FURP.ORG / PUBLIC DATA EXPLORER

MONTGOMERY GENERAL HOSPITAL INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
MONTGOMERY GENERAL HOSPITAL INC (EIN 55-0372580)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-15
IRS object ID
202323199349306162
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-15T09:44:44-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

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

Filer Filer

FieldValueIRS element (for citing)
EIN550372580EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MONTGOMERY GENERAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMONTBusinessNameControlTxt
Phone3044425151PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 SIXTH AVENUEAddressLine1Txt
CityMONTGOMERYCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25136ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSHERRI MURRAYPersonNm
Person TitleCFOPersonTitleTxt
Phone3044421246PhoneNum
Signature2023-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSHERRIPersonFirstNm
Person LastMURRAYPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDOLORES ROSEPreparerPersonNm
PTINP01286262PTIN
Phone3043460441PhoneNum
Preparation2023-11-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

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

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDEBORAH HILLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 SIXTH AVENUEAddressLine1Txt
CityMONTGOMERYCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25136ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$32,749,617GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MGHWV.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1970FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionTO PROVIDE QUALITY, COST-EFFECTIVE, AND CONVENIENT HEALTHCARE SERVICES THAT MEET AND EXCEED REASONABLE INTERNAL AND EXTERNAL CUSTOMER EXPECTATIONS.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee370TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,793,360PYContributionsGrantsAmt
CY Contributions Grants$305,005CYContributionsGrantsAmt
PY Program Service Revenue$28,253,237PYProgramServiceRevenueAmt
CY Program Service Revenue$31,477,401CYProgramServiceRevenueAmt
PY Investment Income$31,940PYInvestmentIncomeAmt
CY Investment Income$24,919CYInvestmentIncomeAmt
PY Other Revenue$1,230,604PYOtherRevenueAmt
CY Other Revenue$942,292CYOtherRevenueAmt
PY Total Revenue$32,309,141PYTotalRevenueAmt
CY Total Revenue$32,749,617CYTotalRevenueAmt
PY Grants And Similar Paid$4,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,500CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,654,735PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$17,184,796CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$15,083,111PYOtherExpensesAmt
CY Other Expenses$15,433,153CYOtherExpensesAmt
PY Total Expenses$28,741,846PYTotalExpensesAmt
CY Total Expenses$32,620,449CYTotalExpensesAmt
PY Revenues Less Expenses$3,567,295PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$129,168CYRevenuesLessExpensesAmt
Total Assets BOY$13,407,051TotalAssetsBOYAmt
Total Assets EOY$11,084,086TotalAssetsEOYAmt
Total Liabilities BOY$8,740,462TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,114,720TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,666,589NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,969,366NetAssetsOrFundBalancesEOYAmt
MissionMONTGOMERY GENERAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL. IT ALSO PROVIDES OUTPATIENT SERVICES INCLUDING LABORATORY, RADIOLOGY, SURGERY AND THERAPY SERVICES; PHYSICIAN SERVICES; AND SKILLED NURSING SERVICES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$25,412,804ExpenseAmt
Grant$2,500GrantAmt
Revenue$32,414,490RevenueAmt
DescTHE HOSPITAL PROVIDED HEALTH CARE SERVICES INCLUDING 1,060 ACUTE INPATIENT DAYS; 2,175 SWING BED DAYS; 12,037 SKILLED NURSING DAYS; 22,573 OUTPATIENT VISITS; 7,538 EMERGENCY ROOM VISITS; 845 AMBULATORY SURGERY PROCEDURES; AND 22,624 PHYSICIAN OFFICE VISITS. CHARGES FOREGONE FOR CHARITY CARE AMOUNTED TO $25,353.Desc
Total Program Service Expenses$25,412,804TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document51IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee370EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHERRI MURRAYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3044421246PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 SIXTH AVENUEAddressLine1Txt
CityMONTGOMERYCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25136ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
RALEIGH COLLINS
TRUSTEE0.501.50Yes (X)$1,800$0$0
GHASSAN Y DAGHER MD
CHAIR0.501.50Yes (X)$2,600$0$0Yes (X)
JOYCE BROWN
SECRETARY0.501.50Yes (X)$2,100$0$0Yes (X)
BARBARA CRIST
VICE-CHAIR0.500.50Yes (X)$2,400$0$0Yes (X)
DEBORAH HILL
PRESIDENT & CEO39.500.50Yes (X)$30,778$0$305Yes (X)
RITA BOHANNA
TRUSTEE0.501.50Yes (X)$900$0$0
DONALD SMITH
TRUSTEE0.501.50Yes (X)$2,600$0$0
PATRICIA TUCKER
TRUSTEE0.501.50Yes (X)$2,100$0$0
LOU ANN BOWEN
TRUSTEE0.501.50Yes (X)$2,000$0$0
DEANNE VALENTINE
TRUSTEE0.501.50Yes (X)$2,400$0$0
DUSTIN SMITH
TRUSTEE0.501.50Yes (X)$1,200$0$0
SHERRI MURRAY
CFO39.500.50$138,267$0$317Yes (X)
ROBERT EGGLESTON MD
PHYSICIAN40.00$316,684$0$8,373Yes (X)
MYRA PRIDDY MD
PHYSICIAN40.00$373,564$0$0Yes (X)
MARK TARAKJI MD
