2023-11-01T08:34:46-05:00 2022-12-31 390859910 BAKER TILLY US LLP 101 WASHINGTON STREET EAST CHARLESTON WV 25301 990 2022-01-01 550329724 ELKINS REGIONAL CONVALESCENT CENTER INC ELKI 3046361391 1175 BEVERLY PIKE ELKINS WV 26241 TARA SHAVER ADMINISTRATOR 3046361391 2023-10-26 1 TARA SHAVER 999009999 0 DOLORES ROSE P01286262 3043460441 2023-10-26 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ELKINS REHABILITATION AND CARE CENTER TARA SHAVER 1175 BEVERLY PIKE ELKINS WV 26241 18236968 0 X WWW.ERCC.BIZ X 1953 WV PROVIDES SUPERIOR, PERSONALIZED HEALTH CARE IN AN OPEN AND FRIENDLY SETTING. 15 15 352 7 0 0 1000030 332576 15609442 17718791 124464 97403 78498 7725 16812434 18156495 8418 2873 0 0 8799783 9817948 0 0 0 7414620 8129149 16222821 17949970 589613 206525 19210570 18731278 11074639 10474818 8135931 8256460 X WE ARE COMMITTED TO PROVIDING EACH RESIDENT WITH SUPERIOR, PERSONALIZED HEALTH CARE IN AN OPEN AND FRIENDLY SETTING THAT WELCOMES FAMILY PARTICIPATION. 0 0 9657890 2873 10099205 INTERMEDIATE CARE- THE ORGANIZATION IS A 111 BED, DUALLY-CERTIFIED NURSING HOME, PROVIDING 24-HOUR INTERMEDIATE CARE TO RESIDENTS OF THE COMMUNITY AND SURROUNDING COUNTIES. THE ORGANIZATION EMPLOYS OVER 150 EMPLOYEES, WHO ARE INVOLVED IN THE COMMUNITY PROGRAMS HELPING TO PROMOTE CARE FOR THE ELDERLY AND THOSE WITH EXTENDED CARE NEEDS. 1110097 1532312 SKILLED CARE- THE ORGANIZATION'S NURSING STAFF INCLUDES MORE THAN 75 PROFESSIONALS WHO WORK WITH PHYSICIANS TO PROVIDE A FULL RANGE OF SKILLED AN DAILY CARE. THE ORGANIZATION PROVIDES 24-HOUR SKILLED CARE TO RESIDENTS OF THE COMMUNITY AND SURROUNDING COUNTIES. CURRENTLY, THE ORGANIZATION IS THE ONLY NURSING HOME IN RANDOLPH COUNTY THAT ACCEPTS SKILLED MEDICARE RESIDENTS. THE ORGANIZATION PROVIDES RESIDENTS WITH IV THERAPIES, FEEDING TUBES, CATHETERS, WOUND CARE, VACCINATIONS OR OTHER TREATMENTS AND DAILY LIVING SUCH AS EATING, DRESSING AND BATHING. 738578 3334821 REHABILITATION- THE OUTPATIENT DEPARTMENT CONTINUES ITS SERVICES TO ASSIST THE RESIDENTS AND OUTPATIENTS WITH ISSUES OF INCONTINENCE AND TO PROVIDE SERVICES SUCH AS E-STIM AND NAUTILUS EQUIPMENT TO IMPROVE BALANCE, GAIT AND STRENGTH. THE ORGANIZATION USES A MEDICAL RECORDS SYSTEM WHICH ELECTRONCIALLY RECORDS DOCUMENTATION OF DIRECT PATIENT CARE BY THE CERTIFIED NURSING AIDES TO BETTER BENEFIT THE RESIDENTS AND STAFF. THE ACTIVITIES DEPARTMENT HAS CONTINUED TO INCREASE INVOLVEMENT OF THE RESIDENTS IN COMMUNITY ACTIVITIES SUCH AS ATTENDING CONCERTS AT THE LOCAL COMMUNITY ARTS CENTER, THE FOREST FESTIVAL PARADE, ARTS AND CRAFTS SHOW, SYMPHONY CONCERT, TRAIN RIDES ON THE LOCAL TRAIN SERVICE, AND LOCAL HIGH SCHOOL SPORTING EVENTS. THE ORGANIZATION PROVIDES PET THERAPY FOR RESIDENTS AS WELL AS ALLOWS A LOCAL BOY'S SCHOOL TO VISIT WEEKLY TO PLAY BOARD GAMES AND BINGO WITH RESIDENTS. 