||
| 943 MAPLE DRIVE | MORGANTOWN | WV | 26505 | 550614636 | REHABILITATION SERVICES | WV | N/A | C | Yes (1) |
| CARE PARTNER'S INC | |||||||||
| 511 BURROUGHS STREET SUITE 102 | MORGANTOWN | WV | 26505 | 550754326 | HOME HEALTH | WV | N/A | C | Yes (1) |
| 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 | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | 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 | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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