MONTGOMERY GENERAL HOSPITAL INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MONTGOMERY GENERAL HOSPITAL INC (EIN 55-0372580)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-15
- IRS object ID
- 201213209349304486
- Schema version
- 2011v1.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-15T12:48:32-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550486667 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Arnett Foster Toothman PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550372580 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Montgomery General Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MONT | NameControl |
| Phone | 3044425151 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 Sixth Avenue | AddressLine1 |
| City | Montgomery | City |
| State | WV | State |
| ZIP Code | 25136 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Vickie Gay | Name |
| Title | CEO | Title |
| Phone | 3044425151 | Phone |
| Date Signed | 2012-11-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Dale Carpenter | Name |
| PTIN | P00189642 | PTIN |
| Phone | 3043460441 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Vickie Gay | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 Sixth Avenue | AddressLine1 |
| City | Montgomery | City |
| State | WV | State |
| ZIP Code | 25136 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 24181352 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.mghwv.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1970 | YearFormation |
| State Legal Domicile | WV | StateLegalDomicile |
| Activity Or Mission Description | To provide quality, cost-effective, and convenient healthcare services that meet and exceed reasonable internal and external customer expectations. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 270 | TotalNbrEmployees |
| Total Nbr Volunteers | 17 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 84725 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 77692 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 21908840 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 23973504 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5 | InvestmentIncomePriorYear |
| Investment Income Current Year | -96 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 120311 | OtherRevenuePriorYear |
| Other Revenue Current Year | 130150 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 22113881 | TotalRevenuePriorYear |
| Total Revenue Current Year | 24181250 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 19176 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 12204151 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12201219 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 10209188 | OtherExpensePriorYear |
| Other Expenses Current Year | 11191157 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 22413339 | TotalExpensesPriorYear |
| Total Expenses Current Year | 23411552 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -299458 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 769698 | RevenuesLessExpensesCY |
| Total Assets BOY | 7787787 | TotalAssetsBOY |
| Total Assets EOY | 7437094 | TotalAssetsEOY |
| Total Liabilities BOY | 7243742 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7219717 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 544045 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 217377 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 17426072 | Expense |
| Revenue | 23973504 | Revenue |
| Description | The Hospital provided health care services including 2,177 acute inpatient days; 13,293 skilled nursing days; 22,956 outpatient visits; 9,419 emergency room visits; 1,180 ambulatory surgery procedures; and 28,277 physician office visits. Charges foregone for charity care amounted to $148,899. | Description |
| Total Program Service Expense | 17426072 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 63 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 270 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sherri Murray | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3044421246 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 Sixth Avenue | AddressLine1 |
| City | Montgomery | City |
| State | WV | State |
| ZIP Code | 25136 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Vickie Gay | ||||||||
| CEO | 40.00 | X | X | 133360 | 0 | 1706 | ||
| Rita Bohanna | ||||||||
| Chair | 1.00 | X | 0 | 0 | 0 | |||
| Donald Smith | ||||||||
| Vice Chair | 1.00 | X | 0 | 0 | 0 | |||
| Barbara Crist | ||||||||
| Secretary | 1.00 | X | 0 | 0 | 0 | |||
| Robert Neal | ||||||||
| Treasurer | 1.00 | X | 0 | 0 | 0 | |||
| Patsy Tucker | ||||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |||
| Ghassan Dagher MD | ||||||||
| Trustee | 1.00 | X | 0 | 0 | 2544 | |||
| Percy Mosley Jr | ||||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |||
| Robert Gilliam | ||||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |||
| Michelle Fox | ||||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |||
| Kelli Vance | ||||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |||
| Garnes Reed | ||||||||
| Trustee | 1.00 | X | 0 | 0 | 0 | |||
| Sherri Murray | ||||||||
| CFO | 40.00 | X | 85853 | 0 | 0 | |||
| Traci Acklin | ||||||||
| Chief of Staff | 40.00 | 0 | 183415 | 0 | X | |||
| Mohamad Sankari | ||||||||
| Physician | 40.00 | 351469 | 0 | 2515 | X | |||
| Paul Jackson | ||||||||
| Physician | 40.00 | 395694 | 0 | 0 | X | |||
| Myra Priddy | ||||||||
| Physician | 40.00 | 253341 | 0 | 0 | X | |||
| Kenneth Dwyer | ||||||||
| Physician | 40.00 | 249995 | 0 | 1303 | X | |||
| Samuel Davis | ||||||||
| Physician | 40.00 | 249995 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1719707 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 183415 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 8068 | TotalOtherCompensation |
| Number Individuals GT100 K | 13 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Advantage Rehab | |||||
| 150 Hidden Valley Road | Scott Depot | WV | 25560 | Therapy Services | 381634 |
| Interim Physicians | |||||
| 12140 Woodcrest Executive Drive | St Louis | MO | 63141 | Physician Services | 211106 |
| SVI Laboratory | |||||
| 3004 Chesterfield Avenue | Charleston | WV | 25304 | Lab Services | 144651 |
| Arnett & Foster | |||||
| PO Box 2629 | Charleston | WV | 25329 | Accounting Services | 130809 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Government Grants | 77692 | GovernmentGrants |
| Total Contributions | 77692 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient services | Description |
| Business Code | 622110 | BusinessCode |
| Total Revenue Column | 23973504 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23973504 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 23973504 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6 | TotalRevenueColumn |
| Exclusion | $6 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 63300 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 63300 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 63300 | TotalRevenueColumn |