2901471 2779821 THE STAFF PARTICIPATES IN LOCAL HEALTH FAIRS, RELAY FOR LIFE, ALZHEIMER'S WALK, RECRUITMENT FAIRS AT LOCAL COLLEGES, AND VARIOUS CIVIC ORGANIZATIONS SUCH AS ROTARY, WOMAN'S CLUB, WV CENTER FOR NURSING, WV HEALTH CARE ASSOCIATION, ETC. 2901471 2779821 14408036 1 1 0 1 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 44 0 352 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 1 0 X BETSY L JONES CFO 3046361391 1175 BEVERLY PIKE ELKINS WV 26241 ROBERT WILMOTH CHAIRPERSON 1.00 X X 0 0 0 MARK TOMBLYN VICE CHAIRPERSON 1.00 X X 0 0 0 WILLIAM RIFFEE UNTIL XXXXX SECRETARY 1.00 X X 0 0 0 RAYMOND GODWIN TREASURER 1.00 X X 0 0 0 DENA COLLETT MEMBER 1.00 1.00 X 0 0 0 ROBERT J PHILLIPS MEMBER 1.00 X 0 0 0 MATT DAVIS MEMBER 1.00 1.00 X 0 0 0 TERRI PHIPPS MEMBER 1.00 X 0 0 0 SANDRA ELZA MEMBER 1.00 1.00 X 0 0 0 KURT GAINER UNTIL XXXXXX MEMBER 1.00 X 0 0 0 CHAD SHOEMAKER MEMBER 1.00 X 0 0 0 R HEATHER HALL MEMBER 1.00 X 0 0 0 HERK KESSLER MEMBER 1.00 X 0 0 0 ROBBIE MORRIS MEMBER 1.00 X 0 0 0 TARA SHAVER ADMINISTRATOR 40.00 X 133974 0 31384 BETSY JONES CFO 40.00 X 89835 0 40257 CHRISTINA KITTLE EXECUTIVE DIRECTOR 40.00 X 118467 0 4182 342276 0 75823 2 0 1 0 ODYSSEY REHABILITATION 415 BENEDUM DRIVE BRIDGEPORT WV 26330 THERAPY SERVICES 1218491 LRS HEALTH (LAWRENCE RECRUITING SPECIALI PO BOX 850781 MINNEAPOLIS MN 554850781 NURSING SERVICES 497889 MLK STAFFING PO BOX 219081 KANSAS CITY MO 64121 NURSING SERVICES 311473 PRIME TIME HEALTH LLC 15380 WEIR ST OMAHA NE 68137 NURSING SERVICES 240746 THE CHIPS NETWORK 12978 GARRETT HWY SUITE 200 OAKLAND MD 21550 IT SPECIALIST 209078 6 329595 2981 332576 SKILLED/INTERMEDIATE CARE 623000 14662253 14662253 ASSISTED LIVING 623000 3056538 3056538 17718791 98697 98697 1294 -1294 -1294 -1294 59536 79179 -19643 -19643 OTHER REVENUE 900099 27368 27368 27368 18156495 17746159 0 77760 X 2873 2873 418099 327874 90225 7016673 5502475 1514198 9239 7245 1994 2373937 1861642 512295 52334 52334 93554 93554 2082670 1633230 449440 80522 63145 17377 119611 93799 25812 253273 198617 54656 347553 272551 75002 16059 12593 3466 411648 322814 88834 708942 555952 152990 468513 367408 101105 MEDICAL SUPPLIES 904164 904164 COVID-19 EXPENES 705634 553358 152276 PROVIDER TAXES 674511 674511 FOOD EXPENSES 488825 488825 721336 564960 156376 17949970 14408036 3541934 0 736303 486561 2876089 2919820 732790 1499721 39721 37066 543924 378003 19929596 9486781 9909113 10442815 963176 617818 2758723 2300440 650731 49034 19210570 18731278 1557455 1316693 9517184 9158125 11074639 10474818 X 8135931 8256460 8135931 8256460 19210570 18731278 206525 -85996 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1850 1850 0 PART II-B, LINE 1: THE ORGANIZATION PAYS DUES TO THE WEST VIRGINIA HEALTH CARE ASSOCIATION (WVHCA) AND THE AMERICAN HEALTH CARE ASSOCIATION (AHCA). WVHCA AND AHCA REPORT THE PERCENTAGE OF THE DUES USED FOR LOBBYING PURPOSES REGARDING HEALTH CARE ISSUES. 1072471 1072471 13073277 6122126 6951151 1524387 344812 1179575 3527751 2417238 1110513 731710 602605 129105 10442815 ASSETS WHOSE USE IS LIMITED 2300440 C 2300440 X 17816106 -86105 79179 -6926 17823032 333463 333463 18156495 17695686 79179 79179 17616507 333463 333463 17949970 PART X, LINE 2: THE CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS RECOGNIZED AS EXEMPT FROM INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC AND SIMILAR SECTIONS OF STATE STATUTES. