2014-11-06T06:41:17-06:00 2013-12-31 550486667 Arnett Foster Toothman PLLC P O Box 2629 Charleston WV 25329 990 2013-01-01 311097818 Preston Memorial Hospital PRES 3043291400 300 South Price Street Kingwood WV 265371442 Robert Milvet Chief Financial Officer 3043291400 2014-10-29 1 Dale Carpenter P00189642 3043460441 2013 2015-11-30 17:44:51Z Melissa Lockwood 300 South Price Street Kingwood WV 265371442 26211410 0 X prestonmemorial.org X 1955 WV To offer access to high quality, patient centered, and affordable healthcare to all our patients. 10 9 353 37 0 0 795419 42346 24200725 25599700 6240 12250 498621 545351 25501005 26199647 0 0 0 0 13474109 14634364 0 0 0 9986819 10714396 23460928 25348760 2040077 850887 8741081 10756451 4807876 5834987 3933205 4921464 X To offer access to high quality, patient centered, and affordable healthcare to all our patients. 0 0 17344683 25548064 The Hospital had 2,329 inpatient days, cared for 7,885 emergency patients and treated 52,157 patients in its outpatient clinics. The Hospital provides care regardless of the patient's ability to pay. Charges foregone for charity care amounted to $599,878.The Hospital promotes and provides activities such as health fairs, blood drives, and a fitness center to improve the health and welfare of its patients. The Hospital also conducts community-wide speaker bureaus to help educate the community on specific health and wellness matters.The Hospital strives to provide and promote needed services in the community by partnering with local agencies such as the Preston County Health Department, Family Resource Network, Preston Prevention Partnership, and the Preston County Chamber of Commerce. 563876 51636 The organization sponsored health fairs, blood drives, cancer screenings, CPR/first aid classes, crisis intervention, diabetes intervention, family/parenting/sibling education, fitness education, flu shots, nutrition/weight maintenance, school based programs, senior education and outreach programs, sports injury prevention, substance abuse and tobacco/smoking cessation. 17908559 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 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 80 0 1 353 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 1 1 1 1 1 1 1 1 0 X Robert Milvet CFO 3043291400 300 South Price Street Kingwood WV 265371442 Ron Crites Chair 1.00 1.00 X 0 0 0 Kathy McNeil Vice Chair 1.00 1.00 X 0 0 0 Rita McCrobie Secretary 1.00 1.00 X 0 0 0 Roger Metheny Treasurer 1.00 X 0 0 0 Vicki Cole Board Member 1.00 X 0 0 0 Mary Jo Gregg Board Member 1.00 1.00 X 0 0 0 Roger Hardesty Board Member 1.00 X 0 0 0 Larry Williams Board Member 1.00 X 0 0 0 Frederick Conley II Chief of Staff/Board Membe 40.00 X 285699 0 32209 Carl Spear Board Member 1.00 X 0 0 0 Melissa Lockwood Chief Executive Officer 40.00 1.00 X 158232 0 17243 Robert Milvet Chief Financial Officer 40.00 1.00 X 137709 0 20790 Marisa Holland Physician 40.00 X 270574 0 17500 Dale M Myers Physician 40.00 X 258489 0 15353 Theresa S Rutledge Physician 40.00 X 274438 0 34015 John Peterson Physician 40.00 X 207713 0 39515 Denise C Lucas Smyth Physician 40.00 X 241569 0 14497 1834423 0 191122 19 0 1 0 Johnson Johnson Crabtree Architects 4551 Trousdale Drive Nashville TN 37204 New Building Architect 1108949 Turner Construction Company Two PNC Plaza 27th Floor620 Liber Pittsburgh PA 15222 New Building General Contractor 667111 Computer Programs & Systems Inc PO Box 85039 Mobile AL 366850309 Computer System Maintenance 413791 Mountaineer Radiology Assoc PC 100 Hummingbird Lane Morgantown WV 26508 Radiology Services 377977 Allied Health Services PO Box 8034 Morgantown WV 26506 MRI Services 284299 13 12187 30159 42346 Patient services 622110 25599700 25599700 25599700 11150 11150 19800 11763 8037 8037 8037 1100 0 1100 1100 1100 Electronic Health Records 518210 239815 239815 340B Drug Program 900099 120021 120021 Cafeteria Sales 722212 86473 86473 91005 91005 537314 26199647 25599700 0 557601 652445 453515 198930 11067417 7692962 3374455 278782 193781 85001 1816712 1262797 553915 819008 569292 249716 249019 173093 75926 49271 49271 80837 80837 2457383 1708127 749256 143049 99433 43616 2526186 1755952 770234 189746 131892 57854 431943 300244 131699 120033 83435 36598 137046 137046 1006772 699807 306965 416955 289825 127130 Medical supplies 1304258 1304258 Repairs & maintenance 525010 364935 160075 Healthcare provider tax 505410 505410 Sales tax 214825 149325 65500 356653 170476 186177 25348760 17908559 7440201 0 6208 313280 2890802 2838005 130126 711271 608352 102648 114094 19083764 13554344 3418293 5529420 264760 119240 1471 1227859 1221703 8741081 10756451 3804462 4385611 450000 304361 1441703 249053 7673 4807876 5834987 X 3067138 4805397 866067 116067 3933205 4921464 8741081 10756451 X 850887 137372 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4338 4338 0 Part II-B, Line 1: The organization pays membership fees to the West Virginia Hospital Association and the American Hospital Association, both which participate in lobbying activities. 