PHYSICIAN40.00$399,164$0$115,625Yes (X)
DILIP GHODASARA MD
PHYSICIAN40.00$586,024$0$0Yes (X)
WILLIAM CASTO MD
PHYSICIAN40.00$484,393$0$12,212Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,348,974TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$136,832TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K17IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ADVANTAGE REHAB
150 HIDDEN VALLEY ROADSCOTT DEPOTWV25560THERAPY SERVICES$1,264,434
MEDICAL INFORMATION TECHNOLOGY INC
MEDITECH CIRCLEWESTWOODMA02090EMR SERVICES$617,561
KANAWHA VALLEY RADIOLOGISTS
PO BOX 3428CHARLESTONWV25334RADIOLOGIST SERVICES$468,000
SHARP ANESTHESIA
PO BOX 88FAYETTEVILLEWV25840ANESTHESIA SERVICES$308,000
AMN HEALTHCARE
PO BOX 281939ATLANTAGA30384NURSING SERVICES$257,474
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Government Grants$278,376GovernmentGrantsAmt
All Other Contributions$26,629AllOtherContributionsAmt
Total Contributions$305,005TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICESDesc
Business622110BusinessCd
Total Revenue Column$31,477,401TotalRevenueColumnAmt
Related Or Exempt Func Income$31,477,401RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$31,477,401TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,919TotalRevenueColumnAmt
Exclusion$21,919ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$5,203RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$5,203RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,203TotalRevenueColumnAmt
Exclusion$5,203ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$3,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$3,000OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,000TotalRevenueColumnAmt
Exclusion$3,000ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
340B PROGRAM900099$863,017$863,017
CAFETERIA722210$69,537$69,537

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,535TotalRevenueColumnAmt
Related Or Exempt Func Income$4,535RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$937,089OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$32,749,617TotalRevenueColumnAmt
Related Or Exempt Func Income$32,414,490RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$30,122ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$2,500TotalAmt
Program Services$2,500ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$189,767TotalAmt
Program Services$139,568ProgramServicesAmt
Management And General$50,199ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$14,043,220TotalAmt
Program Services$10,328,388ProgramServicesAmt
Management And General$3,714,832ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$437,987TotalAmt
Program Services$322,127ProgramServicesAmt
Management And General$115,860ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,585,956TotalAmt
Program Services$1,166,425ProgramServicesAmt
Management And General$419,531ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$927,866TotalAmt
Program Services$682,419ProgramServicesAmt
Management And General$245,447ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$122,086TotalAmt
Management And General$122,086ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$259,360TotalAmt
Management And General$259,360ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,875,117TotalAmt
Program Services$2,850,038ProgramServicesAmt
Management And General$1,025,079ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$59,233TotalAmt
Program Services$43,564ProgramServicesAmt
Management And General$15,669ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$471,609TotalAmt
Program Services$346,855ProgramServicesAmt
Management And General$124,754ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$636,148TotalAmt
Program Services$467,869ProgramServicesAmt
Management And General$168,279ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,321,999TotalAmt
Program Services$972,293ProgramServicesAmt
Management And General$349,706ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$57,306TotalAmt
Program Services$42,147ProgramServicesAmt
Management And General$15,159ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$42,726TotalAmt
Management And General$42,726ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$570,216TotalAmt
Program Services$419,378ProgramServicesAmt
Management And General$150,838ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$677,995TotalAmt
Program Services$498,646ProgramServicesAmt
Management And General$179,349ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBTS$3,235,000$3,235,000
MEDICAL SUPPLIES$2,786,631$2,786,631
HEALTH CARE PROVIDER TA$528,493$528,493
DUES AND SUBSCRIPTIONS$310,671$228,490$82,181

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$478,563TotalAmt
Program Services$351,973ProgramServicesAmt
Management And General$126,590ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$32,620,449TotalAmt
Program Services$25,412,804ProgramServicesAmt
Management And General$7,207,645ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,806,583BOYAmt
EOY$3,335,681EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,955,865BOYAmt
EOY$3,058,860EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$646,415BOYAmt
EOY$600,162EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$27,536BOYAmt