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRES THE CENTER TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY OR ASSET IF THE CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICES (IRS). THE CENTER 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. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. MANAGEMENT OF THE CENTER BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO THE YEAR ENDED DECEMBER 31, 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 79,179. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 333,463. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 79,179. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 333,463. 0 0 0 0 0 0 0 0 0 TARA SHAVER ADMINISTRATOR 133974 0 0 0 0 0 4043 0 27341 0 165358 0 0 0 BRENDA ROMINE SISTER OF BETSY JONES, CFO 48434 COMPENSATION FOR IT SPECIALIST 0 WILLIAM M JONES BROTHER-IN-LAW OF BETSY JONES, CFO 38893 COMPENSATION FOR MAINTENANCE ASSISTANT 0 FORM 990, PART VI, SECTION B, LINE 11B DURING THE BOARD OF DIRECTORS MEETING, THE 990 IS PRESENTED AND REVIEWED BY A REPRESENTATIVE FROM BAKER TILLY US, LLP, WITH ALL MEMBERS ATTENDING THE MEETING. FORM 990, PART VI, SECTION B, LINE 12C AS PART OF THE ANNUAL AUDIT PROCESS, THE CONFLICT OF INTEREST POLICY AND FORMS ARE DISTRIBUTED TO BOARD MEMBERS AT THE JANUARY MEETING. THE CONFLICT OF INTEREST POLICY IS EXPLAINED AND ANY QUESTIONS ARE ANSWERED. FULLY DISCLOSING ANY AND ALL CONFLICTS IS CONVEYED AND STRESSED TO ALL BOARD MEMBERS. FORMS ARE COMPLETED BY EACH BOARD MEMBER IN ATTENDANCE AND RETURNED TO GRACE ROY, DIRECTOR OF HUMAN RESOURCES. ANY BOARD MEMBER NOT IN ATTENDANCE WILL RECEIVE THE POLICY AND FORMS AT THE FEBRUARY MEETING. THE SAME PROCESS IS FOLLOWED AT THE FEBRUARY MEETING. ALL FORMS ARE GENERALLY COMPLETED NO LATER THAN MARCH OF EACH YEAR. FORM 990, PART VI, SECTION B, LINE 15 AN ANALYSIS IS DONE WITH WAGE INFORMATION PROVIDED BY STATE SURVEY VS. WAGE SCALES AND WAGES WITHIN THE AREA AND INDUSTRY, PROVIDED BY HOSPITAL AND HEALTHCARE COMPENSATION SERVICE, AND THIS IS USED AS A GUIDELINE ALONG WITH EXPERIENCE OR REVIEW BY THE BOARD'S PERSONNEL COMMITTEE, THE BOARD OR MANAGEMENT IN FULFILLING THE POSITION. FORM 990, PART VI, SECTION C, LINE 18 UPON REQUEST FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE ON FILE WITH THE WEST VIRGINIA HEALTH CARE AUTHORITY AND ARE ALSO AVAILABLE UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE ALSO PUBLISHED IN THE LOCAL NEWSPAPERS. FORM 990, PART IX, LINE 11G NURSING PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 510,696. MANAGEMENT AND GENERAL EXPENSES 140,536. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 651,232. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,122,534. MANAGEMENT AND GENERAL EXPENSES 308,904. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,431,438. MOUNTAIN MEMORIES ASSISTED LIVING & RETIREMENT CENTER LLC 301 WILSOM LANE ELKINS WV 262413259 861600008 ASSISTED LIVING CENTER WV 3078225 7572407 ELKINS REGIONAL CONVALESCENT CENTER INC 1 1