MINNIE HAMILTON HEALTH CARE CENTER: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MINNIE HAMILTON HEALTH CARE CENTER (EIN 55-0629032)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-10-29
- IRS object ID
- 201403029349300000
- Schema version
- 2013v3.0
- 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 | 2014-10-29T05:22:47-05:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 550486667 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Arnett Foster Toothman PLLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 2629 | AddressLine1 |
| City | Charleston | City |
| State | WV | State |
| ZIP Code | 25329 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550629032 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Minnie Hamilton Health Care Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MINN | BusinessNameControlTxt |
| Phone | 3043549244 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 186 Hospital Drive | AddressLine1 |
| City | Grantsville | City |
| State | WV | State |
| ZIP Code | 26147 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kyle Pierson | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3043549244 | PhoneNum |
| Signature | 2014-10-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Dale Carpenter | PreparerPersonNm |
| PTIN | P00189642 | PTIN |
| Phone | 3043460441 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Minnie Hamilton Health System | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Stephen S Whited | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 186 Hospital Drive | AddressLine1 |
| City | Grantsville | City |
| State | WV | State |
| ZIP Code | 26147 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,421,482 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.mhhcc.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1983 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | The organization operates a critical access hospital, community health center, federal qualified health center, and long-term care unit. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 299 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,622,700 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,688,404 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $16,633,968 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,539,535 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,255 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,012 | CYInvestmentIncomeAmt |
| PY Other Revenue | $273,546 | PYOtherRevenueAmt |
| CY Other Revenue | $191,531 | CYOtherRevenueAmt |
| PY Total Revenue | $18,537,469 | PYTotalRevenueAmt |
| CY Total Revenue | $19,421,482 | 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 | $11,646,451 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,450,134 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,641,201 | PYOtherExpensesAmt |
| CY Other Expenses | $7,257,850 | CYOtherExpensesAmt |
| PY Total Expenses | $18,287,652 | PYTotalExpensesAmt |
| CY Total Expenses | $19,707,984 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $249,817 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$286,502 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,328,766 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,550,728 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,776,347 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,284,811 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,552,419 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,265,917 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Minnie Hamilton Health System is dedicated to maintaining the health and improving the quality of life of all people in our service area through an innovative delivery system of services and education. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,871,452 | ExpenseAmt |
| Revenue | $17,539,535 | RevenueAmt |
| Desc | Inpatient services provided included 895 acute care days, 8,343 long-term care days and 530 swing bed days. Outpatient services included 20,401 outpatient visits and 3,026 emergency room visits. Primary care services included 35,999 clinic and dental visits. | Desc |
| Total Program Service Expenses | $16,871,452 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 299 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kyle Pierson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3043549730 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 186 Hospital Drive | AddressLine1 |
| City | Grantsville | City |
| State | WV | State |
| ZIP Code | 26147 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Jean Simers | ||||||||
| President | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| Randy Ball | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Reta Kight | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Kathy Frederick | ||||||||
| Secretary | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Ronald Blankenship | ||||||||
| Vice President | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Harold Carpenter | ||||||||
| Treasurer | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| John Lowther | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Beverly Marks | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Helen Johnson | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| David Bishop | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Richard Fitzwater | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Stephen S Whited | ||||||||
| CEO | 40.00 | $129,750 | $0 | $6,065 | Yes (X) | |||
