2020-05-14T14:25:06-05:00 2019-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-07-01 550599096 COMMUNITY CARE OF WEST VIRGINIA INC % CONNIE JOHNSTON CFO COMM 3049246262 PO BOX 217 ROCK CAVE WV 26234 RICK SIMON CEO 3049246262 2020-04-27 true Krystal K Creach P01248198 4178658701 167.68.126.162 43032920201355000043 2020-05-14 P 8F438207F781E16C0FE969051AA52AD6F3A8EA5F C3432A87FBFF9491E59BD7298F2E512B0D9B3700 2018 2021-01-29 14:40:06Z DBA TRI-COUNTY HEALTH CLINIC INC RICHARD SIMON PO BOX 217 ROCK CAVE WV 26234 36422594 false X CCWV.ORG 1979 WV TO PROVIDE HIGH QUALITY, ACCESSIBLE, COMPREHENSIVE AND COST-EFFECTIVE HEALTHCARE SERVICES TO OUR PATIENTS WHILE SERVING AS THEIR MEDICAL HOME. 11 11 431 13 373 5322083 5421359 26339369 30987939 1832 4296 4268 421 31667552 36414015 0 9084 0 0 19901094 20197421 0 0 0 11879462 14322439 31780556 34528944 -113004 1885071 11230200 14397573 6835489 8117791 4394711 6279782 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 27189932 9084 30987939 THE ORGANIZATION PROVIDES RURAL MEDICAL, DENTAL AND PHARMACY HEALTHCARE SERVICES TO APPROXIMATELY 44,000 PATIENTS IN BRAXTON, CLAY, HARRISON, LEWIS, POCAHONTAS, RANDOLPH AND UPSHUR COUNTIES IN WEST VIRGINIA. 27189932 true true false false false false false false false true false false true false false true false false false false false false false false false false false true true true false false false false false false false false false false true false false false false false false false false true 36 0 true 431 true false false false false false false false false false false false false X 11 11 false false true 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 VICE PRESIDENT END 12/18 1.0 0.0 X X 0 0 0 KAREN GRANT SECRETARY 1.0 0.0 X X 0 0 0 THELMA SAMPLES TREASURER; VICE PRES BEG 01/19 1.0 0.0 X X 0 0 0 GREGORY MOORE BOARD MEMBER; TREAS. BEG 01/19 1.0 0.0 X X 0 0 0 DAVID TAYLOR BOARD MEMBER 1.0 0.0 X 0 0 0 MICHELLE SAMPLES BOARD MEMBER 1.0 0.0 X 0 0 0 CHAD MORRISON BOARD MEMBER 1.0 0.0 X 0 0 0 JOYCE GIBSON BOARD MEMBER END 12/18 1.0 0.0 X 0 0 0 DAVID MALCOMB BOARD MEMBER 1.0 0.0 X 0 0 0 STEVE FLAUGHERS BOARD MEMBER BEG 01/19 1.0 0.0 X 0 0 0 KAPPY HORNER BOARD MEMBER BEG 01/19 1.0 0.0 X 0 0 0 SARINA SMITH BOARD MEMBER BEG 01/19 1.0 0.0 X 0 0 0 MARTIN BAECHTEL CIO 40.0 0.0 X 88347 0 7586 PATRICIA COLLETT DIR MED OPS/COO BEG 08/18 40.0 0.0 X 145637 0 22134 CONNIE JOHNSTON CFO 40.0 0.0 X 150154 0 18504 RICHARD SIMON CEO 40.0 0.0 X 237219 0 24000 SARAH CHOUINARD MEDICAL DIRECTOR 40.0 0.0 X 347229 0 26511 BROCK MALCOLM COO END 08/18 40.0 0.0 X 119354 0 9496 CHRISTINA GILLENWATER PHYSICIAN 40.0 0.0 X 241703 0 11659 KELLY DUNAVANT PHYSICIAN 40.0 0.0 X 245363 0 26917 BENJAMIN HINES PSYCHIATRIST 40.0 0.0 X 250705 0 8439 KEVIN JUNKINS PSYCHIATRIST 40.0 0.0 X 255820 0 1991 GREGORY PETERS PHYSICIAN 40.0 0.0 X 283503 0 28470 2365034 0 185707 42 false true false QUALITY HOME AND OFFICE CLEANING 34 BOGGESS STREET BUCKHANNON WV 26201 