2023-11-15T15:08:57-06:00 2022-12-31 861065772 DELOITTE TAX LLP 50 SOUTH SIXTH STREET MINNEAPOLIS MN 55402 990 2022-07-01 550621551 MONONGALIA HEALTH SYSTEM INC MONO 3045981242 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 JEFF SANDENE EXECUTIVE VP AND CFO 3045981242 2023-11-14 1 JEFF SANDENE XXX-XX-XXXX 0 ANNE FULTON P00941863 6123974000 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z DAVID S GOLDBERG 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 25710328 0 X WWW.MONGENERAL.COM X 1983 WV TO PROVIDE MANAGEMENT, PLANNING, DEVELOPMENT, COORDINATION, AND OTHER ACTIVITIES RELATED TO THE PROMOTION OF HEALTH CARE WITHIN THE SYSTEM'S SERVICE AREA. 14 12 203 12 63180 0 0 0 45871298 24249996 1302006 759386 883750 241221 48057054 25250603 0 0 0 0 20386696 13214653 0 0 0 31768854 13567463 52155550 26782116 -4098496 -1531513 86123608 77838169 48766501 52620824 37357107 25217345 TO ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. 0 0 19430951 24249996 MONONGALIA HEALTH SYSTEM, INC. IS A NOT-FOR-PROFIT ORGANIZATION INCORPORATED FOR THE PURPOSE OF PROVIDING MANAGEMENT, PLANNING, DEVELOPMENT, COORDINATION, AND OTHER ACTIVITIES RELATED TO THE PROMOTION OF HEALTH CARE WITHIN THE SYSTEM'S SERVICE AREA. 19430951 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 90 0 1 203 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 12 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 WV X GENE TOWNSEND - CONTROLLER 3042853676 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 DAVID L RAMSEY DIRECTOR & VANDALIA CEO 1.00 57.00 X 0 1488436 197739 DAVID GOLDBERG DIRECTOR & MHS CEO 41.00 9.00 X X 911058 0 131451 ED BOYLE 9122 START CHAIR 1.00 6.50 X X 0 0 0 JOHN LAW CPA SECRETARY, TREASURER 1.00 2.00 X X 0 0 0 KATHY MCNEILL VICE CHAIR 1.00 4.50 X X 0 0 0 BOBBIE CONKLIN DIRECTOR 1.00 1.00 X 0 0 0 GREGORY CUNNINGHAM DIRECTOR 1.00 2.00 X 0 0 0 MARK JOHNSON MD DIRECTOR 1.00 1.00 X 0 0 0 MIKE MORRIS DIRECTOR 1.00 1.00 X 0 0 0 NATALIE STONE DIRECTOR 1.00 2.00 X 0 0 0 RAY THOMPSON DIRECTOR 1.00 3.00 X 0 0 0 RODNEY BEAN DIRECTOR 1.00 1.00 X 0 0 0 RONALD G STOVASH DIRECTOR 1.00 6.00 X 0 0 0 TERRY SHAFFER DIRECTOR 1.00 1.00 X 0 0 0 JEFF CRUDELE INTERIM CFO 41.00 9.00 X 480000 0 0 LISA SIMON CPA VP FINANCE/CFO 41.00 10.00 X 421179 0 15219 BRADFORD WARDEN PHYSICIAN 50.00 X 852682 0 48381 MARK GILLIAM CHIEF ADMINISTRATIVE OFFICER 50.00 X 384923 0 14057 EDWARD PHILLIPS CHIEF LEGAL OFFICER 50.00 X 340402 0 33210 KRYSTAL ATKINSON CHIEF NURSING EXECUTIVE 50.00 1.00 X 297414 0 22372 MARK COMBS CHIEF TECHNOLOGY OFFICER 50.00 X 291150 0 24110 3978808 1488436 486539 53 0 1 0 CERNER CORPORATION INC PO BOX 959156 ST LOUIS MO 63195 IT SERVICES 7066139 CDW GOVERNMENT INC 75 REMITTANCE DRIVE STE 1515 CHICAGO IL 60675 IT PRODUCT/SERVICES 2271790 STEPTOE AND JOHNSON PLLC PO BOX 247 BRIDGEPORT WV 26330 LEGAL SERVICES 1207319 CHANGE HEALTHCARE PO BOX 98347 CHICAGO IL 60693 IT SERVICES 765125 3M DEPT 0881 PO BOX 120881 DALLAS TX 75312 IT SERVICES 