| Kyle Pierson | ||||||||
| CFO | 40.00 | $86,424 | $0 | $3,641 | Yes (X) | |||
| Suresh Balasubramony | ||||||||
| Chief of Staff | 52.00 | $522,600 | $0 | $18,415 | Yes (X) | |||
| Alfonso Cinco | ||||||||
| Physician | 38.00 | $411,624 | $0 | $9,528 | Yes (X) | |||
| John D'Angelo | ||||||||
| Physician | 52.00 | $241,446 | $0 | $0 | Yes (X) | |||
| Chadwick Smith | ||||||||
| Physician | 52.00 | $457,965 | $0 | $18,415 | Yes (X) | |||
| Jason Fincham | ||||||||
| Physician | 52.00 | $443,061 | $0 | $0 | Yes (X) | |||
| Matthew Siwicik | ||||||||
| Pharmacist | 40.00 | $164,168 | $0 | $15,195 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,457,038 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $71,259 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | 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/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Radiological Physician Associates | |||||
| 700 Village Drive | Fairmont | WV | 26554 | Radiological Professional Services | $234,034 |
| CPSI | |||||
| 600 Wall Street | Mobile | AL | 36695 | Computer Operating Systems | $211,835 |
| Labcorp of America | |||||
| 231 Maple Ave | Burlington | NC | 27216 | Reference Lab | $119,309 |
| Arnett Foster Toothman | |||||
| PO Box 2629 | Charleston | WV | 25329 | Accounting Services | $100,919 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,651,197 | GovernmentGrantsAmt |
| All Other Contributions | $37,207 | AllOtherContributionsAmt |
| Total Contributions | $1,688,404 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient services | 622110 | $16,840,983 | $16,840,983 |
| Other health care | 622110 | $698,552 | $698,552 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,539,535 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,012 | TotalRevenueColumnAmt |
| Exclusion | $2,012 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,672 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,672 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,672 | TotalRevenueColumnAmt |
| Exclusion | $6,672 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| Cafeteria | 722210 | $83,364 | $83,364 |
| Day care | 624410 | $48,601 | $48,601 |
| Rebates/refunds | 900099 | $42,472 | $42,472 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,422 | TotalRevenueColumnAmt |
| Exclusion | $10,422 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $184,859 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,421,482 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,539,535 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $193,543 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $767,002 | TotalAmt |
| Program Services | $647,273 | ProgramServicesAmt |
| Management And General | $119,729 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,129,573 | TotalAmt |
| Program Services | $8,548,347 | ProgramServicesAmt |
| Management And General | $1,581,226 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,677 | TotalAmt |
| Program Services | $149,098 | ProgramServicesAmt |
| Management And General | $27,579 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $623,182 | TotalAmt |
| Program Services | $525,903 | ProgramServicesAmt |
| Management And General | $97,279 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $753,700 | TotalAmt |
| Program Services | $636,047 | ProgramServicesAmt |
| Management And General | $117,653 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,677 | TotalAmt |
| Management And General | $7,677 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,519 | TotalAmt |
| Management And General | $97,519 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $873,713 | TotalAmt |
| Program Services | $737,326 | ProgramServicesAmt |
| Management And General | $136,387 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,261 | TotalAmt |
| Program Services | $57,605 | ProgramServicesAmt |
| Management And General | $10,656 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $879,016 | TotalAmt |
| Program Services | $741,802 | ProgramServicesAmt |
| Management And General | $137,214 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,443 | TotalAmt |
| Program Services | $192,783 | ProgramServicesAmt |
| Management And General | $35,660 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $255,638 | TotalAmt |
| Program Services | $215,733 | ProgramServicesAmt |
| Management And General | $39,905 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,587 | TotalAmt |
| Program Services | $87,417 | ProgramServicesAmt |
| Management And General | $16,170 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,348 | TotalAmt |
| Management And General | $94,348 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $708,026 | TotalAmt |
| Program Services | $597,503 | ProgramServicesAmt |
| Management And General | $110,523 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,130 | TotalAmt |
| Management And General | $126,130 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Bad debts | $1,967,273 | $1,967,273 | |
| Medical supplies | $1,077,074 | $1,077,074 | |
| Healthcare provider tax | $229,515 | $229,515 | |
| WV use taxes | $111,818 | $94,363 | $17,455 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $429,812 | TotalAmt |
| Program Services | $366,390 | ProgramServicesAmt |
| Management And General | $63,422 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,707,984 | TotalAmt |
| Program Services | $16,871,452 | ProgramServicesAmt |
| Management And General | $2,836,532 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,174 | BOYAmt |
