2024-11-14T09:21:04-06:00 2023-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 46204 990 2023-01-01 550740121 PRESTON MEMORIAL HOSPITAL FOUNDATION INC PRES 3043291400 150 MEMORIAL DRIVE KINGWOOD WV 26537 JEFF SANDENE EXECUTIVE VP AND CFO 3043291400 2024-11-13 1 0 ANGELA M MOORE P00244342 3174648600 2023 2024-10-15 13:58:12Z MELISSA LOCKWOOD 150 MEMORIAL DRIVE KINGWOOD WV 26537 148695 0 X WWW.MONHEALTH.COM/PRESTON-MEMORIAL/FOUNDATION X 1997 WV RAISE, RECEIVE, AND APPLY FUNDS FOR FACILITY IMPROVEMENTS, EQUIPMENT, TECHNOLOGY, AND EXPANSION OF SERVICES FOR PRESTON MEMORIAL HOSPITAL. 11 9 0 9 0 0 4946 52239 0 0 14909 37282 334 21521 20189 111042 0 0 0 0 0 0 0 0 33369 4804 43214 4804 43214 15385 67828 1363972 1467943 3172 162 1360800 1467781 RAISE, RECEIVE, AND APPLY FUNDS FOR FACILITY IMPROVEMENTS, EQUIPMENT, TECHNOLOGY, AND EXPANSION OF SERVICES. 0 0 0 52255 THE FOUNDATION SUPPORTS ACTIVITIES OF PRESTON MEMORIAL HOSPITAL AND ITS AFFILIATED NON-PROFIT ORGANIZATIONS BY PROVIDING A COORDINATED PROGRAM OF FUND DEVELOPMENT AND CONTINUED PHILANTHROPIC SUPPORT FOR THE HOSPITAL, ASSISTING THE HOSPITAL IN OBTAINING GRANTS FROM OTHER FOUNDATIONS, PROMOTING COMMUNITY AWARENESS OF AND SUPPORT FOR THE HOSPITAL AND ASSISTING THE HOSPITAL IN IDENTIFYING COMMUNITY EXPECTATIONS AND NEEDS FOR HEALTHCARE SERVICES IN THE SERVICE AREA. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 WV X KEVIN GESSLER VP OF FINANCE 3043291400 150 MEMORIAL DRIVE KINGWOOD WV 265371442 MELISSA LOCKWOOD DIRECTOR/PMH CAO 5.00 45.00 X X 0 289328 52848 KEVIN GESSLER TREASURER/PMH VP OF FINANCE 5.00 45.00 X X 0 248249 1153 CORRENA SMITHBURGER DIRECTOR/SECRETARY 1.00 0.00 X X 0 0 0 KERRY GNIK VICE CHAIR 1.00 0.00 X X 0 0 0 TARRELL RIES DIRECTOR/CHAIR 1.00 2.00 X X 0 0 0 CLINT MCCABE DIRECTOR 1.00 0.00 X 0 0 0 LAURIE THOMPSON DIRECTOR 1.00 0.00 X 0 0 0 MIKE SHAFFER DIRECTOR 1.00 0.00 X 0 0 0 RITA MCCROBIE DIRECTOR 1.00 2.00 X 0 0 0 SARAH WARCHOLA DIRECTOR (END JUNE 2023) 1.00 0.00 X 0 0 0 TRELLA GREASER DIRECTOR 1.00 0.00 X 0 0 0 WILLIAM SHOCKEY DIRECTOR 1.00 0.00 X 0 0 0 DAVID GOLDBERG MHS PRESIDENT & CEO 1.00 49.00 X 0 853663 36373 0 1391240 90374 0 0 1 0 0 52239 52239 49083 49083 11801 -11801 -11801 -11801 47357 25852 21505 21505 16 16 16 111042 16 0 58787 1500 1500 6181 6181 2164 2164 INDIRECT FUNDRAISING 33369 0 0 33369 43214 0 9845 33369 18183 25459 0 9946 1345789 1432538 1363972 1467943 3172 162 3172 162 X 1360800 1467781 1360800 1467781 1363972 1467943 67828 39153 0 X 0 1 X 1 0 X X 1 PRESTON MEMORIAL HOSPITAL 311097818 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE A, PART IV, SECTION C, LINE 1: MONONGALIA HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF THE FOUNDATION AND THE FOUNDATION'S SUPPORTED ORGANIZATION, PRESTON MEMORIAL HOSPITAL. MONONGALIA HEALTH SYSTEM, INC. APPOINTS OR ELECTS ALL MEMBERS OF THE BOARD OF DIRECTORS FOR BOTH ENTITIES AND MUST APPROVE ANY GOVERNANCE CHANGES OR OTHER MAJOR MATTERS OF BOTH ORGANIZATIONS. 0 VOLUNTEER PROGRAM 162 162 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. TAX RETURNS FOR THE YEAR ENDED JUNE 30, 2019, ARE OPEN FOR THE MHS ENTITIES AND TAX RETURNS FOR THE YEAR ENDED DECEMBER 31, 2020, ARE OPEN FOR CAMC ENTITIES. IN THE BAG (PURSE SALE) 21728 21728 14420 FIRST NIGHT OUT 16237 16237 3004 468 400 50 1 9392 9392 60 7450 47357 47357 3004 60 468 400 21920 25852 21505 0 1 0 0 0 0 0 0 0 DAVID GOLDBERG MHS PRESIDENT & CEO 0 714488 0 139175 0 0 0 30000 0 6373 0 890036 0 0 MELISSA LOCKWOOD DIRECTOR/PMH CAO 0 257560 0 31768 0 0 0 49500 0 3348 0 342176 0 0 KEVIN GESSLER TREASURER/PMH VP OF FINANCE 0 227811 0 20438 0 0 0 0 0 1153 0 249402 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 THE CEO: COMPENSATION COMMITTEE; INDEPENDENT COMPENSATION CONSULTANT; COMPENSATION SURVEY OR STUDY; -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 PRESTON MEMORIAL HOSPITAL FOUNDATION IS PRESTON MEMORIAL HOSPITAL CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A PRESTON MEMORIAL HOSPITAL FOUNDATION'S BOARD MEMBERS ARE ELECTED OR APPOINTED BY PRESTON MEMORIAL HOSPITAL CORPORATION AND MONONGALIA HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B PRESTON MEMORIAL HOSPITAL FOUNDATION'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 FOUNDATION OR THE BYLAWS; (B) SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF THE FOUNDATION AND ANY EXPENDITURE IN EXCESS OF $750,000; (C) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION; (D) ELECTION TO DISSOLVE THE FOUNDATION ENTITY; (E) APPROVAL OF THE BUDGET OF THE FOUNDATION 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 MEMBERS SHALL NOT PARTICIPATE IN. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE KEPT ONSITE AT PRESTON MEMORIAL HOSPITAL FOUNDATION AND ARE MADE AVAILABLE UPON REQUEST. 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