EOY$37,916EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$34,135,164LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$30,554,305LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,690,535BOYAmt
EOY$3,580,859EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$280,117BOYAmt
EOY$470,608EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$13,407,051BOYAmt
EOY$11,084,086EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,997,552BOYAmt
EOY$2,632,044EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$269,960BOYAmt
EOY$158,426EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,472,950BOYAmt
EOY$3,324,250EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,740,462BOYAmt
EOY$6,114,720EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,666,589BOYAmt
EOY$4,969,366EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,666,589BOYAmt
EOY$4,969,366EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,407,051BOYAmt
EOY$11,084,086EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$129,168ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$173,609OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$869,878OtherCostOrOtherBasisAmt
Book Value$869,878BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,175,288OtherCostOrOtherBasisAmt
Depreciation$12,052,350DepreciationAmt
Book Value$122,938BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,704,490OtherCostOrOtherBasisAmt
Depreciation$18,123,240DepreciationAmt
Book Value$2,581,250BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$385,508OtherCostOrOtherBasisAmt
Depreciation$378,715DepreciationAmt
Book Value$6,793BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,580,859TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ACCRUED PENSION OBLIGATION$1,584,901
DUE TO THIRD PARTY PAYERS$1,335,680
OPERATING LEASE LIABILITY$403,669
FieldValueIRS element (for citing)
Total Liability$3,324,250TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION ARE NONPROFIT ORGANIZATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND HAVE BEEN RECOGNIZED AS TAX EXEMPT UNDER SECTION 501(A) OF THE CODE AND SIMILAR STATE STATUTES RELATING TO NOT-FOR-PROFIT ORGANIZATIONS. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE ORGANIZATION TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY OR ASSET IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE-LIKELY-THAN-NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICES (IRS). THE ORGANIZATION HAS CONCLUDED THAT AS OF DECEMBER 31, 2022 AND 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR ASSET OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. GENERALLY, TAX RETURNS FOR YEARS ENDED DECEMBER 31, 2019, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other120.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other120.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$539,088TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$539,088NetCommunityBenefitExpnsAmt
Total Expense0.01830TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,365,185TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,030,346DirectOffsettingRevenueAmt
Net Community Benefit Expns$334,839NetCommunityBenefitExpnsAmt
Total Expense0.01140TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,904,273TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,030,346DirectOffsettingRevenueAmt
Net Community Benefit Expns$873,927NetCommunityBenefitExpnsAmt
Total Expense0.02970TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,500NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,500NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,906,773TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,030,346DirectOffsettingRevenueAmt
Net Community Benefit Expns$876,427NetCommunityBenefitExpnsAmt
Total Expense0.02980TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,235,000BadDebtExpenseAmt
Reimbursed By Medicare$4,761,582ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$4,761,582CostOfCareReimbursedByMedcrAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MONTGOMERY GENERAL HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 SIXTH AVENUEAddressLine1Txt
CityMONTGOMERYCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25136ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MONTGOMERY GENERAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTPS://MGHWV.COM/COMMUNITY-HEALTHOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTPS://MGHWV.COM/COMMUNITY-HEALTHStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care120.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://MGHWV.COM/FINANCIAL-RESOURCESFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://MGHWV.COM/FINANCIAL-RESOURCESFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://MGHWV.COM/FINANCIAL-RESOURCESFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
MONTGOMERY GENERAL HOSPITAL, INC.PART V, SECTION B, LINE 5: MONTGOMERY GENERAL HOSPITAL (MGH) ENLISTED THE ASSISTANCE OF KINGERY AND COMPANY, LLC, TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT THAT DETERMINES THE PRIORITY HEALTH ISSUES FACING THEIR PATIENTS AND THE SURROUNDING COMMUNITIES. THE PROJECT INCLUDED SURVEYING RESIDENTS AND SERVICE PROVIDERS, HOSTING FOCUS GROUPS, INTERVIEWING BOARD MEMBERS, COMMUNITY MEMBERS, AND KEY STAKEHOLDERS, CONDUCTING SECONDARY DATA RESEARCH, AND PROVIDING A SUMMARY REPORT WITH KEY FINDINGS AND RECOMMENDATIONS.