| EOY | $3,235 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $755,485 | BOYAmt |
| EOY | $296,627 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,663 | BOYAmt |
| EOY | $59,972 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,407,588 | BOYAmt |
| EOY | $3,989,215 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,449 | BOYAmt |
| EOY | $140,151 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,022 | BOYAmt |
| EOY | $45,109 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,668,128 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,757,935 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,929,385 | BOYAmt |
| EOY | $2,910,193 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,000 | BOYAmt |
| EOY | $12,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $94,226 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,328,766 | BOYAmt |
| EOY | $7,550,728 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,139,219 | BOYAmt |
| EOY | $2,090,973 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,341 | BOYAmt |
| EOY | $512,635 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,063,383 | BOYAmt |
| EOY | $798,292 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $314,862 | BOYAmt |
| EOY | $823,353 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,542 | BOYAmt |
| EOY | $59,558 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,776,347 | BOYAmt |
| EOY | $4,284,811 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,552,419 | BOYAmt |
| EOY | $3,265,917 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,552,419 | BOYAmt |
| EOY | $3,265,917 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,328,766 | BOYAmt |
| EOY | $7,550,728 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$286,502 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $72,395 | OtherCostOrOtherBasisAmt |
| Book Value | $72,395 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,302,738 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,292,290 | DepreciationAmt |
| Book Value | $1,010,448 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $462,218 | OtherCostOrOtherBasisAmt |
| Depreciation | $112,932 | DepreciationAmt |
| Book Value | $349,286 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,830,777 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,352,713 | DepreciationAmt |
| Book Value | $1,478,064 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,910,193 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Capital leases | Desc |
| Amt | $59,558 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $59,558 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $17,454,209 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $17,454,209 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,967,273 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,967,273 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $19,421,482 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $17,740,711 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $17,740,711 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,967,273 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,967,273 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $19,707,984 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | Accounting principles generally accepted in the United States of America require the management of the System to evaluate tax positions taken by the System. Management has evaluated the System's tax positions and did not become aware of any course of action on services or events that might adversely affect the System's tax exempt status. Therefore, no provision or liability for income taxes has been included in the financial statements. |
| Part XI, Line 4b - Other Adjustments: | Bad debts netted against revenue in the financial statements 1,967,273. |
| Part XII, Line 4b - Other Adjustments: | Bad debts netted against revenue in the financial statements 1,967,273. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| 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 | 0 | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $820,174 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,277,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$456,826 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,713,711 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,598,973 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $114,738 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00650 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,533,885 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,875,973 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$342,088 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00650 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 15 | ActivitiesOrProgramsCnt |
| Persons Served | 1300 | PersonsServedCnt |
| Total Community Benefit Expns | $123,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $118,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 12 | ActivitiesOrProgramsCnt |
| Persons Served | 110 | PersonsServedCnt |
| Total Community Benefit Expns | $4,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 27 | ActivitiesOrProgramsCnt |
| Persons Served | 1410 | PersonsServedCnt |
| Total Community Benefit Expns | $127,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $118,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 27 | ActivitiesOrProgramsCnt |
| Persons Served | 1410 | PersonsServedCnt |
