2021-11-15T13:34:43-06:00 2020-12-31 390859910 Baker Tilly US LLP P O Box 2629 Charleston WV 25329 990 2020-01-01 550372580 Montgomery General Hospital Inc MONT 3044425151 401 Sixth Avenue Montgomery WV 25136 Vickie Gay CEO 3044425151 2021-11-12 1 Vickie Gay 999009999 Dolores Rose P01286262 3043460441 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z Vickie Gay 401 Sixth Avenue Montgomery WV 25136 25151406 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. 11 10 318 50 0 0 43536 4360636 22796650 19042953 7952 24151 2286419 1723666 25134557 25151406 1700 350 0 0 13616445 12719737 0 0 0 11762571 12044805 25380716 24764892 -246159 386514 8220971 9152395 7290334 8867257 930637 285138 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 19268736 350 20721439 The Hospital provided health care services including 2,950 acute inpatient days; 12,568 skilled nursing days; 15,163 outpatient visits; 5,518 emergency room visits; 484 ambulatory surgery procedures; and 10,017 physician office visits. Charges foregone for charity care amounted to $102,127. 19268736 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 0 318 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 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 Chair 0.50 1.50 X X 1000 0 0 Ghassan Y Dagher MD Vice-Chair 0.50 1.50 X X 1000 0 0 Joyce Brown Treasurer 0.50 1.50 X X 1000 0 0 Barbara Crist Secretary 0.50 0.50 X 1000 0 0 Vicki Gay President & CEO 39.50 0.50 X X 156340 0 1674 Rita Bohana Trustee 0.50 1.50 X 1000 0 0 Donald Smith Trustee 0.50 1.50 X 1000 0 0 Patricia Tucker Trustee 0.50 1.50 X 1000 0 0 Lou Ann Bowen Trustee 0.50 1.50 X 200 0 0 Deanne Valentine Trustee 0.50 1.50 X 200 0 0 Garnes Reed Trustee 0.50 1.50 X 600 0 0 Sherri Murray CFO 39.50 0.50 X 120173 0 0 Robert Eggleston MD Physician 40.00 X 333614 0 5174 Myra Priddy MD Physician 40.00 X 270491 0 0 Mohamad Sankari MD Physician 40.00 X 280995 0 489 Dilip Ghodasara MD Physician 40.00 X 268646 0 742 Jonathan White MD Physician 40.00 X 380602 0 7128 1818861 0 15207 10 0 1 0 Advantage Rehab 150 Hidden Valley Road Scott Depot WV 25560 Therapy Services 1273772 Medical Information Technology Inc Meditech Circle Westwood MA 02090 EMR Services 650345 Kanawha Valley Radiologists PO Box 3428 Charleston WV 25334 Radiologist Services 481935 Arnett Carbis Toothman PO Box 45723 Baltimore MD 21297 Pharmacy Vendor 186697 Labcorp of America PO Box 60850 Charlotte NC 28260 Laboratory Services 183064 16 4360636 4360636 Patient services 622110 19042953 19042953 19042953 24151 24151 45180 0 45180 45180 45180 340B Program 900099 1639186 1639186 Cafeteria 722210 34205 34205 5095 5095 1678486 25151406 20721439 0 69331 X 350 350 286187 210005 76182 10021480 7353803 2667677 299105 219484 79621 1416867 1039703 377164 696098 510800 185298 44550 44550 166882 166882 2925353 2146636 778717 24958 18314 6644 583479 428158 155321 794732 583178 211554 1212522 889754 322768 17669 12966 4703 577847 424027 153820 528774 388017 140757 Bad debts 2419680 2419680 Medical supplies 1943370 1943370 Health care provider ta 337295 337295 Dues and subscriptions 167453 122878 44575 300241 220318 79923 24764892 19268736 5496156 0 3473176 4160653 2072572 446846 492552 43108 88485 32640710 29940895 3331813 2699815 238551 325795 8220971 9152395 3088959 2278769 243501 247794 3957874 6340694 7290334 8867257 X 930637 285138 930637 285138 8220971 9152395 X 386514 -869242 -162771 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 869878 869878 12579917 12246998 332919 18812200 17315182 1497018 378715 378715 0 2699815 Accrued pension obligation 2948340 Due to third party payers 1045354 PPP Loan 2347000 6340694 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, 2017, 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 366056 366056 3216758 2342518 874240 0.03910 3582814 2708574 874240 0.03910 3582814 2708574 874240 0.03910 1 2419680 4689160 4689160 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 Health Montgomery General Hospital Board Members Fayette County Schools Bridge Valley Community and Technical College Fresenius Dialysis of Montgomery City of Montgomery Representatives Montgomery 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 $ 2,419,680. 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 Jonathan White MD Physician 380602 0 0 0 0 0 0 0 7128 0 387730 0 0 0 Robert Eggleston MD Physician 333614 0 0 0 0 0 0 0 5174 0 338788 0 0 0 Mohamad Sankari MD Physician 280995 0 0 0 0 0 0 0 489 0 281484 0 0 0 Myra Priddy MD Physician 270491 0 0 0 0 0 0 0 0 0 270491 0 0 0 Dilip Ghodasara MD Physician 268646 0 0 0 0 0 0 0 742 0 269388 0 0 0 Vicki Gay President & CEO 155640 0 700 0 0 0 0 0 1674 0 158014 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 219,612. Management and general expenses 79,667. Fundraising expenses 0. Total expenses 299,279. ER Professional Fees: Program service expenses 31,073. Management and general expenses 11,272. Fundraising expenses 0. Total expenses 42,345. LTC Purchased Services: Program service expenses 338,011. Management and general expenses 122,617. Fundraising expenses 0. Total expenses 460,628. Therapy Purchased Services: Program service expenses 562,355. Management and general expenses 204,001. Fundraising expenses 0. Total expenses 766,356. Admin Purchased Services: Program service expenses 130,008. Management and general expenses 47,162. Fundraising expenses 0. Total expenses 177,170. Medical Purchased Services: Program service expenses 726,526. Management and general expenses 263,556. Fundraising expenses 0. Total expenses 990,082. Other Purchased Services: Program service expenses 139,051. Management and general expenses 50,442. Fundraising expenses 0. Total expenses 189,493. Form 990, Part XI, line 9: Transfers from related parties 26,556. Change in pension funded plan status -189,327. 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 1