Highland Hospital Foundation Inc: Form 990EZ, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- Highland Hospital Foundation Inc (EIN 55-0705451)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-15
- IRS object ID
- 201822279349201127
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-15T15:48:36-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 550486667 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Arnett Carbis Toothman LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 2629 | AddressLine1Txt |
| City | Charleston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25329 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550705451 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Highland Hospital Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HIGH | BusinessNameControlTxt |
| Phone | 3049254756 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 56th Street | AddressLine1Txt |
| City | Charleston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25304 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Chris Miller | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3043481426 | PhoneNum |
| Signature | 2018-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Dolores Rose | PreparerPersonNm |
| PTIN | P01286262 | PTIN |
| Phone | 3043460441 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Website Address | N/A | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $112,795 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $97,653 | ContributionsGiftsGrantsEtcAmt |
| Other Revenue Total | $15,142 | OtherRevenueTotalAmt |
| Total Revenue | $112,795 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $69,732 | GrantsAndSimilarAmountsPaidAmt |
| Fees And Other Pymt To Ind Cntrct | $11,650 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $12,592 | OccupancyRentUtltsAndMaintAmt |
| Other Expenses Total | $356,417 | OtherExpensesTotalAmt |
| Total Expenses | $450,391 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$337,596 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $514,613 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | -$177,017 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,742 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $373,163 | BOYAmt |
| EOY | $0 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $528,905 | BOYAmt |
| EOY | $0 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,292 | BOYAmt |
| EOY | $0 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $514,613 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | The purpose of the foundation is to solicit, raise, hold and invest endowment funds for the support of Highland Hospital, a 501(c)(3) organization. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (2 entries)
| Description Program Srvc AccomDescriptionProgramSrvcAccomTxt | Grants And AllocationsGrantsAndAllocationsAmt | Program Service ExpensesProgramServiceExpensesAmt |
|---|---|---|
| Provided financial support services for Highland Hospital Association. Support included receiving gifts, grants, contributions, bequests and making distributions of such funds. | $0 | $0 |
| Reimburse Highland Behavioral Health Services for 2 low income individuals' care. | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $0 | TotalProgramServiceExpensesAmt |
| Info In Schedule O Part IV | Yes (X) | InfoInScheduleOPartIVInd |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (12 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| Byard M Matt Coleman | ||||
| Chairman | 4.00 | $0 | $0 | $0 |
| Cynthia Persily | ||||
| President/CEO | 5.00 | $0 | $0 | $0 |
| Tricia Clark | ||||
| Trustee | 1.00 | $0 | $0 | $0 |
| J Thomas Clark | ||||
| Trustee | 1.00 | $0 | $0 | $0 |
| Michelle Easton | ||||
| Trustee | 2.00 | $0 | $0 | $0 |
| Sam Fox | ||||
| Trustee | 1.00 | $0 | $0 | $0 |
| Cary Levenson | ||||
| Trustee | 1.00 | $0 | $0 | $0 |
| Ann Starcher | ||||
| Trustee | 1.00 | $0 | $0 | $0 |
| David Townsend | ||||
| Trustee | 1.00 | $0 | $0 | $0 |
| Elizabeth Liz Weisberg | ||||
| Trustee | 1.00 | $0 | $0 | $0 |
| Raye King White | ||||
| Trustee | 1.00 | $0 | $0 | $0 |
| R Terrance Rodgers | ||||
| Trustee | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | Yes (1) | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Chris Miller | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1418 MacCorkle Avenue SW | AddressLine1Txt |
| City | Charleston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25303 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3043481426 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Highland Hospital Association | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550392395 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail (2 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| Greater Kanawha Valley Foundation | |||||||||
| Cash and Temporary investments | 2017-09-26 | $43,002 | FMV | 556024430 | 900 Lee Street E | Charleston | WV | 25301 | 501(c)3 |
| Greater Kanawha Valley Foundation | |||||||||
| Pledges receivables and other receivables | 2017-09-26 | $42,139 | Book value | 556024430 | 900 Lee Street E | Charleston | WV | 25301 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | 0 | DirectorOfSuccessorInd |
| Employee Of Successor | 0 | EmployeeOfSuccessorInd |
| Owner Of Successor | 0 | OwnerOfSuccessorInd |
| Receive Compensation | 0 | ReceiveCompensationInd |
| Assets Distributed | Yes (1) | AssetsDistributedInd |
| Required To Notify AG | Yes (1) | RequiredToNotifyAGInd |
| Attorney General Notified | Yes (1) | AttorneyGeneralNotifiedInd |
| Liabilities Paid | Yes (1) | LiabilitiesPaidInd |
| Bonds Outstanding | 0 | BondsOutstandingInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 6c: | FormAndLineReferenceDesc |
| Explanation | All liabilities due were paid and the Articles of Dissolution were filed and authorized by the West Virginia Secretary of State as of September 26, 2017 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990-EZ, Part I, Line 8 - Other Revenue | Description: Dividend Income. Amount: 11,434. Description: Interest Income. Amount: 3,708. Total to Form 990-EZ, line 8: 15,142. |
| Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid | Activity Classification: Foundation. Grantee Name: Highland Hospital Association. Grantee Address: 300 56th St. Charleston, WV 25304. Amount Given: 69,732. |
| Form 990-EZ, Part I, Line 16 - Other Expenses | Description: Grants. Amount: 316,592. Description: Salaries. Amount: 10,257. Description: Employee Benefits. Amount: 693. Description: Payroll Taxes. Amount: 4,765. Description: Investment Fees. Amount: 1,071. Description: Other Fees. Amount: 5,165. Description: Office Expenses. Amount: 6,125. Description: Information Technology. Amount: 1,642. Description: Conferences. Amount: 9,046. Description: Insurance. Amount: 739. Description: Miscellaneous Expense. Amount: 322. Total to Form 990-EZ, line 16: 356,417. |
| Form 990-EZ, Part I, Line 20 - Other Changes in Net Assets | Description: Transfer of assets to Greater Kanawha Valley Foundation. Amount: -177,017. |
| Form 990-EZ, Part II, Line 24 - Other Assets | Description: Pledges Receivable. Beg. of Year Amount: 79,747. End of Year Amount: 0. Description: Intercompany Receivable. Beg. of Year Amount: 293,416. End of Year Amount: 0. |
| Form 990-EZ, Part II, Line 26 - Other Liabilities | Description: Accounts Payable. Beg. of Year Amount: 14,292. End of Year Amount: 0. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | The organization did not, during the year, receive any funds, directly,or indirectly, to pay premiums on a personal benefit contract.The organization, did not, during the year, pay any premiums, directly,or indirectly, on a personal benefit contract. | DeclarationDesc |