WEST VIRGINIA HEALTH IMPROVEMENT INSTITUTE: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- WEST VIRGINIA HEALTH IMPROVEMENT INSTITUTE (EIN 26-4059386)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-10-29
- IRS object ID
- 201443029349300904
- Schema version
- 2013v3.1
- 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 | 2014-10-29T11:27:53-07:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARE AND HALL PLLC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 819 | AddressLine1 |
| City | HUNTINGTON | City |
| State | WV | State |
| ZIP Code | 25712 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264059386 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST VIRGINIA HEALTH IMPROVEMENT INSTITUTE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WEST | BusinessNameControlTxt |
| Phone | 3042041609 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6354 US ROUTE 60 E | AddressLine1 |
| City | BARBOURSVILLE | City |
| State | WV | State |
| ZIP Code | 25504 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID CAMPBELL | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3042041609 | PhoneNum |
| Signature | 2014-10-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DANIEL J WARE CPA | PreparerPersonNm |
| Phone | 3045257202 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROGER CHAUFOURNIER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6701 DEMOCRACY BLVD | AddressLine1 |
| City | BETHESDA | City |
| State | MD | State |
| ZIP Code | 20817 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,031,273 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.wvhealthimprovement.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2009 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | THE WVHII IS A STATEWIDE COLLABORATION AMONG MULTIPLE STAKEHOLDERS FOCUSING ON IMPROVING THE HEALTH AND HEALTH CARE OF THE CITIZENS OF WEST VIRGINIA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,577,130 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,656,066 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $608,761 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $375,207 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $3,185,891 | PYTotalRevenueAmt |
| CY Total Revenue | $3,031,273 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,009,982 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $722,958 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,191,256 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,129,457 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $975,909 | PYOtherExpensesAmt |
| CY Other Expenses | $965,066 | CYOtherExpensesAmt |
| PY Total Expenses | $3,177,147 | PYTotalExpensesAmt |
| CY Total Expenses | $2,817,481 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,744 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $213,792 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $522,865 | TotalAssetsBOYAmt |
| Total Assets EOY | $767,460 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $514,121 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $544,924 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,744 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $222,536 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE WVHII IS A STATEWIDE COLLABORATION | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,816,856 | ExpenseAmt |
| Grant | $722,958 | GrantAmt |
| Revenue | $320,291 | RevenueAmt |
| Desc | WV HEALTH INFORMATION TECHNOLOGY PROGRAM: TO IDENTIFY AND DISSEMINATE BEST PRACTICES AND PROVIDE TECHNICAL ASSISTANCE SUPPORTING THE ADOPTION AND MEANINGFUL USE OF HEALTH INFORMATION TECHNOLOGY TO IMPROVE CARE QUALITY WHILE PROTECTING PATIENT PRIVACY. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $597,170 | ExpenseAmt |
| Desc | TRI-STATE CHILDREN'S HEALTH IMPROVEMENT CONSORTIUM: TO IMPROVE ACCESS TO HIGH QUALITY HEALTH CARE FOR ALL CHILDREN IN WV. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $128,529 | ExpenseAmt |
| Desc | PROVIDE DIRECT TECHNICAL ASSISTANCE SERVICES TO HEALTH CARE PROVIDERS TO CONNECT TO THE WVHIN HEALTH INFORMATION SYSTEM. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $54,916 | ExpenseAmt |
| Revenue | $54,916 | RevenueAmt |
| Desc | MEDICAID ASSISTANCE PROGRAM | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $54,916 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $54,916 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $2,597,471 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WV | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LINDA KELLY | PersonNm |
| Phone | 3042041609 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6354 US ROUTE 60 E SUITE 9 | AddressLine1 |
| City | BARBOURSVILLE | City |
| State | WV | State |
| ZIP Code | 25504 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| DAVID CAMPBELL | ||||||
| CEO/DIRECTOR | 20.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JAMES COMERCI | ||||||
| VICE CHAIRMAM/DIRECTOR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ROGER CHAUFOURNIER | ||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| HELEN MATHENY | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| EDWARD DOLLY | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SARAH CHOUINARD | ||||||
| CMO/DIRECTOR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KENT TAPPER | ||||||
| CFO | 20.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WV MEDICAL INSTITUTE | |||||
| 3001 CHESTERFIELD PLACE | CHARLESTON | WV | 25304 | NETWORK & COMPUTER SERVICES | $641,432 |
| CSI SOLUTIONS LLC | |||||
| 6701 DEMOCRACY BLVD | BETHESDA | MD | 20817 | MANAGEMENT & PROGRAM SERVICES | $318,837 |
| COMMUNITY HEALTH NETWORK OF WV | |||||
| 6354 US RT 60 E STE 9 | BARBOURSVILLE | WV | 25504 | MANAGEMENT & PROGRAM SERVICES | $211,963 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,656,066 | GovernmentGrantsAmt |
| Total Contributions | $2,656,066 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt |
|---|---|---|
| MEMBERSHIP FEES | 541511 | $13,200 |
| CONTRACTUAL SERVICES | 541511 | $109,935 |
| MEMBER SERVICES | 541511 | $252,072 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $375,207 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,031,273 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $375,207 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $722,958 | TotalAmt |
| Program Services | $722,958 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $914,180 | TotalAmt |