31195 31195 7893806 6869815 1023991 7701990 6512887 1189103 3456773 171642 3285131 5529420 Due from third party payors 136703 Land held for development 1085000 1221703 Capital leases 7673 7673 26162105 11763 11763 26150342 49305 49305 26199647 25344364 11763 11763 25332601 16159 16159 25348760 Part XI, Line 2d - Other Adjustments: Rental expenses netted with income on Form 990 11,763. Part XI, Line 4b - Other Adjustments: Capital campaign contributions 33,146. Grant revenue netted against expense on financial statements 16,159. Part XII, Line 2d - Other Adjustments: Rental expenses netted with income on Form 990 11,763. Part XII, Line 4b - Other Adjustments: Grant revenue netted against expense on financial statements 16,159. 1 1 X 1 X 300.000000000000 1 X 1 1 0 1 1 358247 12962 345285 0.01360 1 7040 4484708 4277346 207362 0.00820 1 456 143787 122648 21139 0.00080 2 7496 4986742 4412956 573786 0.02260 105 10850 466904 51486 415418 0.01640 72 330 77361 150 77211 0.00300 1 7885 3389231 2793885 595346 0.02350 1 25 139 139 0.00000 194 2789 56261 56261 0.00220 373 21879 3989896 2845521 1144375 0.04510 375 29375 8976638 7258477 1718161 0.06770 7 3244 2275 0 2275 0.00010 3 181 11347 0 11347 0.00040 36 62 757 757 0.00000 9 160 468 0 468 0.00000 55 3647 14847 14847 0.00050 0 2161912 0 5616569 5616569 X 1 1 1 1 Preston Memorial Hospital 300 South Price Street Kingwood WV 26537 X X X X 24X7 lab and radiology. Center of Excellence in Bariatric Surgery. Preston Memorial Hospital 1 1 X X X X X X X X X 13 1 0 1 X X X X X X 1 0 1 1 300.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X X X 1 X X 0 X X X X 1 X 0 0 Preston Memorial Hospital Part V, Section B, Line 3: The Hopital received community input from the following expert advisors: Preston County Commissioner; Preston County Health Department Administrator; WVU-Nutrition Outreach Instructor; Preston Memorial Hospital Foundation Director; Wesbanco Banking Center Manager; Preston Memorial Hospital CEO; Family Practice Physician; Preston-Taylor Community Health Center CFO; Owner of Preston Healthcare Services; Office Manager of Family Practice office; General Surgeon from Preston Memorial Hospital. When the survey analysis was complete, the information and summary conclusions was put before the local group of experts who were asked to agree or disagree with the summary conclusions. New needs emerged from the exchange with the experts. Preston Memorial Hospital Part V, Section B, Line 6i: Conducted speaker's bureaus throughout the community talking about services offered at the hospital to various organizations regarding community health needs. Offered specialized physicals targeted to reduce coronary heart disease. Preston Memorial Hospital Part V, Section B, Line 18e: The Hospital includes information about hospital billing and patient's responsibility in hospital visitor guides that are located in public areas and in patient rooms. Preston Memorial Hospital Part V, Section B, Line 20d: The CFO and financial counselor review charges for discount adjustments on all charity applications. Also, all self-pay patients are offered discounts and prompt pay discounts from charges billed. Part I, Line 3c: The CFO and financial counselor review all charity applications. The CFO and counselor then determine, based on financial information given by the patient (tax returns, pay stubs, household expenses, and other family considerations), if deep discounts can be provided to the patient, or if a complete write-off to free-care is deemed appropriate. Part I, Line 7: Actual revenue and costs were taken from the general ledger. Reasonable estimates were used where appropriate. Financial assistance at cost was calculated from worksheet S-10, line 17 of the cost report multiplied by the calculated cost-to-charge ratio. Unreimbursed Medicaid and unreimbursed cost - other means-tested government programs were calculated using the calculated cost-to-charge ratio. Medicaid had surplus revenue due to the DSH payments received for uncompensated care. Community health improvement services and community benefit operations and health professions