665802 68 MANAGEMENT FEE & RELAT 541610 24249996 24249996 24249996 759386 759386 1710564 459725 1250839 1250839 1250839 PARTNERSHIP INCOME 900099 -1009618 63180 -1072798 -1009618 25250603 24249996 63180 937427 10939409 9846067 1093342 373556 336200 37356 1340242 1206137 134105 561446 505301 56145 75219 67697 7522 143194 128875 14319 1358899 1087118 271781 558673 279337 279336 191388 95694 95694 15390 7695 7695 37584 30067 7517 43841 35067 8774 460921 368737 92184 1492517 1194014 298503 1173384 234677 938707 REPAIRS & MAINTENANCE 5963452 2981726 2981726 MISCELLANEOUS 876277 438180 438097 SALES TAX 539546 269773 269773 CONTINUING EDUCATION 216624 108312 108312 420554 210277 210277 26782116 19430951 7351165 0 794071 148625 2896941 2989281 3339389 4169608 51438372 16266451 57190327 35171921 17657065 16706483 4245815 18652251 86123608 77838169 4934866 6344130 786428 738362 31761110 30775856 11284097 14762476 48766501 52620824 X 37357107 25217345 37357107 25217345 86123608 77838169 X -1531513 -98253 -9651143 -858853 X 0 1 X 1 0 X X 2 MONONGALIA COUNTY GENERAL HOSPITAL CO 237441353 3 1 0 0 MON ELDER SERVICES INC 311520863 10 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 SCHEDULE A, PART IV, SECTION D, LINE 3: MONONGALIA HEALTH SYSTEM IS THE CONTROLLING ORGANIZATION OF THE SUPPORTED ORGANIZATIONS LISTED IN PART I. THE HEALTH SYSTEM AND ITS SUPPORTED ORGANIZATIONS SHARE AN INVESTMENT POLICY. SCHEDULE A, PART IV, SECTION E, LINE 3A: MONONGALIA HEALTH SYSTEM IS THE CONTROLLING ORGANIZATION OF THE SUPPORTED ORGANIZATIONS LISTED IN PART I. THE HEALTH SYSTEM APPOINTS THE BOARD OF DIRECTORS FOR ITS SUPPORTED ORGANIZATIONS. SCHEDULE A, PART IV, SECTION E, LINE 3B: MONONGALIA HEALTH SYSTEM IS THE CONTROLLING ORGANIZATION OF THE SUPPORTED ORGANIZATIONS LISTED IN PART I. THE HEALTH SYSTEM HAS RESERVED POWERS THAT ALLOWS FOR A SUBSTANTIAL DEGREE OF DIRECTION OVER POLICIES, PROGRAMS, AND ACTIVITIES OF EACH OF ITS SUPPORTED ORGANIZATIONS. 230000 230000 48801758 15978232 32823526 2406614 288219 2118395 35171921 EMS 1314383 C INTERMED LABS 500000 C MON HEALTH CARE, INC. 2558345 C MORGANTOWN ACCOMODATIONS LLC 1178211 C MORGANTOWN PHYSICAL THERAPY (HEALTHWORKS) 3019458 C MOUNTAIN STATE 212500 C MOUNTAINVIEW REHAB HOSPITAL (HEALTHSOUTH) 257696 C PREMIER, INC. 4909828 C RABBI TRUST 2756062 C 16706483 OTHER ASSETS 18060868 OPERATING LEASE 591383 18652251 LIABILITY - RABBI TRUST 2756062 DUE TO AFFILIATES 10371810 OPERATING LEASE 1984604 PROFESSIONAL AND GENERAL LIABILITY -350000 14762476 X PART X, LINE 2: THE IRS HAS DETERMINED THAT THE SYSTEM ENTITIES ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE CODE AND APPLICABLE STATE STATUTES, EXCEPT FOR MHC WHICH IS A CORPORATION SUBJECT TO INCOME TAX. THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 AND 2021. X X X X 1 1 0 0 0 0 0 0 0 DAVID L RAMSEY DIRECTOR & VANDALIA CEO 0 962283 0 312916 0 213237 0 155200 0 42539 0 1686175 0 0 DAVID GOLDBERG DIRECTOR & MHS CEO 576356 0 237960 0 96742 0 