2024-11-13T20:41:32-06:00 2023-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 46204 990 2023-01-01 853994078 MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC MONH 3045981242 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 JEFF SANDENE EXECUTIVE VP AND CFO 3045981242 2024-11-13 1 0 ANGELA M MOORE P00244342 3174648600 2023 2024-10-15 13:58:12Z DAVID S GOLDBERG 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 9014781 0 X WWW.MONGENERAL.COM X 2020 WV OUR GOAL IS TO OFFER THE QUALITY OF CARE WE WOULD EXPECT AND DEMAND FOR OUR OWN FAMILIES. STREAMLINED ADMITTING PROCEDURES, HIGHLY QUALIFIED PHYSICIANS AND MEDICAL SPECIALISTS AT EVERY LEVEL OF CARE AND THE LATEST DIAGNOSTIC EQUIPMENT ARE JUST A FEW OF THE DISTINCTIONS WE OFFER. 6 4 56 4 0 0 0 36100 3174197 8978681 0 0 0 0 3174197 9014781 0 0 0 0 2078992 4121053 0 0 0 3394592 5615100 5473584 9736153 -2299387 -721372 12708607 13889779 21531212 23433756 -8822605 -9543977 TO ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, ONE PERSON AT A TIME. 0 0 8244601 8978681 MON HEALTH MARION NEIGHBORHOOD HOSPITAL OFFERS AROUND-THE-CLOCK EMERGENCY CARE, A COMPREHENSIVE INPATIENT WING FOR OVERNIGHT STAYS, ON-SITE LABORATORY TESTING AND IMAGING INCLUDING CT, ULTRASOUND AND X-RAY. 8244601 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 5 0 1 56 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 WV X GENE TOWNSEND - MANAGING ACCOUNTANT 3042853676 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 DAVID GOLDBERG SECRETARY/TREASURER/PRESIDENT/CEO 1.00 50.00 X X 0 853663 36373 CHRISTOPHER EDWARDS CAO 50.00 0.00 X X 121154 0 0 DIXIE YANN VICE CHAIR 1.00 0.00 X X 0 0 0 RONALD G STOVASH CHAIR 1.00 5.00 X X 0 0 0 JOHN SCHIRRIPA DIRECTOR 1.00 0.00 X 0 0 0 SENATOR ROMAN PREZIOSO DIRECTOR 1.00 0.00 X 0 0 0 CARLA HAMNER ADMINISTRATOR 50.00 0.00 X 124390 0 25566 AMBER ROCK PHARMACIST IN CHARGE 50.00 0.00 X 106572 0 6350 JESSICA SEMPLICE RN 50.00 0.00 X 105329 0 0 BAILEIGH BRITTON RN 50.00 0.00 X 100804 0 3618 558249 853663 71907 5 0 1 0 EMERUS DEVELOPMENT 8686 NEW TRAILS DRIVE STE 100 WOODLANDS TX 77381 MANAGEMENT SERVICES 1110528 ABC HEALTH 105 MARCO POLO DRIVE MORGANTOWN WV 26508 HOSPITALIST SERVICES 334583 2 36100 36100 NET PATIENT SVC REV 621990 8978681 8978681 8978681 9014781 8978681 0 0 X 3206942 3206942 83668 83668 601180 601180 229263 229263 1858948 1858948 100664 100664 248635 248635 342521 342521 380111 380111 MANAGEMENT FEES 1491552 1491552 MEDICAL SUPPLIES 839477 839477 MEDICARE PROVIDER TAX 203145 203145 REPAIRS AND MAINTENANCE 59817 59817 90230 90230 9736153 8244601 1491552 0 206698 615137 1119301 1316553 63988 0 11489165 505986 11318620 10983179 0 974910 12708607 13889779 878941 772350 13871192 13522694 6781079 9138712 21531212 23433756 X -8822605 -9543977 -8822605 -9543977 12708607 13889779 -721372 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2667003 2667003 6973838 235519 6738319 1848324 270467 1577857 10983179 ROU 385506 THIRD PARTY SETTLEMENTS 589404 974910 DUE TO AFFILIATES 9138712 9138712 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, FHE, CMC, AND HFI, WHICH ARE CORPORATIONS SUBJECT TO INCOME TAX. THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2023. 