education were calculated using internal cost accounting systems that use direct and indirect cost reporting. Part I, Line 7g: Emergency room and Level 4 trauma services. Part I, Ln 7 Col(f): The cost of bad debt was estimated using a cost-to-charge ratio derived from woksheet 2 of the schedule H instructions. Part I, Line 6b The hospital presented results of financial assistance and other community benefits to the Preston County Commission (local government), and such report was posted in the local newpapers. The hospital also posts community benefit information on its website - www.prestonmemorial.org. Part II, Community Building Activities: Preston offers its conference room space for multiple community meetings, including birthing classes, CPR, EMS & First Responder classes, parenting classes, etc. Part III, Line 4: Patients seeking financial assistance complete financial assistance applications and work with the hospital's financial counselor to determine appropriate levels of discounts (or complete free care) based on information supplied by the patient. All self-pay patients are offered baseline discounts of 10% from charges, and an additional 30% prompt payment discount if payment is made within a certain time period after receiving a bill. Patients who refuse assistance and refuse payment options are turned over to a collection agency after 3 bills have been submitted, and bad debt is recognized at that time.The cost of bad debt was estimated using a cost-to-charge ratio derived from Worksheet 2 of the schedule H instructions. Part III, Line 8: The majority of Medicare shortfall is included in subsidized services for the Emergency Room and Level 4 Trauma. Part III, Line 9b: The hospital financial counseling staff helps patients seek financial assistance through government programs or other payment services before applying for charity care. If government programs or other services are denied, a financial counselor works with patient to obtain financial information like tax returns, household bills, bank account information, etc. The financial counselor works with the CFO to determine if a patient is eligible for full or partial charity care. Once this determination is made, the financial counselor communicates results with the patient. If partial payment is due after a discount has been recommended, the financial counselor works with the patient on a payment arrangement. If a patient, who has been deemed eligible for partial charity care, agrees to a payment plan and then fails to pay the remaining balance agreed to, the remaining balance will be adjusted off as bad debt. The remaining balance will be turned over to a collection agency. Part VI, Line 2: The Hospital conducted a Community Needs Assessment during 2013 to identify local health and medical needs of the residents served by the Hospital. To complete the Assessment the Hospital performed several independent data analyses based on secondary source data and combined the results with local survey data and opinions from local experts. Part VI, Line 3: The Hospital personnel instruct patients during the registration process who do not have insurance or the inability to pay, to complete an application for charity care after all other sources of financial assistance have been denied. Hospital personnel assist patients with obtaining other financial assistance before applying for charity care. The financial counseling policy is posted in the waiting rooms and at the front-desk. The hospital also has a formal resolution in place with the Preston County Commmission (local government) informing all local citizens of the Hospital's financial assistance program. Part VI, Line 4: Preston Memorial Hospital located in Kingwood, WV, is situated in a rural geographic location. Preston County has a population of 33,781, with more than 16% of the service area population over the age of 65. The median household income was $43,571 which is higher than the State median income of $38,582, but lower than the national median income of $49,233. The Hospital's Medicaid utilization is 17%, Medicare utilization is 40%, and an estimated 10% of the Hospital's patients served are uninsured (or underinsured). Preston Memorial Hospital is the only hospital in the county. There are 2 major competitors outside of the county - West Virginia University Hospitals and Monongalia General Hospital. Both hospitals are located approximately 50 minutes away from the hospital and are situated in urbanized locations in Monongalia County, WV. Other hospitals are also approximately 45 