128124 0 3327 0 1042509 0 0 0 BRADFORD WARDEN PHYSICIAN 739118 0 110000 0 3564 0 47500 0 881 0 901063 0 0 0 JEFF CRUDELE INTERIM CFO 480000 0 0 0 0 0 0 0 0 0 480000 0 0 0 LISA SIMON CPA VP FINANCE/CFO 35487 0 46842 0 338850 0 14673 0 546 0 436398 0 0 0 MARK GILLIAM CHIEF ADMINISTRATIVE OFFICER 212122 0 46505 0 126296 0 10503 0 3554 0 398980 0 0 0 EDWARD PHILLIPS CHIEF LEGAL OFFICER 301068 0 37012 0 2322 0 26800 0 6410 0 373612 0 0 0 KRYSTAL ATKINSON CHIEF NURSING EXECUTIVE 265591 0 30250 0 1573 0 16212 0 6160 0 319786 0 0 0 MARK COMBS CHIEF TECHNOLOGY OFFICER 277340 0 13000 0 810 0 17950 0 6160 0 315260 0 0 0 PART I, LINES 4A-B LISA SIMON RECEIVED A SEVERANCE PAYMENT IN 2022 OF $338,707. MARK GILLIAM RECEIVED A SEVERANCE PAYMENT IN 2022 OF $124,956. THE FOLLOWING INDIVIDUALS PARTICIPATED IN 457(F) PLAN: DAVID L. RAMSEY, DAVID GOLDBERG AND LISA SIMON. FORM 990, PART VI, SECTION B, LINE 11B THE GOVERNING BODY IS PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW PRIOR TO SUBMISSION. THE MEMBERS ARE ASKED TO INFORM MANAGEMENT OF ANY QUESTIONS OR REVISIONS THEY MAY HAVE. IF CHANGES ARE MADE, BASED ON MEMBER'S REVISIONS, MANAGEMENT REDISTRIBUTES A FINAL VERSION TO ALL MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, A CONFLICT OF INTEREST QUESTIONNAIRE IS SENT OUT TO ALL BOARD MEMBERS. THE BOARD REVIEWS ALL RESPONSES FOR POSSIBLE CONFLICTS OF INTEREST AND DETERMINES WHAT TYPES OF DECISIONS THAT A MEMBER IS PROHIBITED FROM PARTICIPATING. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY, A CONSULTANT COMPILES A MARKET DATA REPORT ON CEO COMPENSATION; THIS REPORT IS THEN REVIEWED BY THE EXECUTIVE COMMITTEE TO DETERMINE COMPENSATION FOR THE INDIVIDUAL. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. FINANCIAL STATEMENTS ARE MADE AVAILABLE THROUGH PUBLIC DISCLOSURE WITH THE WV HEALTH CARE AUTHORITY. FORM 990, PART XI, LINE 9: ADMIN GAIN/LOSS -985,861. CHANGE IN NET ASSETS FROM MON HEALTH CARE, INC. 127,008. VANDALIA HEALTH INC PO BOX 1547 CHARLESTON WV 253261547 550664138 PARENT COMPANY WV 501(C)(3) 12C, III-FI N/A 0 CAMC FOUNDATION INC PO BOX 1547 CHARLESTON WV 253261547 310887133 FUNDRAISING WV 501(C)(3) 12A, I CHARLESTON AREA MEDICAL CENTER INC 1 CHARLESTON AREA MEDICAL CENTER INC PO BOX 1547 CHARLESTON WV 253261547 550526150 HOSPITAL WV 501(C)(3) 3 VANDALIA HEALTH INC 0 MONONGALIA COUNTY GENERAL HOSPITAL COMPANY 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 237441353 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 MON ELDER SERVICES INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 311520863 CONTINUING CARE RETIREMENT CENTER WV 501(C)(3) 10 MONONGALIA HEALTH SYSTEM INC 1 THE FOUNDATION OF MONONGALIA GENERAL HOSPITAL 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550570338 RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL WV 501(C)(3) 7 MONONGALIA COUNTY GENERAL HOSPITAL CO 1 PRESTON MEMORIAL HOSPITAL 150 MEMORIAL DRIVE KINGWOOD WV 26537 311097818 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 