1 1 1 X 0 1 1 0 1 1 1275492 212365 1063127 0.11870 2944487 918854 2025633 0.22620 4219979 1131219 3088760 0.34490 4219979 1131219 3088760 0.34490 0 1275492 794683 1445612 -650929 X 1 1 1 1 MON HEALTH MARION NEIGHBORHOOD HOSPITAL INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 HTTPS://WWW.MONHEALTH.COM/MHMH/MHMH-HO 174 X X X MON HEALTH MARION NEIGHBORHOOD HOSPITAL 1 0 0 1 X X X X X X X X X 23 1 0 0 1 X HTTPS://WWW.MONHEALTH.COM/MHMH/ABOUT-US-MHMH X 1 23 1 HTTPS://WWW.MONHEALTH.COM/MHMH/ABOUT-US-MHMH 0 1 X 200.000000000000 200.000000000000 X X X 1 1 X X X X 1 X HTTPS://WWW.MONHEALTH.COM/MAIN/FINANCIAL-ASSISTANCE X HTTPS://WWW.MONHEALTH.COM/MAIN/FINANCIAL-ASSISTANCE X HTTPS://WWW.MONHEALTH.COM/MAIN/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 MON HEALTH MARION NEIGHBORHOOD HOSPITAL, INC. PART V, SECTION B, LINE 5: THE 2023 CHNA INCLUDED QUANTITATIVE RESEARCH METHODS AND COMMUNITY CONVERSATIONS TO DETERMINE HEALTH TRENDS AND DISPARITIES AFFECTING RESIDENTS. THROUGH A COMPREHENSIVE REVIEW OF STATISTICAL HEALTH INDICATORS AND COMMUNITY STAKEHOLDER FEEDBACK, A PROFILE OF PRIORITY AREAS WAS DETERMINED. THESE FINDINGS WILL GUIDE HEALTHCARE SERVICES AND HEALTH IMPROVEMENT EFFORTS, AS WELL AS SERVE AS A COMMUNITY RESOURCE FOR GRANTMAKING AND ADVOCACY, AND TO SUPPORT THE MANY PROGRAMS PROVIDED BY HEALTH AND SOCIAL SERVICE PARTNERS.IN 2022, MON HEALTH PARTNERED WITH WVU MEDICINE RUBY MEMORIAL HOSPITAL AND THE MONONGALIA COUNTY HEALTH DEPARTMENT TO CONDUCT A COLLABORATIVE NEEDS ASSESSMENT FOR THEIR COLLECTIVE SERVICE AREAS, INCLUDING MARION COUNTY. AS PART OF THE ASSESSMENT, THE COLLABORATIVE CONDUCTED A PUBLIC INPUT SURVEY WHICH SOLICITED AND RECEIVED INPUT FROM DIVERSE COMMUNITY RESIDENTS. THIS INFORMATION WAS ALSO UTILIZED IN THE QUANTITATIVE DATA.A TOTAL OF 1,945 SURVEYS WERE COMPLETED BY ADULT RESIDENTS FROM THE AREA, INCLUDING 403 SURVEYS BY MARION COUNTY RESIDENTS. SURVEY TOPICS INCLUDED QUESTIONS ABOUT SPECIFIC HEALTH ISSUES, THOUGHTS ON OVERALL HEALTH OF THE COMMUNITY, QUALITY OF LIFE, ACCESS TO HEALTHCARE AND MEDICAL NEEDS (INCLUDING SPECIALIST CARE), RISK BEHAVIORS AND PERSONAL CHOICES, EXPERIENCES DURING THE COVID-19 PANDEMIC, AND DEMOGRAPHIC INFORMATION INCLUDING GEOGRAPHIC LOCATION AND INCOME. RESULTS FROM THE SURVEY, INCLUDING TOP RESIDENT CONCERNS, WERE INCLUDED AS PART OF THE CHNA. MON HEALTH MARION NEIGHBORHOOD HOSPITAL, INC. PART V, SECTION B, LINE 11: THE HOSPITAL DEVELOPED AN IMPLEMENTATION PLAN THAT ADDRESSED ALL OF THE SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA. THE SIGNIFICANT NEEDS IDENTIFIED AND HOW THE HOSPITAL RESPONDED ARE:1. CHRONIC DISEASE PREVENTION: ENSURE ALL RESIDENTS HAVE KNOWLEDGE OF, AND EQUITABLE ACCESS TO, THE RESOURCES THEY NEED TO MAINTAIN THEIR HEALTH. INCREASE ACCESS TO TRADITIONAL AND ALTERNATIVE PLACES PEOPLE CAN ACCESS HEALTHCARE.2. MENTAL HEALTH - STRENGTHEN AND SUPPORT COMMUNITY INITIATIVES THAT PROMOTE MENTAL WELLNESS, RECOVERY, AND RESILIENCE. IMPROVE ACCESS TO MENTAL HEALTH SERVICES AND SUPPORTS. INCREASE AWARENESS OF MENTAL HEALTH TO REDUCE STIGMA AND FEAR OF SEEKING TREATMENT.3. SUBSTANCE USE DISORDER - STRENGTHEN AND SUPPORT COMMUNITY INITIATIVES TO PREVENT THE INITIATION OF SUBSTANCE USE AND PROMOTE RECOVERY. IMPROVE ACCESS TO TREATMENT AND SERVICES FOR SUBSTANCE USE DISORDER. INCREASE AWARENESS OF SUBSTANCE USE DISORDER TO PREVENT INITIATION AND REDUCE FEAR OF SEEKING TREATMENT. PART I, LINE 7: THE HOSPITAL USED A COST-TO-CHARGE RATIO DERIVED FROM MEDICARE COST REPORT FOR TOTAL PROGRAM COSTS AND TOTAL PROGRAM CHARGES TO ESTIMATE THE OVERALL COST-TO-CHARGE RATIO (CCR). THIS CCR WAS USED IN COMPUTATIONS FOR UNREIMBURSED MEDICAID AND CHARITY CARE. 