minutes to one hour driving distance from Preston Memorial Hosptial. There is a FQHC located in the county (Preston-Taylor Community Health Center). There are no other designated medically underserves areas in the county. Part VI, Line 5: Preston Memorial Hospital has a governing body comprised of citizens of Preston County. They are not employees, contractors or family members thereof. They represent labor, elderly, the business community and the poor. The hospital extends privileges to qualified physicians in the community and beyond to help take care of the needs of its patients. The organization routinely does not have surplus funds available from operations, and struggles to maintain operations with less than 5 days cash on hand. However, the hospital has identified resources through borrowing or fundraising to invest in new technologies for imaging services, electronic health records, facility improvements, patient care room upgrades and other clinical capital improvements (e.g., monitors, vents, surgical equipment, etc.). The hospital also provides 24 x 7 emergency services and a level 4 trauma center. The hospital's emergency department and all other clinical services where medical need is demonstrated is available to all patients regardless of ability to pay. The hospital's specialized services include: ENT, OB/Gyn care, general surgery, orthopedics, psychiatry, physical therapy, cardiology, laboratory, radiology, and neurology. If these services were not available, patients in the primary service area would have to travel more than 45 minutes to obtain these services elsewhere. The hospital works diligently to attract charitable support through its Foundation, and engages over 30 volunteers to support multiple activities at the hospital. Part VI, Line 6: Preston Memorial Hospital is part of the Preston Healthcare Corporation (PHCC). The PHCC includes Preston Memorial Hospital, Preston Memorial Medical Group, and Preston Memorial Foundation. All entities are under common governance and control, and collectively operate to serve the healthcare needs and charitable needs of the community. The medical group provides women's healthcare services ranging from family planning and pre/postnatal care to weight management and healthy living. The Foundation serves as a fundraising arm of the Hospital to help provide support for capital improvements, maintenance costs for the radiology department, and to support community activities through charitable giving. X X X 0 0 0 0 0 0 0 0 0 Frederick Conley II Chief of Staff/Board Membe 285699 0 0 0 0 0 15300 0 17164 0 318163 0 0 0 Melissa Lockwood Chief Executive Officer 158232 0 0 0 0 0 9587 0 7862 0 175681 0 0 0 Robert Milvet Chief Financial Officer 137709 0 0 0 0 0 4276 0 16617 0 158602 0 0 0 Marisa Holland Physician 270574 0 0 0 0 0 17500 0 255 0 288329 0 0 0 Dale M Myers Physician 258489 0 0 0 0 0 15300 0 284 0 274073 0 0 0 Theresa S Rutledge Physician 274438 0 0 0 0 0 17500 0 16770 0 308708 0 0 0 John Peterson Physician 207713 0 0 0 0 0 23000 0 16515 0 247228 0 0 0 Denise C Lucas Smyth Physician 241569 0 0 0 0 0 14497 0 255 0 256321 0 0 0 Form 990, Part VI, Section B, line 11 The CFO reviews the return for accuracy to audited financial statements and to reasonableness to prior years returns. The CEO also reviews but more for their knowledge of what is on return. Form 990, Part VI, Section B, line 12c Board members are required to sign a conflict of interest statement annually/other ways to monitor are by following policies and procedures for obtaining bids or issuing RFP's for large dollar projects and also requiring the Board to approve any major contracts and purchases over $15,000. Form 990, Part VI, Section B, line 15 PMH utilizes salary surveys and local hospital comparisons in order to determine compensation. Form 990, Part VI, Section C, line 19 The organization only provides for these if requested. Form 990, Part XI, line 9: Pension plan minimum liability adjustment 339,183. Audit adjustment-elimination of related party balances -201,811. Other Adjustments Preston Memorial Medical Group 300 South Price St Kingwood WV 26537 550717988 Primary care services WV 501(c)(3) Hospital N/A 0 Preston Memorial Foundation 300 South Price St Kingwood WV 26537 550740121 Support activities of other charitable organizations WV 501(c)(3) Supporting Organizat N/A 0 Preston Health Care Corporation 300 South Price St Kingwood WV 26537 550747067 Monitor and guide other charitable organizations WV 501(c)(3) Supporting Organizat N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1