2019-05-14T17:31:33-05:00 2018-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2017-07-01 550599096 COMMUNITY CARE OF WEST VIRGINIA INC % CONNIE JOHNSTON CFO COMM 3049246262 PO BOX 217 ROCK CAVE WV 26234 RICHARD SIMON CEO 3049246262 2018-11-08 true Krystal K Creach P01248198 4178658701 167.68.126.162 43032920191345000036 2019-05-14 P 353840E92A19E57AE3D09FB5FB5D869273682438 8F438207F781E16C0FE969051AA52AD6F3A8EA5F 2017 2019-02-21 02:37:17Z DBA TRI-COUNTY HEALTH CLINIC INC RICHARD SIMON PO BOX 217 ROCK CAVE WV 26234 31676034 false X CCWV.ORG X 1979 WV TO PROVIDE HIGH QUALITY, ACCESSIBLE, COMPREHENSIVE AND COST-EFFECTIVE HEALTHCARE SERVICES TO OUR PATIENTS WHILE SERVING AS THEIR MEDICAL HOME. 10 10 420 11 3819 5754 6063210 5322083 23026493 26339369 29161 1832 0 4268 29118864 31667552 0 0 0 0 18422392 19901094 0 0 0 10654755 11879462 29077147 31780556 41717 -113004 11053874 11230200 6542758 6835489 4511116 4394711 X THE MISSION OF CCWV IS TO HELP OUR COMMUNITIES LIVE THE HEALTHIEST LIVES POSSIBLE BY MEETING THEIR IMMEDIATE AND LONG-TERM HEALTHCARE NEEDS. SEE SCHEDULE O. false false 23147908 26339369 THE ORGANZIATION PROVIDES RURAL MEDICAL, DENTAL AND PHARMACY HEALTHCARE SERVICES TO APPROXIMATELY 42,000 PATIENTS IN BRAXTON, CLAY, HARRISON, LEWIS, POCAHONTAS, RANDOLPH AND UPSHUR COUNTIES IN WEST VIRGINIA. 23147908 true true false false false false false false false false true false false true true false true false false false false false false false false false false false false true true false false false false false false false false false false true false false false false false false false false true 35 0 true 420 true false false false false false false false false false false X 10 10 false false false false false false false true true false false true true true true true true true true false X CONNIE JOHNSTON CFO 3049246262 PO BOX 217 ROCK CAVE WV 26234 TOM LYNCH PRESIDENT 1.0 0.0 X X 0 0 0 RENEE HOFER BOARD MEMBER; VP BEG 3/2018 1.0 0.0 X X 0 0 0 KAREN GRANT SECRETARY 1.0 0.0 X X 0 0 0 THELMA SAMPLES TREASURER 1.0 0.0 X X 0 0 0 JOYCE GIBSON VP END 2/2018; BOARD MEMBER 1.0 0.0 X X 0 0 0 CHAD MORRISON BOARD MEMBER 1.0 0.0 X 0 0 0 DAVID TAYLOR BOARD MEMBER 1.0 0.0 X 0 0 0 GREGORY MOORE BOARD MEMBER 1.0 0.0 X 0 0 0 TRAVIS MILLER BOARD MEMBER ENDING 12/2017 1.0 0.0 X 0 0 0 DAVID MALCOMB BOARD MEMBER BEGINNING 1/2018 1.0 0.0 X 0 0 0 MICHELLE SAMPLES BOARD MEMBER BEGINNING 1/2018 1.0 0.0 X 0 0 0 MARTIN BAECHTEL CIO 40.0 0.0 X 85828 0 6934 SARAH CHOUINARD MEDICAL DIRECTOR 40.0 0.0 X 346914 0 24327 PATRICIA COLLETT DIRECTOR OF MEDICAL OPERATIONS 40.0 0.0 X 139509 0 20685 CONNIE JOHNSTON CFO 40.0 0.0 X 145154 0 17107 BROCK MALCOLM COO 40.0 0.0 X 146551 0 17107 RICHARD SIMON CEO 40.0 0.0 X 223595 0 16651 GREGORY PETERS PHYSICIAN 40.0 0.0 X 289047 0 33070 DENZIL HAWKINBERRY PHYSICIAN 40.0 0.0 X 279260 0 22942 KELLY DUNAVANT PHYSICIAN 40.0 0.0 X 238870 0 24822 AIMEE WHITEHAIR PHYSICIAN 40.0 0.0 X 230000 0 11192 CHRIS KENNEDY PHYSICIAN 40.0 0.0 X 217228 0 9909 2341956 0 204746 28 false true false HIGH POINT CONSTRUCTION GROUP LLC PO BOX 577 BUCKHANNON WV 