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 $ 780,538. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE CARRIED AT THE ORIGINAL CHARGE LESS AN ESTIMATE MADE FOR DOUBTFUL OR UNCOLLECTIBLE ACCOUNTS. THE ALLOWANCE IS BASED UPON A REVIEW OF THE OUTSTANDING BALANCES AGED BY FINANCIAL CLASS. MANAGEMENT USES COLLECTION PERCENTAGES BASED UPON HISTORICAL COLLECTION EXPERIENCE TO DETERMINE COLLECTABILITY. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS MGH RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE BASED 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 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 CALCULATED USING A COST TO CHARGE RATIO. THE COSTS ARE ALLOCATED TO THE VARIOUS DEPARTMENTS USING A STEP DOWN APPROACH AND REMOVING ANY COSTS THAT ARE NOT ALLOWABLE UNDER MEDICARE RULES. THE ORGANIZATION IS A TAX EXEMPT, NOT-FOR-PROFIT ENTITY THAT SERVES MONONGALIA AND SURROUNDING COUNTIES PATIENT POPULATION REGARDLESS OF THEIR MEANS TO PAY OR HEALTH INSURANCE STATUS. MEDICARE PATIENTS IN OUR SERVICE AREA DEPEND ON THE ORGANIZATION TO DELIVER THEIR HEALTH CARE AND MEET THEIR MEDICAL NEEDS REGARDLESS OF MEDICARE COVERAGE OF COST FOR PROVIDING THE NEEDED SERVICE. SINCE THE ORGANIZATION CONSTANTLY WORK TO OPERATE AS COST EFFICIENT AS POSSIBLE, WE FEEL STRONGLY THAT MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. PART III, LINE 9B: THERE ARE PROVISIONS IN THE DEBT COLLECTION POLICY TO BE FOLLOWED FOR PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. THE POLICY STATES THAT FINANCIAL ASSISTANCE SHALL BE OFFERED TO THE HOSPITAL'S UNINSURED AND UNDERINSURED PATIENTS ON A NONDISCRIMINATORY BASIS TO MEET THE NEED OF THE COMMUNITY. CHARITY CARE REQUESTS WILL BE REVIEWED AND EVALUATED BY THE CFO AND DIRECTOR OF PATIENT ACCOUNTING FOR APPROVAL. PATIENTS THAT QUALIFY FOR 100% CHARITY CARE ARE NOT PURSUED FOR COLLECTION. PART VI, LINE 2: THE NEEDS OF THE COMMUNITY WERE ASSESSED BASED ON DISCUSSIONS AMONGST MANAGEMENT AND CROSS-SECTION OF COMMUNITY MEMBERS, WHICH PROVIDES OPINIONS FROM VARYING DEMOGRAPHICS. PART VI, LINE 3: THE PLAIN LANGUAGE SUMMARY OF THE FAP AND FAP APPLICATION ARE AVAILABLE ON THE HOSPITAL'S WEBSITE. PAPER COPIES OF THE FAP, PLAIN LANGUAGE SUMMARY OF THE FAP, AND FAP APPLICATION ARE AVAILABLE UPON REQUEST AND COPIES ARE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. THE HOSPITAL HAS SIGNS THAT NOTIFY THE PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. UNINSURED PATIENTS ARE PROVIDED A PLAIN LANGUAGE SUMMARY AND FAP APPLICATION FORM. BILLING STATEMENTS INCLUDE A NOTICE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO OBTAIN INFORMATION. THE HOSPITAL HAS FINANCIAL COUNSELORS AVAILABLE TO EDUCATE PATIENTS ON THE ELIGIBILITY OF ASSISTANCE. PART VI, LINE 4: THE HOSPITAL SERVES PRIMARILY MARION COUNTY, HOWEVER, THERE IS UTILIZATION BY MANY SURROUNDING COUNTIES AS WELL. MARION