MONTGOMERY GENERAL HOSPITAL, INC.PART V, SECTION B, LINE 11: THE RESULTS OF THE CHNA WILL ENABLE THE HOSPITAL, AS WELL AS OTHER COMMUNITY PROVIDERS, TO COLLABORATE THEIR EFFORTS TO PROVIDE THE NECESSARY RESOURCES FOR THE COMMUNITY. AFTER REVIEWING DATA SOURCES PROVIDING DEMOGRAPHIC, POPULATION, SOCIOECONOMIC, AND HEALTH STATUS INFORMATION, IN ADDITION TO COMMUNITY FEEDBACK, HEALTH NEEDS OF THE COMMUNITY WERE PRIORITIZED. THE FOLLOWING HAVE BEEN SELECTED AS THE PRIORITY HEALTH ISSUES TO BE ADDRESSED:1. OBESITY IN ADULTSTHE FITNESS CENTER AT MGH WILL CONTINUE TO BE AVAILABLE TO ITS COMMUNITY MEMBERS FREE OF CHARGE DURING WEEKLY STAFFED HOURS. THIS STATE-OF-THE-ART FACILITY PROVIDES A WIDE VARIETY OF EQUIPMENT INCLUDING: TREADMILLS, ELLIPTICALS, STAIR-MASTERS, A SITH GYM, FREE WEIGHTS, AND RECUMBENT BIKES.2. SUBSTANCE ABUSETHE HOSPITAL WILL MAINTAIN ITS COLLABORATION AND REFERRAL NETWORK TO ADDRESS PATIENTS' NEEDS WITH REGARDS TO ADDICTION AND ABUSE. MGH WILL CONTINUE TO PROVIDE OUTREACH AND EDUCATION TO THE RESIDENTS OF MONTGOMERY AND THE SURROUNDING COMMUNITIES.3. DIABETESTHE HOSPITAL WILL CONTINUE TO TREAT EMERGENT ISSUES RELATED TO DIABETES. IN ADDITION, MGH WILL PROVIDE COUNSELING AND EDUCATION TO THE RESIDENTS TO ENCOURAGE PREVENTION AND TREATMENT.

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE COST OF CHARITY CARE HAS BEEN CALCULATED BY OBTAINING GROSS CHARGES FROM THE AUDITED FINANCIAL STATEMENTS FOR CHARITY CARE WRITE OFFS AND MULTIPLYING THESE CHARGES BY THE AGGREGATE HOSPITAL COST TO CHARGE RATIO. MEDICAID COMMUNITY BENEFIT COST WAS ESTIMATED BASED ON THE COSTS IN EXCESS OF REIMBURSEMENTS FOR THE HOSPITAL'S SKILLED NURSING UNIT. OTHER HOSPITAL SERVICES ARE REIMBURSED BY WV MEDICAID AT 100% OF COST. SINCE THOSE COSTS AND REIMBURSEMENTS WOULD NET TO ZERO COMMUNITY BENEFIT EXPENSE, THOSE AMOUNTS ARE NOT INCLUDED IN THE MEDICAID COSTS AND OFF-SETTING REVENUE TOTALS REPORTED.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,235,000.
PART III, LINE 2:BAD DEBTS AS REPORTED ON FINANCIAL STATEMENTS.
