2022-11-14T12:52:00-06:00 2021-12-31 390859910 BAKER TILLY US LLP 101 WASHINGTON STREET EAST CHARLESTON WV 25329 990 2021-01-01 550372580 MONTGOMERY GENERAL HOSPITAL INC MONT 3044425151 401 SIXTH AVENUE MONTGOMERY WV 25136 SHERRI MURRAY CFO 3044421246 2022-11-11 1 SHERRI MURRAY 999009999 DOLORES ROSE P01286262 3043460441 2022-11-11 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z DEBORAH HILL 401 SIXTH AVENUE MONTGOMERY WV 25136 32309141 0 X WWW.MGHWV.COM X 1970 WV TO PROVIDE QUALITY, COST-EFFECTIVE, AND CONVENIENT HEALTHCARE SERVICES THAT MEET AND EXCEED REASONABLE INTERNAL AND EXTERNAL CUSTOMER EXPECTATIONS. 10 9 350 25 0 0 4360636 2793360 19042953 28253237 24151 31940 1723666 1230604 25151406 32309141 350 4000 0 0 12719737 13654735 0 0 0 12044805 15083111 24764892 28741846 386514 3567295 9152395 13407051 8867257 8740462 285138 4666589 MONTGOMERY 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. 0 0 22404158 4000 29483841 THE HOSPITAL PROVIDED HEALTH CARE SERVICES INCLUDING 2,724 ACUTE INPATIENT DAYS; 10,382 SKILLED NURSING DAYS; 18,012 OUTPATIENT VISITS; 6,910 EMERGENCY ROOM VISITS; 727 AMBULATORY SURGERY PROCEDURES; AND 16,714 PHYSICIAN OFFICE VISITS. CHARGES FOREGONE FOR CHARITY CARE AMOUNTED TO $117,492. 22404158 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 49 0 350 1 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X SHERRI MURRAY 3044421246 401 SIXTH AVENUE MONTGOMERY WV 25136 RALEIGH COLLINS TRUSTEE 0.50 1.50 X 600 0 0 GHASSAN Y DAGHER MD CHAIR 0.50 1.50 X X 600 0 0 JOYCE BROWN SECRETARY 0.50 1.50 X X 600 0 0 BARBARA CRIST VICE-CHAIR 0.50 0.50 X 800 0 0 VICKIE GAY PRESIDENT & CEO 39.50 0.50 X X 145809 0 6264 RITA BOHANNA TRUSTEE 0.50 1.50 X 800 0 0 DONALD SMITH TRUSTEE 0.50 1.50 X 800 0 0 PATRICIA TUCKER TRUSTEE 0.50 1.50 X 600 0 0 LOU ANN BOWEN TRUSTEE 0.50 1.50 X 800 0 0 DEANNE VALENTINE TRUSTEE 0.50 1.50 X 600 0 0 SHERRI MURRAY CFO 39.50 0.50 X 115971 0 5000 ROBERT EGGLESTON MD PHYSICIAN 40.00 X 301874 0 0 MYRA PRIDDY MD PHYSICIAN 40.00 X 245547 0 0 MOHAMAD SANKARI MD PHYSICIAN 40.00 X 255346 0 0 DILIP GHODASARA MD PHYSICIAN 40.00 X 325700 0 0 WILLIAM CASTO MD PHYSICIAN 40.00 X 394514 0 0 1790961 0 11264 12 0 1 0 ADVANTAGE REHAB 150 HIDDEN VALLEY ROAD SCOTT DEPOT WV 25560 THERAPY SERVICES 1259862 MEDICAL INFORMATION TECHNOLOGY INC MEDITECH CIRCLE WESTWOOD MA 02090 EMR SERVICES 599301 KANAWHA VALLEY RADIOLOGISTS PO BOX 3428 CHARLESTON WV 25334 RADIOLOGIST SERVICES 468099 SHARP ANESTHESIA PO BOX 88 FAYETTEVILLE WV 25840 ANESTHESIA SERVICES 189073 ARNETT CARBIS TOOTHMAN PO BOX 45723 BALTIMORE MD 21297 PHARMACY VENDOR 172987 7 2793360 2793360 PATIENT SERVICES 622110 28253237 28253237 28253237 17140 17140 14800 0 14800 14800 14800 340B PROGRAM 900099 1191406 1191406 CAFETERIA 722210 33425 33425 5773 5773 1230604 32309141 29483841 0 31940 X 4000 4000 292387 209890 82497 11265678 8087085 3178593 223758 160625 63133 1093778 785170 308608 779134 559303 219831 158258 158258 149132 149132 3333925 2393263 940662 36120 25929 10191 466621 334965 131656 804831 577749 227082 1171719 841120 330599 31980 22957 9023 20887 20887 555906 399058 156848 606054 435057 170997 BAD DEBTS 3717715 3717715 MEDICAL SUPPLIES 2875924 2875924 HEALTH CARE PROVIDER TA 517172 517172 DUES AND SUBSCRIPTIONS 200966 144264 56702 435901 312912 122989 28741846 22404158 6337688 0 3473176 4806583 