COUNTY HAS APPROXIMATELY 56,000 RESIDENTS. MARION COUNTY HAS A POVERTY RATE OF 15.4%. MEDIAN HOUSEHOLD INCOME IS $59,974 WHILE THE NATIONAL AVERAGE WAS $74,580, A 20% DIFFERENCE. PART VI, LINE 5: THE HOSPITAL HAS AN OPEN MEDICAL STAFF SERVING A MULTITUDE OF SPECIALTIES. THE BOARD OF DIRECTORS IS COMPRISED OF VARIOUS MEMBERS OF THE COMMUNITY AS REQUIRED UNDER ITS BYLAWS. THE ORGANIZATION SPONSORS AN ANNUAL HEALTH FAIR AT THE LOCAL MALL, IN WHICH THOUSANDS OF CITIZENS FROM THE LOCAL COMMUNITY COME TO LEARN ABOUT SERVICES OFFERED AND ARE PROVIDED THE OPPORTUNITY TO RECEIVE MULTIPHASIC BLOODWORK FOR A NOMINAL FEE. PART VI, LINE 6: THE HOSPITAL IS PART OF MONONGALIA HEALTH SYSTEM, INC. WHICH INCLUDES THE FOLLOWING OTHER HEALTH CARE ENTITIES IN THE COMMUNITY: MONONGALIA COUNTY GENERAL HOSPITAL, MON ELDER SERVICES, INC. DBA THE VILLAGE AT HERITAGE POINT, MON HEALTH CARE, INC., PRESTON MEMORIAL HOSPITAL, PRESTON MEMORIAL MEDICAL GROUP, AND STONEWALL JACKSON MEMORIAL HOSPITAL. MONONGALIA COUNTY GENERAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL. MON ELDER SERVICES, INC. IS A NOT-FOR-PROFIT RESIDENTIAL AND ASSISTED LIVING PROVIDER. MON HEALTH CARE, INC. IS A FOR-PROFIT DURABLE MEDICAL EQUIPMENT RETAILER. PRESTON MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL. PRESTON MEMORIAL MEDICAL CENTER GROUP IS A NOT-FOR-PROFIT ENTITY WHICH PROVIDES PRIMARY AND URGERT CARE. STONEWALL JACKSON MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT HOSPITAL. PART VI, LINE 7, REPORTS FILED WITH STATES WV 0 1 0 0 0 0 0 0 0 DAVID GOLDBERG SECRETARY/TREASURER/PRESIDENT/CEO 0 714488 0 139175 0 0 0 30000 0 6373 0 890036 0 0 PART I, LINE 3 THE CEO'S COMPENSATION IS PAID BY MONONGALIA HEALTH SYSTEM. MONONGALIA HEALTH SYSTEM USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF - COMPENSATION COMMITTEE - COMPENSATION SURVEY OR STUDY THE CEO - INDEPENDENT COMPENSATION CONSULTANT - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B 457(F) INELIGIBLE DEFERRED COMPENSATION PLAN - A 457 F PLAN IS OFFERED TO CERTAIN MANAGEMENT AND/OR HIGHLY COMPENSATED EMPLOYEES TO OFFER THOSE EMPLOYEES A DEFERRED COMPENSATION OPPORTUNITY. THE PLAN IS INTENDED TO BE A "TOP-HAT PLAN", OR UNFUNDED DEFERRED COMPENSATION PLAN MAINTAINED FOR A SELECT GROUP OF EMPLOYEES. PARTICIPANTS MAY BECOME VESTED IN AMOUNTS CREDITED ON JANUARY 1 ELECTED BY THE PARTICIPANT AT THE TIME THE INITIAL DEFERRAL WAS ELECTED. A PARTICIPANT SHALL BECOME FULLY VESTED UPON DEATH, DISABILITY, ATTAINMENT OF AGE 60, OR SEPARATION OF SERVICE, AS DEFINED BY THE PLAN. ANY UNVESTED CONTRIBUTIONS SHALL BE FORFEITED TO THE PLAN OR EMPLOYER. FOR 2023: PER BENEFITS - NO DISTRIBUTIONS / PAYMENTS WERE MADE FROM THE PLAN; DAVID GOLDBERG WAS THE ONLY PARTICIPANT FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MON HEALTH MARION NEIGHBORHOOD HOSPITAL IS MONONGALIA HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A MON HEALTH MARION NEIGHBORHOOD HOSPITAL'S BOARD MEMBERS ARE ELECTED OR APPOINTED BY MONONGALIA HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B MON HEALTH MARION NEIGHBORHOOD HOSPITAL'S BOARD SHALL GIVE NOTICE TO MONONGALIA HEALTH SYSTEM AND RECEIVE ITS APPROVAL BEFORE ACTING ON ANY OF THE FOLLOWING MATTERS: (A) AMENDMENT OF THE ARTICLES OF INCORPORATION OF THE HOSPITAL OR THE BYLAWS; (B) SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF THE HOSPITAL AND ANY EXPENDITURE IN EXCESS OF $750,000; (C) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION; (D) ELECTION TO DISSOLVE THE HOSPITAL ENTITY; (E) APPROVAL OF THE BUDGET OF THE HOSPITAL' (F) APPROVAL IN ADVANCE OF THE HIRING OF THE PRESIDENT TO THE HOSPITAL. 