PART III, LINE 4:PATIENT ACCOUNTS RECEIVABLE ARE CARRIED AT NET REALIZABLE VALUE TAKING INTO ACCOUNT IMPLICIT AND EXPLICIT PRICE CONCESSIONS. THE ESTIMATED IMPLICIT PRICE CONCESSIONS ARE BASED UPON MANAGEMENT'S JUDGMENTAL ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND GENERAL ECONOMIC CONDITIONS IN ITS SERVICE AREA, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR EXPLICIT PRICE CONCESSIONS, IF NECESSARY. THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ESTIMATED PRICE CONCESSIONS BASED UPON ITS REVIEW OF ACCOUNTS RECEIVABLE PAYOR COMPOSITION AND AGING, TAKING INTO CONSIDERATION RECENT EXPERIENCE BY PAYOR CATEGORY, PAYOR AGREEMENT RATE CHANGES, AND OTHER FACTORS. THE RESULTS OF THESE ASSESSMENTS ARE USED TO MAKE MODIFICATIONS TO PATIENT SERVICE REVENUE AND TO ESTABLISH AN APPROPRIATE ESTIMATE FOR PRICE CONCESSIONS. THE ORGANIZATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITH EXTERNAL COLLECTION AGENCIES.
PART III, LINE 8:THE MEDICARE COSTS AND REIMBURSEMENTS WERE DERIVED FROM THE HOSPITAL'S MEDICARE COST REPORT.
PART III, LINE 9B:CHARITY APPLICATION IS AVAILABLE TO ANY PERSON INTERESTED. COLLECTION STAFF WILL MEET WITH INTERESTED PATIENTS TO HELP COMPLETE AND ASSESS ALL REQUIRED INFORMATION.
PART VI, LINE 2:MONTGOMERY GENERAL HOSPITAL PROVIDES ACUTE CARE SERVICES, SWING BED SNF SERVICES, SKILLED NURSING SERVICES FOR BOTH SKILLED PATIENTS AND INTERMEDIATE CARE PATIENTS AND PHYSICIANS IN GENERAL PRACTICE AND MANY SPECIALTIES. AS THE ONLY HOSPITAL IN FAYETTE COUNTY, MONTGOMERY GENERAL HOSPITAL IS AWARE OF THE HEALTH NEEDS OF THE COMMUNITY AND WORKS TO PROVIDE ALL NECESSARY SERVICES TO ALL CITIZENS OF THE COUNTY.
PART VI, LINE 3:MGH WILL MAKE REASONABLE EFFORTS TO EXPLAIN THE BENEFITS OF MEDICAID AND OTHER AVAILABLE PUBLIC AND PRIVATE PROGRAMS TO PATIENTS AND PROVIDE INFORMATION ON THOSE PROGRAMS THAT MAY PROVIDE COVERAGE FOR SERVICES. INFORMATION ON PUBLIC OR PRIVATE COVERAGE AND MGH'S FINANCIAL ASSISTANCE POLICY WILL BE COMMUNICATED TO PATIENTS IN EASY-TO-UNDERSTAND, CULTURALLY APPROPRIATE LANGUAGE, AND IN THE MOST PREVALENT LANGUAGES SPOKEN IN APPLICABLE HOSPITAL SERVICE AREA COMMUNITIES. MGH WILL MAKE RESOURCES AVAILABLE TO ASSIST PATIENTS IN ENROLLING IN AND/OR APPLYING FOR FEDERAL AND GOVERNMENT PROGRAMS. REQUESTS FOR FINANCIAL ASSISTANCE WILL BE PROCESSED PROMPTLY AND MGH WILL NOTIFY THE PATIENT OR APPLICANT IN WRITING WITHIN 60 DAYS OF RECEIPT OF A COMPLETED APPLICATION.
PART VI, LINE 4:MONTGOMERY GENERAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL LOCATED IN FAYETTE COUNTY, WEST VIRGINIA. MONTGOMERY GENERAL HOSPITAL IS THE ONLY HOSPITAL FOR RURAL FAYETTE COUNTY. FAYETTE COUNTY IS A LOW INCOME AREA THAT MUST COMPETE WITH URBAN KANAWHA COUNTY TO ATTRACT AND RETAIN PHYSICIANS, NURSES AND MEDICAL PERSONNEL. IN ADDITION OF HAVING TO PAY HIGHER SALARIES TO ATTRACT TOP MEDICAL PROFESSIONALS, MONTGOMERY GENERAL HOSPITAL HAS A HIGH PERCENTAGE OF MEDICARE AND MEDICAID PATIENT POPULATION. MONTGOMERY GENERAL HOSPITAL IS LISTED AS A HEALTH PROFESSIONAL SHORTAGE AREA AND A MEDICALLY UNDERSERVED AREA FOR PORTIONS OF FAYETTE COUNTY.