| Total Community Benefit Expns | $2,660,885 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,993,973 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$333,088 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00700 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,526,407 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $3,397,856 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,614,138 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$216,282 | 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 | Minnie Hamilton Health Care Center | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 186 Hospital Drive | AddressLine1 |
| City | Grantsville | City |
| State | WV | State |
| ZIP Code | 26147 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Long Term Care (24 beds) | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Minnie Hamilton Health Care Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| Other Needs Addressed | Yes (X) | OtherNeedsAddressedInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Minnie Hamilton Health Care Center, Inc. | Part V, Section B, Line 3: In addition to the management and various department heads of the Minnie Hamilton Health System, various persons throughout the community were interviewed: Dick Wittberg, Executive Director, Mid-Ohio Valley Health Department; Carol Beam, Administrator, Gilmer County Health Department; Julie Brenneman, Adminstrator, Glenville Center Nursing Facility; Bev Ferguson, RN, Gilmer County School Nurse; Rhonda Williams, RN, Director of Campus Health, Glenville State College; Bob Williams, Executive Director, United Summit Center; Dave Cisler, Director of Quality Assurance, Westbrook Health Services; Sallie Mathess, Executive Director, Gilmer County Senior Center. |
| Minnie Hamilton Health Care Center, Inc. | Part V, Section B, Line 6i: The Hospital expanded education programs, applied for grants, began community programs, etc. to address the needs identified in the most recent CHNA. |
| Minnie Hamilton Health Care Center, Inc. | Part V, Section B, Line 7: The needs identified in the most recent CHNA which have not been addressed include cardiovascular disease, asthma, public transportation. The reasons the Hospital was unable to address these needs are because of limited resources and limited manpower. |
| Minnie Hamilton Health Care Center, Inc. | Part V, Section B, Line 10: Patients are charged the amount via the item master and discounted according to policy and income guideline levels. |
| Minnie Hamilton Health Care Center, Inc. | Part V, Section B, Line 11: Patients are charged the amount via the item master and discounted according to policy and income guideline levels. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gilmer Primary Care | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 809 Medical Drive Suite 1 | AddressLine1 |
| City | Glenville | City |
| State | WV | State |
| ZIP Code | 26351 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Federally Qualified Health Center | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | 1. The qualifications for the Sliding Fee Program are based on both the number of people in the household and the total gross income received in the household. 2. The applicants are required to complete the Sliding Fee Program application and to provide a proof of income within 30 days after filing their application. Acceptable proof of income includes: wage statement, W-2 forms, check stub, retirement statement, unemployment statement, social security check or benefit letter, alimony check, child support check, food stamp voucher, or other documents approved by financial management.3. If the patient has no income, they are asked to declare so by signing a Lack of Income Verification form. 4. The Financial Assistance Application, along with the above mentioned documents verifying income or lack of it, will be processed promptly by the cashier/clerk.5. After the patient has been approved for the Sliding Fee Program, they will receive a Sliding Fee identification card describing the benefits such as: A. Fee of $15 or $25 for an office visit, collected at the time of the visit B. 50% or 75% discount for lab tests C. 50% to 75% discount of diagnostic, non-invasive radiology services, the technical component only. D. 50% to 75% discount on respiratory procedures: Pulse Ox., EKG (Tech.& Prof.), Aerosol Treatment, Pulmonary Function Testing (PFT) and associated PFT testing. E. 50% to 75% discount on speech pathology procedures: limited to evaluations, testing and treatments. Supplies and equipment not included.6. Qualification for Sliding Fee remains in effect for one year from the date of approval, unless the patient or the household income should change within that year.7. The Sliding Fee Program benefits may apply to the outstanding patient accounts which do not exceed 365 days from the day of service. Accounts which have already been sent to a collection agency may not qualify for this program. 8. It is the patient's responsibility to reapply annually for continued participation in the Sliding Fee Program. |
| Part I, Line 7: | Cost of community health improvement and commumity benefit services includes cost of supplies and employee costs. Cash and in-kind contributions to community groups includes cost of employee time and donated space. |
| 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 $ 1,967,273. |