26201 CONSTRUCTION 725240 QUALITY HOME AND OFFICE CLEANING 34 BOGGESS STREET BUCKHANNON WV 26201 CLEANING 124845 2 4923989 398094 294868 5322083 NET PATIENT SERVICE REVENUE 621300 24663646 24663646 OTHER INCOME 900099 1675723 1675723 26339369 1832 1832 0 0 12750 8482 4268 0 4268 3819 449 0 0 0 0 0 0 0 0 0 0 0 31667552 26339369 3819 2281 0 0 0 0 1190362 531435 658927 0 15349955 11841706 3508249 497588 384785 112803 1647245 1254930 392315 1215944 911958 303986 0 38067 38067 109602 109602 0 0 0 1532782 84978 1447804 119576 119576 978934 490433 488501 1628375 1190139 438236 0 1001191 731765 269426 132803 132803 0 99115 99115 161143 36458 124685 0 695412 508273 187139 113076 113076 MEDICAL SUPPLIES & DRUGS 5127341 5127341 LICENSES, DUES, SUBSCRIPTIONS 88338 88338 BAD DEBT 53707 53707 31780556 23147908 8632648 0 550564 617769 450761 475613 55181 15126 1905188 1813258 0 0 0 0 0 0 640240 803650 98004 98089 10826698 4768075 6677604 6058623 0 0 0 0 0 3806 222500 222500 453832 1121766 11053874 11230200 3577215 3160565 0 0 54346 0 144784 118934 0 0 0 0 2625493 3485550 0 0 140920 70440 6542758 6835489 X 4511116 4394711 0 0 0 0 4511116 4394711 11053874 11230200 -113004 -3401 X false true X true true true X 422025 422025 4453026 1454031 2998995 3448924 1318124 2130800 2502723 1995920 506803 0 0 6058623 DUE FROM THIRD PARTY 610000 DEPOSITS 20266 OTHER RECEIVABLES 365343 CSV OF LIFE INSURANCE 126157 1121766 0 LESSOR FINANCED DEBT 70440 70440 31858604 -3401 239678 -45225 191052 31667552 31667552 31975009 239678 239678 31735331 45225 45225 31780556 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D AMOUNTS ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ (53,707) BAD DEBT EXPENSE 8,482 RENTAL EXPENSES --------- $ (45,225) SCHEDULE D, PART XII, LINE 4B AMOUNTS ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 53,707 BAD DEBT EXPENSE (8,482) RENTAL EXPENSES ---------- $ 45,225 X X X false false false false false false false false false SARAH CHOUINARD MEDICAL DIRECTOR 346914 0 0 0 0 0 10800 0 13527 0 371241 0 0 0 PATRICIA COLLETT DIRECTOR OF MEDICAL OPERATIONS 139509 0 0 0 0 0 5825 0 14860 0 160194 0 0 0 CONNIE JOHNSTON CFO 145154 0 0 0 0 0 6000 0 11107 0 162261 0 0 0 BROCK MALCOLM COO 146551 0 0 0 0 0 6000 0 11107 0 163658 0 0 0 RICHARD SIMON CEO 223595 0 0 0 0 0 9000 0 7651 0 240246 0 0 0 GREGORY PETERS PHYSICIAN 289047 0 0 0 0 0 18000 0 15070 0 322117 0 0 0 DENZIL HAWKINBERRY PHYSICIAN 279260 0 0 0 0 0 10800 0 12142 0 302202 0 0 0 KELLY DUNAVANT PHYSICIAN 238870 0 0 0 0 0 9752 0 15070 0 263692 0 0 0 AIMEE WHITEHAIR PHYSICIAN 230000 0 0 0 0 0 9200 0 1992 0 241192 0 0 0 CHRIS KENNEDY PHYSICIAN 217228 0 0 0 0 0 0 0 9909 0 227137 0 0 0 A WEST MILFORD BUILDING COMMISSION 2007-09-25 391000 CONSTRUCTION PROJECT false false false A 272066 0 391000 0 0 0 0 0 391000 0 0 0 2009 false false true true A false false false false 0 false false false false A false false true false true false 0 false 0 false false A false SCHEDULE K, PART I, LINE AB, AC ISSUER EIN AND CUSIP #: AN ATTEMPT TO DETERMINE THE ISSUER EIN AND CUSIP # OF THE WEST MILFORD BUILDING COMMISSION WAS