2024-11-13T19:02:14-06:00 2023-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 46204 990 2023-01-01 550362965 AUXILIARY OF MONONGALIA GENERAL HOSPITAL AUXI 3045981200 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 JEFF SANDENE EXECUTIVE VP AND CFO 3045981200 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 437073 0 X N/A X 1973 WV THE AUXILIARY OF MON GENERAL SUPPORTS PROJECTS AND PROVIDES IMPROVEMENTS VIA VOLUNTEERS AND FINANCIAL EFFORTS FOR PATIENTS, FAMILIES AND STAFF 18 17 0 17 0 0 32449 36110 0 0 518 3921 390930 192824 423897 232855 298465 2000 0 0 53583 0 0 0 49873 33965 156199 386013 158199 37884 74656 420067 448270 161678 115225 258389 333045 THE AUXILIARY OF MON GENERAL SUPPORTS PROJECTS AND PROVIDES IMPROVEMENTS VIA VOLUNTEERS AND FINANCIAL EFFORTS FOR PATIENTS FAMILIES AND STAFF. 0 0 108326 2000 159077 THE AUXILIARY RAISED FUNDS AND PROVIDED FINANCIAL SUPPORT TO THE HOSPITAL AND HOSPITAL FOUNDATION TO SUPPORT PATIENT CARE INITIATIVES. 108326 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 18 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 WV X GENE TOWNSEND - MANAGING ACCOUNTANT 3042853676 1200 JD ANDERSON DRIVE MORGANTOWN WV 26505 LUELLA GUNTER DIRECTOR 1.00 49.00 X 0 193811 21553 BETHANN GAMPONIA VICE PRESIDENT 1.00 0.00 X X 0 0 0 CHARLOTTE CLONCH SECRETARY 1.00 0.00 X X 0 0 0 CHRIS BATTIN PRESIDENT 1.00 0.00 X X 0 0 0 SUSAN MELENRIC TREASURER 1.00 0.00 X X 0 0 0 BETH BURNS DIRECTOR 1.00 0.00 X 0 0 0 BOB SANTEE DIRECTOR 1.00 0.00 X 0 0 0 CONNIE STEAD DIRECTOR 1.00 0.00 X 0 0 0 DENICE KIRCHOFF DIRECTOR 1.00 0.00 X 0 0 0 DONNA PIFER DIRECTOR 1.00 0.00 X 0 0 0 GRETCHEN KACZMARCZYK DIRECTOR 1.00 0.00 X 0 0 0 JILL BUTERBAUGH DIRECTOR 1.00 0.00 X 0 0 0 JOYCE WASSICK DIRECTOR 1.00 0.00 X 0 0 0 KATHY BOYLE DIRECTOR 1.00 0.00 X 0 0 0 KATHY POMPILI DIRECTOR 1.00 0.00 X 0 0 0 KATIE GYORKO DIRECTOR 1.00 0.00 X 0 0 0 MIKE TAYLOR DIRECTOR 1.00 0.00 X 0 0 0 NATE JAMES DIRECTOR 1.00 0.00 X 0 0 0 DAVID GOLDBERG PRES/CEO, MON HEALTH SYSTEMS 1.00 50.00 X 0 853663 36373 0 1047474 57926 0 0 1 0 0 36110 36110 3921 3921 35934 2187 33747 33747 316106 202031 114075 114075 FUNDRAISING INCOME 900099 27045 27045 VENDING 900099 16248 16248 LIFE MEMBERSHIP DUES 900099 1270 1270 439 439 45002 232855 159077 0 37668 X 2000 2000 85567 85567 6871 6871 6407 6407 6369 6369 FUNDRAISING EXPENSES 49873 0 0 49873 1112 1112 158199 108326 0 49873 78828 115401 62611 238500 194315 24746 48212 45610 6308 2106 39222 17315 29793 21907 420067 448270 66204 31350 1437 600 94037 83275 161678 115225 X 258389 333045 258389 333045 420067 448270 74656 0 X 0 0 0 X X 2 MONONGALIA COUNTY GENERAL HOSPITAL 237441353 3 1 0 0 THE FOUNDATION OF MONONGALIA GENERAL HOSPITAL 550570338 7 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 39222 17315 21907 21907 PAYABLE TO FDTN OF MONONGALIA 83275 83275 FOOTBALL PARKING 24598 24598 615 CHRISTMAS TREES 11336 11336 1572 35934 35934 2187 2187 33747 0 1 0 0 0 0 0 0 0 DAVID GOLDBERG PRES/CEO, MON HEALTH SYSTEMS 0 714488 0 139175 0 0 0 30000 0 6373 0 890036 0 0 LUELLA GUNTER DIRECTOR 0 184348 0 9463 0 0 0 14748 0 6805 0 215364 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 B, LINE 11B THE GOVERNING BODY IS PROVIDED A COPY PRIOR TO SUBMISSION FOR THEIR REVIEW AND TO ANSWER QUESTIONS AND/OR REVISE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY BY MAILING A CONFLICT OF INTEREST FORM ANNUALLY. 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 CEO COMPENSATION, THIS REPORT IS THEN REVIEWED BY THE EXECUTIVE COMMITTEE TO DETERMINE COMPENSATION FOR THE INDIVIDUAL. ANNUALLY, A CONSULTANT COMPILES A MARKET DATA REPORT ON CFO AND COO 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 85,567. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 85,567. 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 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 INC 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 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 1 1 0 1 0 1 1 1 0 0