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 BOARD MEMBERS ARE ASKED TO INFORM MANAGEMENT OF ANY QUESTIONS OR REVISIONS THEY MAY HAVE. IF CHANGES ARE MADE, BASED ON BOARD MEMBER'S REVISIONS, MANAGEMENT REDISTRIBUTES A FINAL VERSION TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY A CONFLICT OF INTEREST QUESTIONNAIRE IS SENT OUT TO ALL BOARD MEMBERS. THE BOARD THEN REVIEWS ALL RESPONSES FOR POSSIBLE CONFLICTS OF INTEREST. IF A CONFLICT IS NOTED, THE BOARD MEMBERS DETERMINE WHICH DECISIONS THE CONFLICTED MEMBER SHALL NOT PARTICIPATE IN. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS PAID BY MONONGALIA HEALTH SYSTEM. ANNUALLY, A CONSULTANT COMPILES A MARKET DATA REPORT ON EXECUTIVE 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 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE KEPT ONSITE AT MONONGALIA GENERAL HOSPITAL AND ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 1,858,948. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,858,948. 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 HEALTH SYSTEM INC 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 550621551 PARENT COMPANY WV 501(C)(3) 12C, III-FI 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 INC 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 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 BROADDUS HOSPITAL ASSOCIATION INC PO BOX 930 PHILLIPI WV 26416 550379108 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM INC 1 DAVIS HEALTH SYSTEM INC PO BOX 1484 ELKINS WV 26241 550737655 HEALTH SYSTEM WV 501(C)(3) 12B, II MONONGALIA HEALTH SYSTEM INC 1 DAVIS MEMORIAL HOSPITAL INC PO BOX 1484 ELKINS WV 26241 550375433 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM INC 1 DAVIS HEALTH SYSTEM FOUNDATION INC PO BOX 1188 ELKINS WV 26241 320185772 PROVIDES SUPPORT TO DAVIS HEALTH SYSTEM ENTITIES WV 501(C)(3) 10 DAVIS HEALTH SYSTEM INC 1 WEBSTER MEMORIAL HOSPITAL 812 GORMAN AVENUE ELKINS WV 26241 871759588 HOSPITAL WV 501(C)(3) 3 DAVIS HEALTH SYSTEM 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 CHARLESTON SURGICAL HOSPITAL LLC 1306 KANAWHA BLVD E CHARLESTON WV 25301 550526191 SURGERY CENTER WV 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 N/A C 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 N/A C 1 HEALTH FACILITIES INC 909 GORMAN AVENUE ELKINS WV 26241 550516937 HEALTH CARE WV N/A C 1 CENTRAL WV MEDCORP INC PO BOX 2630 ELKINS WV 26241 550739314 PHYSICIAN SERVICES WV N/A C 1 DAVIS REGIONAL HEALTH PARTNERS INC PO BOX 2632 ELKINS WV 26241 550746206 CONTRACT NEGOTIATIONS WV N/A C 1 ZERCOR RE SEGREGATED PORTFOLIO #2 DAVIS 18 FORUM LANE 2ND FLOOR GRAND CAYMAN CAYMAN ISLANDS CJ KY1-1102 CAPTIVE INSURANCE CJ N/A C 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 1 MONONGALIA COUNTY GENERAL HOSPITAL COMPANY S 450000 FAIR MARKET VALUE MONONGALIA COUNTY GENERAL HOSPITAL COMPANY R 300000 FAIR MARKET VALUE