CLEANING 168540 1 5253473 167886 77383 5421359 NET PATIENT SERVICE REVENUE 621300 29006919 29006919 OTHER INCOME 900099 1981020 1981020 30987939 4296 4296 0 0 9000 8579 421 0 421 373 48 0 0 0 0 0 0 0 0 0 0 0 36414015 30987939 373 4344 0 9084 9084 0 0 1196171 541511 654660 0 15617120 13402491 2214629 434419 170096 264323 1706131 1167187 538944 1243580 1034672 208908 0 110003 110003 108481 108481 0 0 0 2055392 287658 1767734 24950 789 24161 1333435 985515 347920 2840478 2362425 478053 0 1074614 925820 148794 168550 69200 99350 0 96707 66912 29795 203270 143041 60229 0 635597 528087 107510 130019 130019 MEDICAL SUPPLIES & DRUGS 5410674 5410674 LICENSES, DUES, SUBSCRIPTIONS 90752 45253 45499 BAD DEBT 39517 39517 34528944 27189932 7339012 0 617769 1543218 475613 671166 15126 60796 1813258 2397319 0 0 0 0 0 0 803650 1094829 98089 133625 10997702 5365721 6058623 5631981 0 0 0 0 3806 6598 222500 200250 1121766 2657791 11230200 14397573 3160565 4717464 0 0 0 19586 118934 92615 0 0 0 0 3485550 3288126 0 0 70440 0 6835489 8117791 X 4394711 6279782 0 0 0 0 4394711 6279782 11230200 14397573 1885071 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 422025 422025 4453026 1506044 2946982 3486024 1318124 2167900 2614223 2541553 72670 22404 22404 5631981 DUE FROM THIRD PARTY 1020000 DEPOSITS 20266 OTHER RECEIVABLE 1617525 2657791 36699706 316629 -30938 285691 36414015 36414015 34814635 316629 316629 34498006 30938 30938 34528944 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: $ (39,517) BAD DEBT EXPENSE 8,579 RENTAL EXPENSE ---------- $ (30,938) SCHEDULE D, PART XII, LINE 4B AMOUNTS ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 39,517 BAD DEBT EXPENSE ( 8,579) RENTAL EXPENSE ---------- & 30,938 true PATIENT ASSISTANCE PROGRAM 24 9084 SCHEDULE I, PART I, LINE 2 MONITORING USE OF GRANT FUNDS: THE PATIENT MUST BE ELIGIBLE FOR SLIDING FEE IN ORDER TO BE ELIGIBLE FOR KV GRANT ASSISTANCE. THE PATIENT REQUESTS ASSISTANCE THROUGH THEIR MEDICAL PROVIDER, WHO THEN REFERS THE PATIENT FOR ELIGIBILITY REVIEW FOR THE PROGRAM ASSISTANCE. THE FUNDS ARE AVAILABLE ON A FIRST COME, FIRST SERVE BASIS. FOR UTILITY ASSISTANCE, A COPY OF THE PATIENT'S APPROVED SLIDING FEE APPLICATION AND COPY OF THE UTILITY BILL ARE FORWARDED TO THE ACCOUNTING DEPARTMENT WHERE A CHECK IS CUT DIRECTLY TO THE UTILITY COMPANY. FOR PRESCRIPTION ASSISTANCE, THE MEDICAL PROVIDER SENDS A COPY OF THE PATIENT'S APPROVED SLIDING FEE PROGRAM APPROVAL FORM THAT INCLUDES BEGINNING AND ENDING DATES TO THE PHARMACY. THE PHARMACY SCANS THE INFORMATION INTO THE PATIENT'S ELECTRONIC PHARMACY RECORD. X X X X false false false false false false false false false PATRICIA COLLETT DIR MED OPS/COO BEG 08/18 145637 0 0 0 0 0 5427 0 16707 0 167771 0 0 0 CONNIE JOHNSTON CFO 150154 0 0 0 0 0 6203 0 12301 0 168658 0 0 0 RICHARD SIMON CEO 237219 0 0 0 0 0 9600 0 14400 0 261219 0 0 0 SARAH CHOUINARD MEDICAL DIRECTOR 347229 0 0 0 0 0 14000 0 12511 0 373740 0 0 0 CHRISTINA GILLENWATER PHYSICIAN 241703 0 0 0 0 0 9668 0 1991 0 253362 0 0 0 KELLY DUNAVANT PHYSICIAN 245363 0 0 0 0 0 10000 0 16917 0 272280 0 0 0 BENJAMIN HINES PSYCHIATRIST 250705 0 0 0 0 0 0 0 8439 0 259144 0 0 0 KEVIN JUNKINS PSYCHIATRIST 255820 0 0 0 0 0 0 0 1991 0 257811 0 0 0 GREGORY PETERS PHYSICIAN 283503 0 0 0 0 0 11553 0 16917 0 311973 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 4562 77383 FMV false false false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTORS: 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. THE TRIPLE AIM SIMULTANEOUSLY SEEKS TO ACCOMPLISH THESE THREE (3) OBJECTIVES: (1) IMPROVING THE HEALTH OF POPULATIONS; (2) IMPROVING THE PATIENT EXPERIENCE OF CARE (INCLUDING QUALITY AND SATISFACTION); AND (3) REDUCING THE PER CAPITA COST OF HEALTHCARE SERVICES. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO THE GOVERNING DOCUMENTS: THE BYLAWS OF THE ORGANIZATION WERE UPDATE TO STATE THE FOLLOWING: SECTION 3. MISSION STATEMENT. THE MISSION OF COMMUNITY CARE OF WEST VIRGINIA, INC. SHALL BE "TO HELP OUR COMMUNITIES LIVE THE HEALTHIEST LIVES POSSIBLE BY MEETING THEIR IMMEDIATE AND LONG-TERM HEALTHCARE NEEDS." THIS MISSION SHALL BE 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. THE TRIPLE AIM SIMULTANEOUSLY SEEKS TO ACCOMPLISH THESE THREE (3) OBJECTIVES: (1) IMPROVING THE HEALTH OF POPULATIONS; (2) IMPROVING THE PATIENT EXPERIENCE OF CARE (INCLUDING QUALITY AND SATISFACTION); AND (3) REDUCNG THE PER CAPITA COST OF HEALTHCARE SERVICES. SECTION 5. DISSOLUTION. UPON THE DISSOLUTION OF THE CORPORATION AND ITS BOARD OF DIRECTORS, THE CORPORATION'S ASSETS SHALL BE DISTRIBUTED FOR ONE OR MORE EXEMPT PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, OR THE CORRESPONDING SECTION OF ANY FUTURE FEDERAL TAX CODE, OR SHALL BE DISTRIBUTED TO THE FEDERAL GOVERNMENT, OR TO A STATE OR LOCAL GOVERNMENT, FOR A PUBLIC PURPOSE. ANY SUCH ASSETS NOT DISPOSED OF SHALL BE DISPOSED OF BY A COURT OF COMPETENT JURISDICTION OF THE COUNTY IN WHICH THE PRINCIPAL OFFICE OF THE OF THE CORPORATION IS THEN LOCATED, EXCLUSIVELY OF SUCH PURPOSES OR TO SUCH ORGANIZATION, AS SAID COURT SHALL DETERMINE, WHICH ARE ORGANIZED AND OPERATED EXCLUSIVELY FOR SUCH PURPOSES. 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 PROCEDINGS, IF ANY DIRECTOR AY 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 OF 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 DURING CONTRACT RENEWAL USING COMPARABILITY DATA PULLED FROM FORMS 990S OF SIMILAR SIZED FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS. THE COMMITTEE DOCUMENTS THE DELIBERATIONS. THE LAST REVIEW WAS CONDUCTED IN 2019. THE CEO AND BOARD PRESIDENT REVIEWS COMPENSATION OF KEY EMPLOYEES AND OTHER OFFICERS DURING CONTRACT RENEWAL USING COMPARABILITY DATA PULLED FORM 990S OF SIMILAR SIZED FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS. THE LAST REVIEW WAS CONDUCTED IN 2019. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.