2021-05-17T13:18:58-05:00 2020-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2019-07-01 550599096 COMMUNITY CARE OF WEST VIRGINIA INC % CONNIE JOHNSTON CFO COMM 3049246262 PO BOX 217 ROCK CAVE WV 26234 RICHARD SIMON CEO 3049246262 2021-04-30 true Krystal K Creach P01248198 4178658701 2019 2022-09-23 18:48:47Z DBA TRI-COUNTY HEALTH CLINIC INC RICHARD SIMON PO BOX 217 ROCK CAVE WV 26234 42661171 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. 12 12 431 11 421 5421359 8501917 30987939 34146962 4296 3292 421 479 36414015 42652650 9084 54330 0 0 20197421 22448953 0 0 0 14322439 17079798 34528944 39583081 1885071 3069569 14397573 27084717 8117791 17735366 6279782 9349351 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 32235099 54330 34146962 THE ORGANIZATION PROVIDES RURAL MEDICAL, DENTAL AND PHARMACY HEALTHCARE SERVICES TO APPROXIMATELY 43,000 PATIENTS IN BRAXTON, CLAY, HARRISON, LEWIS, POCAHONTAS, RANDOLPH AND UPSHUR COUNTIES IN WEST VIRGINIA. 32235099 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 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 12 12 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 RICHARD SIMON CEO 40.0 0.0 X 237219 0 165199 SARAH CHOUINARD MEDICAL DIRECTOR 40.0 0.0 X 347229 0 16772 GREGORY PETERS PHYSICIAN 40.0 0.0 X 288114 0 16875 KEVIN JUNKINS PSYCHIATRIST 40.0 0.0 X 256211 0 391 BENJAMIN HINES PSYCHIATRIST 40.0 0.0 X 251951 0 1246 KELLY DUNAVANT PHYSICIAN 40.0 0.0 X 231501 0 14637 CHRISTINA GILLENWATER PHYSICIAN 40.0 0.0 X 222703 0 9668 CONNIE JOHNSTON CFO 40.0 0.0 X 150154 0 11118 PATRICIA COLLETT COO 40.0 0.0 X 145638 0 14859 MARTIN BAECHTEL CIO 40.0 0.0 X 88347 0 3653 TOM LYNCH PRESIDENT 1.0 0.0 X X 0 0 0 GREG MOORE TREAS/VICE PRESIDENT BEG 01/20 1.0 0.0 X X 0 0 0 KAPPY HORNER MEMBER/SECRETARY BEG 01/20 1.0 0.0 X X 0 0 0 SARINA SMITH MEMBER/TREASURER BEG 01/20 1.0 0.0 X X 0 0 0 STEVE FLAUGHERS BOARD MEMBER 1.0 0.0 X 0 0 0 DAVID MALCOMB BOARD MEMBER 1.0 0.0 X 0 0 0 J CHAD MORRISON BOARD MEMBER 1.0 0.0 X 0 0 0 SELAH RAINES BOARD MEMBER BEG 02/20 1.0 0.0 X 0 0 0 MICHELLE SAMPLES BOARD MEMBER 1.0 0.0 X 0 0 0 ROSEMARY THOMAS BOARD MEMBER BEG 02/20 1.0 0.0 X 0 0 0 DAVID TAYLOR BOARD MEMBER 1.0 0.0 X 0 0 0 JAMES ESTEP BOARD MEMBER BEG 04/20 1.0 0.0 X 0 0 0 KAREN GRANTS SECRETARY END 12/19 1.0 0.0 X 0 0 0 THELMA SAMPLES VICE PRESIDENT END 12/19 1.0 0.0 X 0 0 0 2219067 0 254418 41 false true false QUALITY HOME AND OFFICE CLEANING L 34 BOGGESS STREET BUCKHANNON WV 26201 CLEANING 168540 1 8260341 241576 93388 8501917 NET PATIENT SERVICE REVENUE 621300 31995101 31995101 OTHER INCOME 900099 2151861 2151861 34146962 3292 3292 0 0 9000 8521 479 0 479 421 58 0 0 0 0 0 0 0 0 0 0 0 42652650 34146962 421 3350 0 54330 54330 0 0 1180188 524498 655690 0 17757525 15083613 2673912 170773 170773 1959262 1362111 597151 1381205 957331 423874 0 157680 157680 103956 103956 0 0 0 2033601 1485107 548494 216379 216379 1068787 751999 316788 3128736 2286647 842089 0 1156425 845226 311199 142548 104188 38360 0 97169 67000 30169 189807 137701 52106 0 651797 475427 176370 154122 154122 BAD DEBT 713894 713894 MEDICAL SUPPLIES & DRUGS 7176381 7176381 LICENSES, DUES, SUBSCRIPTIONS 88516 38873 49643 39583081 32235099 7347982 0 1543218 10093954 671166 587860 60796 690490 2397319 3249500 0 0 0 0 0 0 1094829 1272477 133625 160380 11975598 5985939 5631981 5989659 0 0 0 0 6598 14432 200250 178000 2657791 4847965 14397573 27084717 4717464 7052794 0 0 19586 6985548 92615 65893 0 0 0 0 3288126 3232725 0 125000 0 273406 8117791 17735366 X 6279782 9349351 0 0 6279782 9349351 14397573 27084717 3069569 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 577025 577025 4703026 1789544 2913482 3877618 1724342 2153276 2817929 2472053 345876 5989659 DUE FROM THIRD PARTY 1687579 DEPOSITS 18901 OTHER RECEIVABLE 3141485 4847965 0 LESSOR FINANCED DEBT 273406 273406 42268676 321399 -705373 -383974 42652650 42652650 39199107 321399 321399 38877708 705373 705373 39583081 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: $ (713,894) BAD DEBT EXPENSE 8,521 RENTAL EXPENSE ----------- $ (705,373) SCHEDULE D, PART XII, LINE 4B AMOUNTS ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 713,894 BAD DEBT EXPENSE ( 8,521) RENTAL EXPENSE ---------- $ 705,373 PATIENT ASSISTANCE PROGRAM 316 54330 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. FOR PRODUCE ASSISTANCE, EACH PATIENT IS ALREADY SCREENED FOR FOOD SECURITY DURING VISITS. PATIENTS WITH INSECURITY WERE GIVEN $50 VOUCHERS TO VISIT THE SMALL TOWN MARKET IN CLAY COUNTY AT THEIR VISITS. SMALL TOWN MARKET REMITTED COPIES OF USED VOUCHERS BACK TO THE ORGANIZATION FOR RECORD. FARMACY - PATIENTS WITH POORLY CONTROLLED DIABETES (A1C OVER 7) AND WHO ENDORSED FOOD INSECURITY AS AN ISSUE WERE IDENTIFIED AND ENROLLED IN THE PROGRAM. THE ORGANIZATION KEPT DOCUMENTATION OF VISITS, PICKUPS, AND RELATED HEALTH SCREENING FOR THE PROGRAM WERE KEPT. FARMERS TO FAMILIES - PROVIDERS IN CLINICS WERE ASKED TO COMPILE LISTS PATIENTS THAT HAD LACK OF ACCESS TO PRODUCE WITH A CONCENTRATION ON THOSE WITH DIABETES, AND BOXES WERE DISTRIBUTED TO THE 120 PERSON LIST WEEKLY. THE ORGANIZATION KEPT RECORD OF SCHEDULED DELIVERIES, AND PATIENT LISTS. X X X X false false false false false false false false SARAH CHOUINARD MEDICAL DIRECTOR 347229 0 0 0 0 0 14000 0 2772 0 364001 0 0 0 PATRICIA COLLETT COO 145638 0 0 0 0 0 5427 0 9432 0 160497 0 0 0 CONNIE JOHNSTON CFO 150154 0 0 0 0 0 6203 0 4915 0 161272 0 0 0 RICHARD SIMON CEO 237219 0 0 0 0 0 162418 0 2781 0 402418 0 0 0 KELLY DUNAVANT PHYSICIAN 231501 0 0 0 0 0 10000 0 4637 0 246138 0 0 0 CHRISTINA GILLENWATER PHYSICIAN 222703 0 0 0 0 0 9668 0 0 0 232371 0 0 0 BENJAMIN HINES PSYCHIATRIST 251951 0 0 0 0 0 0 0 1246 0 253197 0 0 0 KEVIN JUNKINS PSYCHIATRIST 256211 0 0 0 0 0 0 0 391 0 256602 0 0 0 GREGORY PETERS PHYSICIAN 288114 0 0 0 0 0 11553 0 5322 0 304989 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 720 21600 FMV X 2500 71788 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 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. CONFLICT OF INTEREST ISSUES ARE REPORTED TO THE SENIOR MANAGEMENT TEAM0. FORM 990, PART VI, SECTION B, LINES 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 2020. 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 2020. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.