PRESTON MEMORIAL MEDICAL GROUP 300 SOUTH PRICE STREET KINGWOOD WV 26537 550717988 PRIMARY AND URGENT CARE WV 501(C)(3) 3 PRESTON MEMORIAL HOSPITAL 1 PRESTON MEMORIAL HOSPITAL FOUNDATION 300 SOUTH PRICE STREET KINGWOOD WV 26537 550740121 RAISE FUNDS FOR PRESTON HOSPITAL WV 501(C)(3) 12B, II PRESTON MEMORIAL HOSPITAL 1 AUXILIARY OF MONONGALIA GENERAL HOSPITAL 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550362965 RAISE FUNDS FOR MONONGALIA GENERAL HOSPITAL WV 501(C)(3) 12A, I MONONGALIA COUNTY GENERAL HOSPITAL CO 1 LIABILITY INSURANCE TRUST FOR MONONGALIA HEALTH SYSTEM 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550689535 LIABILITY INSURANCE TRUST WV 501(C)(3) 12A, I MONONGALIA HEALTH SYSTEM INC 1 STONEWALL JACKSON MEMORIAL HOSPITAL 230 HOSPITAL PLAZA WESTON WV 26452 550422958 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 MON HEALTH MARION NEIGHBORHOOD HOSPITAL 140 MIDDLETOWN LOOP WHITEHALL WV 26554 853994078 HOSPITAL WV 501(C)(3) 3 MONONGALIA HEALTH SYSTEM INC 1 CAMC GREENBRIER VALLEY MEDICAL CENTER INC 1320 MAPLEWOOD AVENUE RONCEVERTE WV 24970 884128022 HOSPITAL WV 501(C)(3) 3 CHARLESTON AREA MEDICAL CENTER INC 1 CAMC PLATEAU MEDICAL CENTER INC 430 MAIN STREET OAK HILL WV 25901 921715117 HOSPITAL WV 501(C)(3) 3 CHARLESTON AREA MEDICAL CENTER INC 1 CAMC HEALTH EDUCATION AND RESEARCH INSTITUTE INC PO BOX 1547 CHARLESTON WV 253261547 550753754 MEDICAL EDUCATIONAL RESEARCH WV 501(C)(3) 12A, I CHARLESTON AREA MEDICAL CENTER INC 1 WOMEN AND CHILDREN'S MEDICAL OFFICE BUILDING LLC PO BOX 1547 CHARLESTON WV 253261547 550669065 MEDICAL OFFICE BUILDING WV N/A 0 0 GENERAL DIVISION MEDICAL OFFICE BUILDING LLC PO BOX 1547 CHARLESTON WV 253261547 550623949 MEDICAL OFFICE BUILDING WV N/A 0 0 DASCO-CAMC HOME MEDICAL EQUIPMENT LLC 501 MORRIS STREET CHARLESTON WV 25301 844487189 HOME MEDICAL EQUIPMENT WV N/A 0 0 MGH SURGERY LLC 2000 MON HEALTH MEDICAL PARK DRIVE MORGANTOWN WV 26505 472736896 SURGERY CENTER WV N/A 0 0 MON HEALTH-DASCO HOME MEDICAL EQUIPMENT LLC 375 N WEST ST WESTERVILLE OH 43082 871577276 HOME MEDICAL EQUIPMENT OH N/A 0 0 VANDALIA INSURANCE COMPANY 76 ST PAUL STREET STE 500 BURLINGTON VT 05401 030308754 INSURANCE VT N/A C 1 MON HEALTH CARE INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550654973 MEDICAL EQUIPMENT WV MONONGALIA HEALTH SYSTEM INC C 1683695 1.00000 1 STONEWALL HOME OXYGEN THERAPY INC 100 MARKET PLACE MALL SUITE 8 WESTON WV 26452 550754278 OXYGEN THERAPY SERVICES WV N/A C 1 FAIRMONT HOME EQUIPMENT AND SUPPLY 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550763259 EQUIPMENT RENT & SVC WV N/A C 1 MORGANTOWN PHYSICAL THERAPY ASSOC INC 943 MAPLE DRIVE MORGANTOWN WV 26505 550614636 REHABILITATION SERVICES WV MONONGALIA HEALTH SYSTEM INC C 184298 3500921 0.51000 1 CARE PARTNER'S INC 511 BURROUGHS STREET SUITE 102 MORGANTOWN WV 26505 550754326 HOME HEALTH WV MONONGALIA HEALTH SYSTEM INC C 49895 486997 1.00000 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0