| Exclusion | $63,300 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 102 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -102 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -102 | TotalRevenueColumn |
| Exclusion | -$102 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Cafeteria | 722210 | 44568 | $44,568 |
| Medical records | 900099 | 3601 | $3,601 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 18681 | TotalRevenueColumn |
| Exclusion | $18,681 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 66850 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24181250 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23973504 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $130,054 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19176 | Total |
| Program Services | 19176 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 223463 | Total |
| Program Services | 156399 | ProgramServices |
| Management And General | 67064 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9644339 | Total |
| Program Services | 6749938 | ProgramServices |
| Management And General | 2894401 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 222685 | Total |
| Program Services | 155854 | ProgramServices |
| Management And General | 66831 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1464564 | Total |
| Program Services | 1025028 | ProgramServices |
| Management And General | 439536 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 646168 | Total |
| Program Services | 452244 | ProgramServices |
| Management And General | 193924 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 189958 | Total |
| Management And General | 189958 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89759 | Total |
| Management And General | 89759 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1401680 | Total |
| Program Services | 981016 | ProgramServices |
| Management And General | 420664 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21973 | Total |
| Program Services | 15379 | ProgramServices |
| Management And General | 6594 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1734184 | Total |
| Program Services | 1213731 | ProgramServices |
| Management And General | 520453 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105663 | Total |
| Program Services | 73952 | ProgramServices |
| Management And General | 31711 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 682953 | Total |
| Program Services | 477989 | ProgramServices |
| Management And General | 204964 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49273 | Total |
| Program Services | 34485 | ProgramServices |
| Management And General | 14788 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 132310 | Total |
| Management And General | 132310 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 617137 | Total |
| Program Services | 431926 | ProgramServices |
| Management And General | 185211 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 406229 | Total |
| Program Services | 284314 | ProgramServices |
| Management And General | 121915 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad debts | 4025000 | 4025000 | 0 |
| Medical supplies | 1014419 | 709978 | 304441 |
| Health care provided ta | 384225 | 384225 | 0 |
| Use taxes | 36118 | 25278 | 10840 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 300276 | Total |
| Program Services | 210160 | ProgramServices |
| Management And General | 90116 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23411552 | Total |
| Program Services | 17426072 | ProgramServices |
| Management And General | 5985480 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3392931 | BOY |
| EOY | 3152512 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9798 | BOY |
| EOY | 30984 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 341479 | BOY |
| EOY | 360535 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 178338 | BOY |
| EOY | 272670 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 30654979 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 27121111 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3829283 | BOY |
| EOY | 3533868 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35958 | BOY |
| EOY | 86525 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7787787 | BOY |
| EOY | 7437094 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4526718 | BOY |
| EOY | 3407844 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1971979 | BOY |
| EOY | 1785303 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 160000 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 585045 | BOY |
| EOY | 2026570 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7243742 | BOY |
| EOY | 7219717 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 544045 | BOY |
| EOY | 217377 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 544045 | BOY |
| EOY | 217377 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7787787 | BOY |
| EOY | 7437094 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 769698 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1096366 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 869878 | OtherCostOrOtherBasis |
| Book Value | 869878 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12565682 | OtherCostOrOtherBasis |
| Depreciation | 11271230 | Depreciation |
| Book Value | 1294452 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16840704 | OtherCostOrOtherBasis |
| Depreciation | 15471166 | Depreciation |
| Book Value | 1369538 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 378715 | OtherCostOrOtherBasis |
| Depreciation | 378715 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3533868 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Accrued pension obligation | Description |
| Amount | $2,026,570 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2026570 | TotalOfAmounts |
| Total Revenue | 24181250 | TotalRevenue |
| Total Expenses | 23411552 | TotalExpenses |
| Excess Or Deficit For Year | 769698 | ExcessOrDeficitForYear |
| Other | -$1,096,366 | OtherAmount |
| Total Adjustments | -1096366 | TotalAdjustments |
| Excess Or Deficit Per FS | -326668 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 24162176 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 102 | OtherRevenues |
| Revenue Not Rptd F990 | 102 | RevenueNotRptdF990 |
| Revenue Subtotal | 24162074 | RevenueSubtotal |
| Other Revenues Not Included | 19176 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 19176 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 24181250 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 23392478 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 102 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 102 | ExpensesNotRptdF990 |
| Expenses Subtotal | 23392376 | ExpensesSubtotal |