| Part III, Line 4: | The cost of bad debts was estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions.Financial statement footnote that describes bad debt expense: Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectible accounts. In evaluating the collectability of accounts receivable, the System analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. 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. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the System records a significant provision for bad debts in the period of service 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 (or the discounted rates if negotiated) 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 estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H instructions. |
| Part III, Line 9b: | All uncollectible accounts will be reviewed by the Collector before being sent to a collection agency or magistrate court. Any account over $500 will be reviewed by the Collector to determine whether it could be taken to magistate court. The CFO will sign off on any account sent to magistrate court. Once a month a list of all accounts to be written off is prepared for approval by the Finance Committee and Board of Directors. |
| Part VI, Line 2: | Records of types of visits and diagnosis are kept and analyzed for adjustment of appropriate services. Official community needs assessments are periodically performed by an outside agency. |
| Part VI, Line 3: | The organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs or under the organization's financial assistance policy by making information available as follows:1) Posting on the facility's website2) Attaching information to billing invoices3) Posting information in emergency rooms, waiting rooms and admission offices4) Providing in writing to patients on admission to the facility5) Making information available on request |
| Part VI, Line 4: | The organization services a rural area of 16,000 people in Calhoun, Gilmer and surrounding counties. The county has one of the highest unemployment rates in the State of WV. Patient principal payers percentages are: 39% medicare, 19% medicaid, 19% commercial, and 23% private pay. The nearest Hospital is over 30 miles away. The Health Care Center is designated as an HPSA site. |
| Part VI, Line 5: | All board members reside in the service area and none are employed by, or have contractual arrangements with Minnie Hamilton Health Care Center. The medical staff privileges are available to all qualified providers in the area. All profit and available funding is utilized for continuation and improvement of the provision of appropriate health services through staffing and acquisition of equipment and supplies. A 24-hour emergency room doctor is provided regardless of a patient's ability to pay. The nearest hospital is 40 minutes away, by car. An active auxiliary is made up of local volunteers and has been present during all years of the facilities hospital services. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Suresh Balasubramony | ||||||||||||||
| Chief of Staff | $522,600 | $0 | $0 | $0 | $0 | $0 | $10,000 | $0 | $8,444 | $0 | $541,044 | $0 | $0 | $0 |
| Alfonso Cinco | ||||||||||||||
| Physician | $411,624 | $0 | $0 | $0 | $0 | $0 | $1,373 | $0 | $8,155 | $0 | $421,152 | $0 | $0 | $0 |
| John D'Angelo | ||||||||||||||
| Physician | $241,446 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $241,446 | $0 | $0 | $0 |
| Chadwick Smith | ||||||||||||||
| Physician | $457,965 | $0 | $0 | $0 | $0 | $0 | $10,000 | $0 | $8,444 | $0 | $476,409 | $0 | $0 | $0 |
| Jason Fincham | ||||||||||||||
| Physician | $443,061 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $443,061 | $0 | $0 | $0 |
| Matthew Siwicik | ||||||||||||||
| Pharmacist | $164,168 | $0 | $0 | $0 | $0 | $0 | $6,780 | $0 | $8,444 | $0 | $179,392 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Calhoun County Building Commission | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 556000308 | BondIssuerEIN |
| Bond Issued | 2006-12-13 | BondIssuedDt |
| Issue Price | $2,455,000 | IssuePriceAmt |
| Purpose | Refinance existing debt and new capital expenditures | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,656,707 | RetiredAmt |
| Total Proceeds | $2,455,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $53,570 | IssuanceCostsFromProceedsAmt |
| Working Capital Expenditures | $902,044 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $1,499,386 | CapitalExpendituresAmt |
| Substantial Completion | 2007 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11 | Form 990 is reviewed by Senior Management, the Finance Committee and the Board of Directors. |
| Form 990, Part VI, Section B, line 12c | The Board of Directors sign the statement annually. Individual members are excused from decision making on issues where conflicts may arise. Board of Directors members recuses themselves from voting on issues where a conflict may exist. |
| Form 990, Part VI, Section B, line 15 | A survey of like facilities in the state, utilizing the Health Care Authority information that is available, to compare salaries of top executives, as well as looking at job responsibilities and years of experience. The CEO is a contracted position and approved by the Board of Directors. Senior management is approved by the CEO. |
| Form 990, Part VI, Section C, line 19 | Audited Financial Statements are available upon request to the public. Annually the audited balance sheet and income statement are published in the local newspaper as per the Health Care Authority financial disclosure requirements. |
| Form 990, Page 1, Line 6 | Volunteers of the organization include members of the hospital auxiliary and teenagers involved in a volunteer program. |