2023-09-20T12:14:08-05:00 2022-12-31 390859910 BAKER TILLY US LLP PO BOX 908 BRIDGEPORT WV 26330 990 2022-01-01 550768457 SUSAN DEW HOFF MEMORIAL CLINIC INC SUSA 3047453700 623 LIBERTY AVENUE WEST MILFORD WV 26451 DR JD HISSEM EXECUTIVE DIRECTOR 3047453700 2023-08-28 1 DR JD HISSEM 999009999 0 WILLIAM H PHILLIPS CPA P00197505 3046245471 2023-08-28 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SUSAN DEW HOFF MEMORIAL CLINIC DR JD HISSEM 623 LIBERTY AVENUE WEST MILFORD WV 26451 377259 0 X N/A X OTHER 1999 WV PROVIDE HEALTH AND DENTAL CARE TO THE UNINSURED WORKING POOR. 26 26 2 26 0 0 486375 376039 0 0 12827 1220 0 0 499202 377259 0 0 0 0 80423 79210 0 0 0 422343 334718 502766 413928 -3564 -36669 642218 604355 5586 4393 636632 599962 TO PROVIDE HEALTH ASSESSMENT, PROMOTION AND REFERRAL SERVICES TO THE WORKING POOR WHO LACK MEDICAL AND DENTAL INSURANCE. 0 0 344484 0 IN 2022, THE CLINIC HELD 73 CLINICS AND SAW 732 PATIENTS. WE PERFORMED 1,127 PROCEDURES, WHICH INCLUDED: 397 X-RAYS, 95 CLEANINGS, 397 FILLINGS, FASHIONED 12 FULL DENTURES AND 8 PARTIALS, 21 REPAIR/RELINES, 161 EXTRACTIONS, 20 ROOT CANALS, 11 CROWNS, 5 REFERRALS TO AN ORAL SURGEON AND 224 REFERRALS TO OUR CONTRACTED OUTSIDE DENTIST. INCLUDED IN THIS WAS SERVICE TO 93 NEW PATIENTS AND 106 VETERAN VISITS, THOSE WHO NO LONGER QUALIFY FOR CARE AT THE LOCAL VA HOSPITAL. 344484 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 2 1 0 0 0 0 0 0 0 0 0 0 X 26 26 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 WV X X SUSAN DEW HOFF MEMORIAL CLINIC INC 3047453700 623 LIBERTY STREET WEST MILFORD WV 26451 X GINA SHARPS DIRECTOR 1.00 X 0 0 0 BERNICE JEAN LUCAS DIRECTOR 1.00 X 0 0 0 MARY LOU VARGO DIRECTOR 1.00 X 0 0 0 DR ROBERT WRANKER DDS DIRECTOR 1.00 X 0 0 0 FRANK NUZUM DIRECTOR 1.00 X 0 0 0 DR MARY BETH HINKLE DDS DIRECTOR 1.00 X 0 0 0 DR ANDREW MINIGH DDS DIRECTOR 1.00 X 0 0 0 LADONNE WETZEL DIRECTOR 1.00 X 0 0 0 GARY WETZEL DIRECTOR 1.00 X 0 0 0 SANDRA MANO DIRECTOR 1.00 X 0 0 0 DR MARK SPIKER DDS DIRECTOR 1.00 X 0 0 0 ANDY WHARTON DIRECTOR 1.00 X 0 0 0 CECILIA REID DIRECTOR 1.00 X 0 0 0 BEVERLY TALBERT DIRECTOR 1.00 X 0 0 0 JOELLEN KEMMNER CHAIR 4.00 X X 0 0 0 TODD SOMMERS DIRECTOR 1.00 X 0 0 0 LOU ORTENZIO DIRECTOR 1.00 X 0 0 0 VIRGIL SMITH DIRECTOR 1.00 X 0 0 0 DR LAURA GRAVES DDS DIRECTOR 1.00 X 0 0 0 SUSAN FORD DRECTOR 1.00 X 0 0 0 BONNIE STARKEY DIRECTOR 1.00 X 0 0 0 SISTER MARY REBECCA FIDLER RSM MD CEO 5.00 X 0 0 0 DR JD HISSEM DDS EXECUTIVE DIRECTOR 10.00 X 0 0 0 DR RICHARD MECKSTROTH DDS VICE-CHAIR 4.00 X 0 0 0 TERRY WAXMAN SECRETARY 4.00 X 0 0 0 BARBARA PRINCE TREASURER 4.00 X 0 0 0 0 0 0 0 0 0 0 0 50696 325343 376039 1220 1220 377259 0 0 1220 73520 26380 47140 5690 2042 3648 9125 9125 2213 2213 30413 26621 3792 1402 1402 10683 10683 CONTRACT SERVICES 270008 270008 DENTAL SUPPLIES 7348 7348 OTHER EXPENSES 3526 3526 413928 344484 69444 0 259991 223035 368588 368901 6843 7025 57079 51685 6796 5394 642218 604355 5586 4393 5586 4393 X 636632 599962 636632 599962 642218 604355 X -36669 -1 X X 0 0 0 X 331104 375267 322963 486375 376040 1891749 331104 375267 322963 486375 376040 1891749 1891749 6379 7182 10146 12827 1220 37754 1929503 0.98040 0.97160 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6647 4578 2069 50432 47107 3325 5394 X 377259 0 377259 0 377259 413928 0 413928 0 413928 PART X, LINE 2: INCOME TAXES: THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND IS RECOGNIZED AS TAX EXEMPT UNDER 501(A) OF THE CODE. IN ADDITION, THE ORGANIZATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ENTITY THAT IS NOT A PRIVATE FOUNDATION UNDER 509(A)(1). THE ORGANIZATION HAD NO UNRELATED BUSINESS INCOME DURING THE YEARS ENDED DECEMBER 31, 2021 AND 2020. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE ORGANIZATION TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY OR ASSET IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICES (IRS). THE ORGANIZATION HAS CONCLUDED THAT AS OF DECEMBER 31, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR ASSET OR DISCLOSURE IN THE FINANCIAL STATEMENTS. GENERALLY, TAX RETURNS FOR YEARS ENDED DECEMBER 31, 2018, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD MEMBERS ARE PROVIDED A COPY OF THE 990 AND IT IS REVIEWED AT BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE CLINIC ENFORCES AN ANNUAL DISCLOSURE REQUIREMENT WITH ITS CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE CLINIC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: ROUNDING -1. FORM 990, PART XI, LINE 2C THE ORGANIZATION HAS A COMMITEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS. THE SELECTION PROCESS FOR CHOOSING AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PREVIOUS YEAR.