| Other Expenses Not Included | 19176 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 19176 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 23411552 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part XI, Line 8 - Other Adjustments: | Change in pension funded plan status -845,462. Transfer to related party -250,904. Total to Schedule D, Part XI, Line 8: -1,096,366. |
| Part XII, Line 2d - Other Adjustments: | Loss on sale included in expense on the financial statements 102. |
| Part XII, Line 4b - Other Adjustments: | Grant expenses netted with revenue on the financial statements 19,176. |
| Part XIII, Line 2d - Other Adjustments: | Loss on sale included in expense on the financial statements 102. |
| Part XIII, Line 4b - Other Adjustments: | Grant expenses netted with revenue on the financial statements 19,176. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 0 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 64607 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 64607 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00330 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 724163 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 605809 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 118354 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00610 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 788770 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 605809 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 182961 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00940 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 788770 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 605809 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 182961 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00940 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,746,448 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 5601325 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5379496 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 221829 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Montgomery General Hospital Inc | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 Sixth Avenue | AddressLine1 |
| City | Montgomery | City |
| State | WV | State |
| ZIP Code | 25136 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Montgomery General Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 0 | ExplainsBasis |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)
| ExplanationExplanation | Return ReferenceReturnReference |
|---|---|
| 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 off's 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 cost was computed by multiplying the Medicaid HMO charges for each hospital department by the respective cost-to-charge ratio that relates to each department. The ratios are obtained from this year's Medicare cost report. The Medicaid cost is then reduced by the payments received from medicaid HMO plans. Only Medicaid HMO charges and payments were included as "traditional" Medicaid is reimbursed by WV Medicaid at 100% of cost so the cost and related payments from non-HMO Medicaid services nets to zero. | |
| 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 $ 4025000. | |
| 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 collectibility. 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 reduction to bad debt expense when received. Interest is not charged on patient accounts receivable. | |
| Part III, Line 8: The Hospital is cost reimbursed at 101% of allowable cost for Medicare and WV Medicaid traditional payer types. HMO Medicare and HMO Medicaid payers are reimbursed based on the individual contracts signed by the hospital with each HMO payer. HMO's do not have a year end settlement process. | |
| Medicare allowable costs were estimated using Worksheet B of the Schedule H instructions. | Part III, Section B, Line 8 |
| 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 specialites. 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 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. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Upper Kanawha Valley Economic Development Corporation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 326 Third Avenue Suite 307 | AddressLine1 |
| City | Montgomery | City |
| State | WV | State |
| ZIP Code | 25136 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 550652373 | EINOfRecipient |
| IRC Section | 501(c)6 | IRCSection |
| Amount Of Cash Grant | 14000 | AmountOfCashGrant |
| Purpose Of Grant | To assist with the economic development purpose of the organization. | PurposeOfGrant |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Traci Acklin | |||||||||||||
| 0 | 168881 | 0 | 14534 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 183415 | 0 | 0 |
| Mohamad Sankari | |||||||||||||
| 351469 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2515 | 0 | 353984 | 0 | 0 | 0 |
| Paul Jackson | |||||||||||||
| 395694 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 395694 | 0 | 0 | 0 |
| Myra Priddy | |||||||||||||
| 253341 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 253341 | 0 | 0 | 0 |
| Kenneth Dwyer | |||||||||||||
| 249995 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1303 | 0 | 251298 | 0 | 0 | 0 |
| Samuel Davis | |||||||||||||
| 249995 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 249995 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Ghassan Dagher MD | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Board member | Relationship |
| Amount Of Transaction | 11220 | AmountOfTransaction |
| Description Of Transaction | Rental of office space. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | The Form 990 is reviewed by the CFO and CEO. | |
| Form 990, Part VI, Section B, line 12c | Annually we provide the board members with the conflict of interest policy and questionnaire. Once these are completed they are returned to administration and reviewed by our in house council. | |
| 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 XI, line 5: | Change in pension funded plan status -845,462. Transfer to related party -250,904. Total to Form 990, Part XI, Line 5: -1,096,366. | Changes in Net Assets or Fund Balances: |
| Form 990, Part XII, Line 2C | The organization has not changed its oversight or selection processes in the past year. | Clarification of 'yes' response |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Laird Health Care Foundation Inc | ||||||||||
| Washington Sixth Avenue | Montgomery | WV | 25136 | 550632743 | Support tax-exempt health care organizations | WV | 501(c)(3) | 11 | N/A | 0 |
| Montgomery General Elderly Care Center | ||||||||||
| Washington Sixth Avenue | Montgomery | WV | 25136 | 550623339 | Extended care facility | WV | 501(c)(3) | 9 | N/A | 0 |
| Montgomery General Healthcare System Inc | ||||||||||
| Washington Sixth Avenue | Montgomery | WV | 25136 | 550632601 | Provide support to affiliated exempt health care providers | WV | 501(c)(3) | 11 | N/A | 0 |
| Montgomery MedCorp Inc | ||||||||||
| washington Sixth Avenue | montgomery | WV | 25136 | 550767169 | Physicians Practice | WV | 501(c)(3) | 9 | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Comments