PART VI, LINE 5:THE MAJORITY OF MONTGOMERY GENERAL HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE ORGANIZATION USES SURPLUS FUNDS FOR IMPROVEMENTS IN PATIENT CARE. CURRENTLY, THE ORGANIZATION IS IN THE PROCESS OF UPDATING ALL PATIENT ROOMS AND IMPLEMENTING AN EMR. THE ORGANIZATION OPERATES AN EMERGENCY ROOM AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY. THE ORGANIZATION OFFERS OPEN MRI SERVICES AND IS IN THE PROCESS OF IMPLEMENTING DIGITAL RADIOLOGY. THE ORGANIZATION INVOLVES ITSELF IN THE COMMUNITY BY SPONSORING HEALTH FAIRS AS WELL AS LUNCH AND LEARN OPPORTUNITIES TO ADDRESS THE DIABETIC POPULATION.

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DILIP GHODASARA MD
PHYSICIAN$586,024$0$0$0$0$0$0$0$0$0$586,024$0$0$0
MARK TARAKJI MD
PHYSICIAN$399,164$0$0$0$0$0$0$0$115,625$0$514,789$0$0$0
WILLIAM CASTO MD
PHYSICIAN$482,393$0$2,000$0$0$0$0$0$12,212$0$496,605$0$0$0
MYRA PRIDDY MD
PHYSICIAN$373,564$0$0$0$0$0$0$0$0$0$373,564$0$0$0
ROBERT EGGLESTON MD
PHYSICIAN$316,684$0$0$0$0$0$0$0$8,373$0$325,057$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED BY THE CFO AND CEO.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY BOARD MEMBERS ARE PROVIDED THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE. ONCE THESE ARE COMPLETED THEY ARE RETURNED TO ADMINISTRATION AND REVIEWED BY OUR IN-HOUSE COUNSEL.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS DETERMINES THE PRESIDENT/CEO'S SALARY BASED UPON COMPARATIVE INDUSTRY STANDARDS. THE CEO DETERMINES THE CFO SALARY BASED UPON COMPARATIVE INDUSTRY STANDARDS.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. THE FINANCIAL STATEMENTS ARE PUBLISHED ANNUALLY IN THE LOCAL NEWSPAPER.
FORM 990, PART IX, LINE 11GLAB SERVICE FEES: PROGRAM SERVICE EXPENSES 648,517. MANAGEMENT AND GENERAL EXPENSES 233,253. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 881,770. ER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 3,089. MANAGEMENT AND GENERAL EXPENSES 1,111. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,200. LTC PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 287,469. MANAGEMENT AND GENERAL EXPENSES 103,394. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 390,863. THERAPY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 677,029. MANAGEMENT AND GENERAL EXPENSES 243,509. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 920,538. ADMIN PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 233,794. MANAGEMENT AND GENERAL EXPENSES 84,089. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 317,883. MEDICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 861,028. MANAGEMENT AND GENERAL EXPENSES 309,688. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,170,716. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 139,112. MANAGEMENT AND GENERAL EXPENSES 50,035. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 189,147.
FORM 990, PART XI, LINE 9:TRANSFERS FROM RELATED PARTIES -494,175. CHANGE IN PENSION FUNDED PLAN STATUS 667,784.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
LAIRD HEALTH CARE FOUNDATION INC
WASHINGTON SIXTH AVENUEMONTGOMERYWV25136550632743SUPPORT TAX-EXEMPT HEALTH CARE ORGANIZATIONSWV501(C)(3)LINE 7MONTGOMERY GENERAL HEALTH CARE SYSTEM0
MONTGOMERY GENERAL ELDERLY CARE CENTER
WASHINGTON SIXTH AVENUEMONTGOMERYWV25136550623339EXTENDED CARE FACILITYWV501(C)(3)LINE 11MONTGOMERY GENERAL HEALTH CARE SYSTEM0
MONTGOMERY GENERAL HEALTH CARE SYSTEM INC
WASHINGTON SIXTH AVENUEMONTGOMERYWV25136550632601PROVIDE SUPPORT TO AFFILIATED EXEMPT HEALTH CARE PROVIDERSWV501(C)(3)LINE 12C, III-FI0N/A
MONTGOMERY MEDCORP INC
WASHINGTON SIXTH AVENUEMONTGOMERYWV25136550767169PHYSICIANS PRACTICEWV501(C)(3)LINE 11MONTGOMERY GENERAL HEALTH CARE SYSTEM0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd