2022-05-10T09:21:42-05:00 2021-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2020-07-01 550599096 COMMUNITY CARE OF WEST VIRGINIA INC % CONNIE JOHNSTON CFO COMM 3049246262 PO BOX 217 ROCK CAVE WV 26234 RICHARD SIMON CEO 3049246262 2022-05-16 true RICHARD SIMON 999009999 Krystal K Creach P01248198 4178658701 3 2020 2022-09-23 18:48:47Z DBA TRI-COUNTY HEALTH CLINIC INC RICHARD SIMON PO BOX 217 ROCK CAVE WV 26234 51984280 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. 10 10 466 11 730 0 5020717 16396174 34704239 35577722 3292 1384 479 844 39728727 51976124 54330 66943 0 0 22448953 27050374 0 0 0 17079798 18833037 39583081 45950354 145646 6025770 27641994 25800917 21216566 13349719 6425428 12451198 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 35715935 66943 35577722 THE ORGANIZATION PROVIDES RURAL MEDICAL, DENTAL AND PHARMACY HEALTHCARE SERVICES TO APPROXIMATELY 48,000 PATIENTS IN BRAXTON, CLAY, HARRISON, LEWIS, POCAHONTAS, RANDOLPH AND UPSHUR COUNTIES IN WEST VIRGINIA. 35715935 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 31 0 true 466 true false false false false false false false false false false false false X 10 10 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 SARAH CHOUINARD MEDICAL DIRECTOR 40.0 0.0 X 329530 0 13970 GREGORY PETERS PHYSICIAN 40.0 0.0 X 277471 0 16485 KEVIN JUNKINS PSYCHIATRIST 40.0 0.0 X 273742 0 391 KIMBERLY BECHER PHYSICIAN 40.0 0.0 X 245833 0 13027 RICHARD SIMON CEO 40.0 0.0 X 214167 0 37397 KELLY DUNAVANT PHYSICIAN 40.0 0.0 X 227643 0 14521 BENJAMIN HINES PSYCHIATRIST 40.0 0.0 X 236524 0 1249 PATRICIA COLLETT COO 40.0 0.0 X 153972 0 14479 CONNIE JOHNSTON CFO 40.0 0.0 X 144471 0 12293 MARTIN BAECHTEL CIO END 05/21 40.0 0.0 X 89211 0 4389 JOHN MEURER CIO BEG 05/21 40.0 0.0 X 61929 0 5282 ROSEMARY THOMAS BOARD MBR/PRESIDENT BEG 01/21 1.0 0.0 X X 0 0 0 KAPPY HORNER SECRETARY/VICE PRES BEG 01/21 1.0 0.0 X X 0 0 0 MICHELLE SAMPLES BOARD MBR/SECRETARY BEG 01/21 1.0 0.0 X X 0 0 0 JAMES ESTEP BOARD MBR/TREASURER BEG 01/21 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 1.0 0.0 X 0 0 0 SARINA SMITH TREASURER END 01/21; BOARD MBR 1.0 0.0 X X 0 0 0 DAVID TAYLOR BOARD MEMBER 1.0 0.0 X 0 0 0 TOM LYNCH PRESIDENT END 01/21 1.0 0.0 X X 0 0 0 GREG MOORE VICE PRESIDENT END 01/21 1.0 0.0 X X 0 0 0 2254493 0 133483 38 false true false QUALITY HOME AND OFFICE CLEANING L 34 BOGGESS STREET BUCKHANNON WV 26201 CLEANING 245162 BKD LLP 910 E ST LOUIS STREET SUITE 200 SPRINGFIELD MO 65801 AUDIT, TAX, COST 111661 2 16095090 301084 79381 16396174 NET PATIENT SERVICE REVENUE 621300 33460110 33460110 OTHER INCOME 900099 2117612 2117612 35577722 1384 1384 0 0 9000 8156 844 0 844 730 114 0 0 0 0 0 0 0 0 0 0 0 51976124 35577722 730 1498 0 66943 66943 0 0 1081090 511951 569139 0 21609163 17728878 3880285 336179 257974 78205 2369296 1475364 893932 1654646 1349386 305260 0 148948 148948 172570 172570 0 0 0 2478590 256485 2222105 214136 5877 208259 1346047 909356 436691 2862231 2305093 557138 0 1251669 943137 308532 0 139767 63049 76718 0 176621 153987 22634 206470 165428 41042 0 511533 410946 100587 186543 186543 MEDICAL SUPPLIES & DRUGS 9056804 9056804 LICENSES, DUES, SUBSCRIPTIONS 81108 55277 25831 45950354 35715935 10234419 0 10093954 7020498 587860 687736 690490 1693318 3249500 3532465 0 0 0 0 0 0 1272477 1203498 160380 284865 12651936 6384105 5989659 6267831 0 0 0 0 14432 21472 178000 155750 5405242 4933484 27641994 25800917 7052794 6382654 0 0 6985548 43725 65893 38119 0 0 0 0 6713925 6548915 125000 100000 273406 236306 21216566 13349719 X 6425428 12451198 0 0 6425428 12451198 27641994 25800917 6025770 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 577025 577025 4703026 1863957 2839069 4396959 1875445 2521514 2895110 2644703 250407 79816 79816 6267831 DUE FROM THIRD PARTY 1985000 DEPOSITS 18901 OTHER RECEIVABLE 2929583 4933484 0 LESSOR FINANCED DEBT 236306 236306 52316118 331838 331838 51984280 -8156 -8156 51976124 46290348 331838 8156 339994 45950354 45950354 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 4B AMOUNTS ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (8,412) RENTAL EXPENSE SCHEDULE D, PART XII, LINE 2D AMOUNTS ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 8,412 RENTAL EXPENSE PATIENT ASSISTANCE PROGRAM 96 66944 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 RENT & MORTGAGE ASSISTANCE, THE PATIENT MUST MEET INCOME LIMITS, COMPLETE A SLIDING FEE APPLICATION, AND BE A PATIENT OF COMMUNITY CARE OF WEST VIRGINIA. X X X X false false false false false false false false RICHARD SIMON CEO 214167 0 0 0 0 0 34664 0 2733 0 251564 0 0 0 PATRICIA COLLETT COO 153972 0 0 0 0 0 6117 0 8362 0 168451 0 0 0 CONNIE JOHNSTON CFO 144471 0 0 0 0 0 6779 0 5514 0 156764 0 0 0 SARAH CHOUINARD MEDICAL DIRECTOR 329530 0 0 0 0 0 11400 0 2570 0 343500 0 0 0 KEVIN JUNKINS PSYCHIATRIST 273742 0 0 0 0 0 0 0 391 0 274133 0 0 0 GREGORY PETERS PHYSICIAN 277471 0 0 0 0 0 11306 0 5179 0 293956 0 0 0 KELLY DUNAVANT PHYSICIAN 227643 0 0 0 0 0 10064 0 4457 0 242164 0 0 0 KIMBERLY BECHER PHYSICIAN 245833 0 0 0 0 0 10675 0 2352 0 258860 0 0 0 BENJAMIN HINES PSYCHIATRIST 236524 0 0 0 0 0 0 0 1249 0 237773 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 51 79381 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 MED 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 GOVERNING DOCUMENTS: THE DUTIES OF THE BOARD OF DIRECTORS WAS AMENDED TO INCLUDE APPROVING THE LOCATION OF HEALTH CENTER SITES AND ENSURING THE HEALTH CENTER OPERATES IN COMPLIANCE WITH APPLICABLE FEDERAL, STATE, AND LOCAL LAWS AND REGULATIONS. 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 TEAM. 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