UNSUCCESSFUL AT THE TIME OF THE 990 FILING. X 6045 294868 FMV false false false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTIONS: THE NUMBER REPORTED IN COLUMN B REPRESENTS THE NUMBER OF ITEMS CONTRIBUTED. FORM 990, PART III, LINE 1 ORGANIZATION MISSION: THIS MISSION IS ACCOMPLISHED BY PROVIDING HIGH QUALITY, ACCESSIBLE, COMPREHENSIVE, CULTURALLY APPROPRIATE, COST-EFFECTIVE HEALTHCARE SERVICES, BY SERVING AS A TRUE COMPREHENSIVE MEDICAL HOME FOR OUR PATIENTS AND CUSTOMERS, AND BY STRIVING TO FULFILL THE OBJECTIVES OF THE INSTITUTE FOR HEALTHCARE IMPROVEMENT'S TRIPLE AIM. FORM 990, PART VI, SECTION B, LINE 11B 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. ONCE THE FORM 990 IS PREPARED BY THE ACCOUNTING FIRM AND REVIEWED BY MANAGEMENT, THE FORM IS PROVIDED TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING. ANY QUESTIONS AND COMMENTS RAISED REGARDING THE FINAL FORM 990 ARE ADDRESSED AT THE FULL BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: NO MEMBER OF THE BOARD OF DIRECTORS SHALL VOTE ON ANY QUESTION IN WHICH HE/SHE IS INTERESTED OTHERWISE THAN AS A BOARD MEMBER, EXCEPT WITH REGARD TO THE ELECTION OF A PRESIDENT OR OTHER OFFICER OR EMPLOYEE, OR BE PRESENT AT THE MEETING OF THE BOARD OF DIRECTORS WHILE THE SAME IS BEING CONSIDERED; BUT IF HIS/HER RETIREMENT FROM THE BOARD IN SUCH CASES REDUCES THE NUMBER PRESENT TO LESS THAN A QUORUM, THE QUESTION MAY NEVERTHELESS BE DECIDED BY THOSE WHO REMAIN. ON ANY QUESTION, THE NAMES OF THOSE VOTING EACH WAY SHALL BE ENTERED IN THE MINUTES OF THE PROCEEDINGS, IF ANY DIRECTOR AT THE TIME REQUIRES IT. EACH BOARD MEMBER IS REQUIRED TO DISCLOSE ANY PROSPECTIVE CONFLICT OF INTEREST AND TO REFRAIN FROM ATTEMPTING TO INFLUENCE ANY CONSIDERATION OF ANY MATTER THAT WOULD CREATE A CONFLICT OF INTEREST FOR THE BOARD OR THE CORPORATION. EACH BOARD MEMBER IS ALSO REQUIRED TO REVIEW AND ACCEPT, AS A CONDITION OF ELECTION TO THE BOARD OF DIRECTORS, THE TERMS OF THE COMMUNITY CARE OF WEST VIRGINIA BOARD OF DIRECTORS CODE OF CONDUCT, AS ADOPTED BY THE CORPORATION, AND TO DISCLOSE ANY CONDITION OR SITUATION THAT EITHER WOULD CONSTITUTE A VIOLATION OF OR COULD CAUSE A VIOLATION OF ANY POLICY, PROCEDURE, RESTRICTION, OR PROHIBITION CONTAINED IN SAID CODE OF CONDUCT. CONFLICT OF INTEREST ISSUES ARE REPORTED TO THE SENIOR MANAGEMENT TEAM AND BOARD OF DIRECTORS, IF APPLICABLE. THE GOVERNING BOARD AND SENIOR MANAGEMENT ADDRESS AND MONITOR ANY ISSUES. FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION REVIEW: THE CEO'S COMPENSATION IS REVIEWED BY THE COO, THE BOARD PERSONNEL COMMITTEE AND THE FULL BOARD OF DIRECTORS USING COMPARABILITY DATA PULLED FROM FORM 990S OF SIMILAR SIZED FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS. THE COMMITTEE DOCUMENTS THE DELIBERATIONS. THE LAST REVIEW WAS CONDUCTED IN 2016. THE CEO AND BOARD PRESIDENT REVIEWS COMPENSATION OF KEY EMPLOYEES AND OTHER OFFICERS USING COMPARABILITY DATA PULLED FROM 990S OF SIMILAR SIZED FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS. THE LAST REVIEW WAS CONDUCTED IN 2015. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.