2072572 4955865 492552 646415 88485 27536 32841194 30150659 2699815 2690535 325795 280117 9152395 13407051 2278769 2997552 247794 269960 6340694 5472950 8867257 8740462 X 285138 4666589 285138 4666589 9152395 13407051 X 3567295 101663 712493 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 869878 869878 12175288 12026806 148482 19417313 17745138 1672175 378715 378715 0 2690535 ACCRUED PENSION OBLIGATION 1858397 DUE TO THIRD PARTY PAYERS 1664101 PPP LOAN 1950452 5472950 X PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT OF THE ORGANIZATION TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION. MANAGEMENT HAS EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAS MAINTAINED ITS TAX EXEMPT STATUS AND HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. GENERALLY, TAX RETURNS FOR YEARS ENDED DECEMBER 31, 2018, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. 1 1 X 1 X 120.000000000000 1 X 120.000000000000 1 0 0 546602 546602 3014135 2448679 565456 0.02260 3560737 2995281 565456 0.02260 4000 4000 0.00020 4000 4000 0.00020 3564737 2995281 569456 0.02280 1 3717715 3812536 3812536 X 1 1 1 1 MONTGOMERY GENERAL HOSPITAL INC 401 SIXTH AVENUE MONTGOMERY WV 25136 X X X X MONTGOMERY GENERAL HOSPITAL INC 1 0 0 1 X X X X X X X X 19 1 0 0 1 X HTTPS://MGHWV.COM/COMMUNITY-HEALTH X 1 19 1 HTTPS://MGHWV.COM/COMMUNITY-HEALTH 0 1 X 100.000000000000 120.000000000000 X X X 1 1 X X X X 1 X HTTPS://MGHWV.COM/FINANCIAL-RESOURCES X HTTPS://MGHWV.COM/FINANCIAL-RESOURCES X HTTPS://MGHWV.COM/FINANCIAL-RESOURCES X X X 1 X 0 X X X 1 X 0 0 MONTGOMERY GENERAL HOSPITAL, INC. PART V, SECTION B, LINE 5: INPUT WAS SOLICITED FROM THOSE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY IN DECEMBER, 2019. DISCUSSIONS INCLUDED THE HEALTH NEEDS OF THE COMMUNITY, BARRIERS TO HEALTHCARE ACCESS, OPPORTUNITIES FOR IMPROVEMENT, PERCEPTION OF MONTGOMERY GENERAL HOSPITAL AND FEEDBACK ON MGHS INITIATIVES. THE FOLLOWING WERE SELECTED TO PROVIDE FEEDBACK: FAYETTE COUNTY DEPARTMENT OF HEALTHMONTGOMERY GENERAL HOSPITAL BOARD MEMBERSFAYETTE COUNTY SCHOOLSBRIDGE VALLEY COMMUNITY AND TECHNICAL COLLEGEFRESENIUS DIALYSIS OF MONTGOMERYCITY OF MONTGOMERY REPRESENTATIVESMONTGOMERY GENERAL HOSPITAL EMPLOYEES AND PHYSICIANS 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. PHYSICAL INACTIVITY AND OBESITYTHE 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 ABUSE AND MENTAL HEALTHTHE 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. TRANSPORTATIONMGH OWNS TWO VANS PRIMARILY USED TO TRANSPORT ELDERLY AND LONG-TERM CARE PATIENTS. MGH WILL EXPLORE ADDITIONAL OPPORTUNITIES TO PROVIDE TRANSPORTATION FOR HEALTHCARE VISITS.4. WOMEN'S HEALTH CARELOCAL PRIMARY CARE PROVIDERS ARE PROVIDING SOME WOMEN'S HEALTH SERVICES, HOWEVER, MGH IS CONTINUING TO LOOK FOR EXTERNAL PARTNERS TO ADDRESS THE WOMEN'S HEALTH NEEDS OF THE AREA. 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. THE RESULTING CHARITY CARE COST WAS THEN INCREASED FOR THE ESTIMATED "CHARITY PORTION" OF BROAD-BASED TAXES PAID TO THE STATE OF WV. THE NET AMOUNT WAS THEN REDUCED BY THE ESTIMATED "CHARITY PORTION" OF THE REVENUE "DISPROPORTIONATE SHARE" PAYMENT RECEIVED FROM THE STATE. 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 $ 3,717,715. PART III, LINE 2: BAD DEBTS AS REPORTED ON FINANCIAL STATEMENTS. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE: PATIENT ACCOUNTS RECEIVABLE ARE CARRIED AT THE ORIGINAL CHARGE LESS AN ESTIMATE MADE FOR DOUBTFUL OR UNCOLLECTABLE ACCOUNTS. THE ALLOWANCE IS BASED UPON A REVIEW OF THE OUTSTANDING BALANCES AGED BY FINANCIAL CLASS. MANAGEMENT USES COLLECTION PERCENTAGES BASED UPON HISTORICAL COLLECTION EXPERIENCE TO DETERMINE COLLECTABILITY. MANAGEMENT ALSO REVIEWS TROUBLED, AGED ACCOUNTS TO DETERMINE COLLECTION POTENTIAL. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF ACCOUNTS PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION TO BAD DEBT EXPENSE WHEN RECEIVED. INTEREST IS NOT CHARGED ON PATIENT ACCOUNTS RECEIVABLE. 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 PATIENT 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. X X 0 0 0 0 0 0 0 0 0 WILLIAM CASTO MD PHYSICIAN 394514 0 0 0 0 0 0 0 0 0 394514 0 0 0 DILIP GHODASARA MD PHYSICIAN 325700 0 0 0 0 0 0 0 0 0 325700 0 0 0 ROBERT EGGLESTON MD PHYSICIAN 301874 0 0 0 0 0 0 0 0 0 301874 0 0 0 MOHAMAD SANKARI MD PHYSICIAN 255346 0 0 0 0 0 0 0 0 0 255346 0 0 0 MYRA PRIDDY MD PHYSICIAN 245547 0 0 0 0 0 0 0 0 0 245547 0 0 0 VICKIE GAY PRESIDENT & CEO 145809 0 0 0 0 0 5000 0 1264 0 152073 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CFO AND CEO. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY 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 15 THE 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 19 THE 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 11G LAB SERVICE FEES: PROGRAM SERVICE EXPENSES 384,718. MANAGEMENT AND GENERAL EXPENSES 151,212. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 535,930. LTC PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 382,881. MANAGEMENT AND GENERAL EXPENSES 150,490. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 533,371. THERAPY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 557,030. MANAGEMENT AND GENERAL EXPENSES 218,938. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 775,968. ADMIN PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 151,768. MANAGEMENT AND GENERAL EXPENSES 59,652. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 211,420. MEDICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 783,092. MANAGEMENT AND GENERAL EXPENSES 307,791. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,090,883. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 133,774. MANAGEMENT AND GENERAL EXPENSES 52,579. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 186,353. FORM 990, PART XI, LINE 9: TRANSFERS FROM RELATED PARTIES -197,971. CHANGE IN PENSION FUNDED PLAN STATUS 910,464. LAIRD HEALTH CARE FOUNDATION INC WASHINGTON SIXTH AVENUE MONTGOMERY WV 25136 550632743 SUPPORT TAX-EXEMPT HEALTH CARE ORGANIZATIONS WV 501(C)(3) LINE 7 MONTGOMERY GENERAL HEALTH CARE SYSTEM 0 MONTGOMERY GENERAL ELDERLY CARE CENTER WASHINGTON SIXTH AVENUE MONTGOMERY WV 25136 550623339 EXTENDED CARE FACILITY WV 501(C)(3) LINE 11 MONTGOMERY GENERAL HEALTH CARE SYSTEM 0 MONTGOMERY GENERAL HEALTH CARE SYSTEM INC WASHINGTON SIXTH AVENUE MONTGOMERY WV 25136 550632601 PROVIDE SUPPORT TO AFFILIATED EXEMPT HEALTH CARE PROVIDERS WV 501(C)(3) LINE 12C, III-FI N/A 0 MONTGOMERY MEDCORP INC WASHINGTON SIXTH AVENUE MONTGOMERY WV 25136 550767169 PHYSICIANS PRACTICE WV 501(C)(3) LINE 11 MONTGOMERY GENERAL HEALTH CARE SYSTEM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0