| Program Services | $876,908 | ProgramServicesAmt |
| Management And General | $37,272 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,114 | TotalAmt |
| Program Services | $104,837 | ProgramServicesAmt |
| Management And General | $4,277 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,163 | TotalAmt |
| Program Services | $102,001 | ProgramServicesAmt |
| Management And General | $4,162 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,415 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $9,415 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $783,744 | TotalAmt |
| Program Services | $655,111 | ProgramServicesAmt |
| Management And General | $128,633 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,887 | TotalAmt |
| Program Services | $5,887 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,810 | TotalAmt |
| Program Services | $3,669 | ProgramServicesAmt |
| Management And General | $4,141 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,669 | TotalAmt |
| Program Services | $4,810 | ProgramServicesAmt |
| Management And General | $3,859 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,949 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $21,949 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,731 | TotalAmt |
| Program Services | $42,887 | ProgramServicesAmt |
| Management And General | $1,844 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,146 | TotalAmt |
| Program Services | $7,199 | ProgramServicesAmt |
| Management And General | $947 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,753 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,753 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| TELECOMMUNICATIONS | $10,018 | $10,018 | $0 | $0 |
| EQUIPMENT RENTAL | $13,859 | $13,526 | $333 | $0 |
| PAYROLL SERVICES | $32,800 | $31,601 | $1,199 | $0 |
| PURCHASED SERVICES | $15,045 | $15,045 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,240 | TotalAmt |
| Program Services | $1,014 | ProgramServicesAmt |
| Management And General | $226 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,817,481 | TotalAmt |
| Program Services | $2,597,471 | ProgramServicesAmt |
| Management And General | $220,010 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $196,088 | BOYAmt |
| EOY | $417,776 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $234,383 | BOYAmt |
| EOY | $287,149 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,680 | BOYAmt |
| EOY | $44,573 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,714 | BOYAmt |
| EOY | $9,962 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,000 | BOYAmt |
| EOY | $8,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $522,865 | BOYAmt |
| EOY | $767,460 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $325,440 | BOYAmt |
| EOY | $331,013 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,681 | BOYAmt |
| EOY | $213,911 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $514,121 | BOYAmt |
| EOY | $544,924 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,744 | BOYAmt |
| EOY | $222,536 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,744 | BOYAmt |
| EOY | $222,536 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $522,865 | BOYAmt |
| EOY | $767,460 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $213,792 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $250,001 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,078,728 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,666,430 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,577,130 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,656,066 | CurrentTaxYearAmt |
| Total | $12,228,355 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $250,001 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,078,728 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,666,430 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,577,130 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,656,066 | CurrentTaxYearAmt |
| Total | $12,228,355 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $12,228,355 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $707 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,309 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4 | CurrentTaxYearMinus2YearsAmt |
| Total | $2,020 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $12,230,375 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $1,141,965 | GrossReceiptsRltdActivitiesAmt |
| First5 Years170 | Yes (X) | First5Years170Ind |
| Public Support CY170 | 0 | PublicSupportCY170Pct |
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Rev Etc Audited Fincl Stmt | $3,040,334 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $9,061 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $9,061 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,031,273 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $3,031,273 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,826,542 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $9,061 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $9,061 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,817,481 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $2,817,481 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WV MEDICAL INSTITUTE | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3001 CHESTERFIELD PLACE | AddressLine1 |
| City | CHARLESTON | City |
| State | WV | State |
| ZIP Code | 25304 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 550539692 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $641,432 | CashGrantAmt |
| Valuation Method Used | BOOK | ValuationMethodUsedDesc |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
| Purpose Of Grant | SUB-GRANTEE | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt I Line 2 | EACH SUB-GRANTEE AGREEMENT PROVIDED A SERIES OF PAYMENTS BASED ON A |
| Pt I Line 2 | STATEMENT OF WORK AND A PAYMENT SCHEDULE ESTABLISHED AT THE TIME OF |
| Pt I Line 2 | THE AWARD. SUCH AGREEMENTS REQUIRED EACH ORGANIZATION TO PARTICIPATE |
| Pt I Line 2 | IN REGULAR PROJECT MANAGEMENT MEETINGS AND PROVIDE A STATUS REPORT |
| Pt I Line 2 | AND AN ACCOUNTING OF THE USE OF THE FUNDS BEFORE PAYMENT APPROVAL. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| COMMUNITY HEALTH NETWORK OF WV | |||
| OFFICER/DIRECTOR | $214,142 | PROGRAM SERVICES | false |
| COMMUNITY HEALTH NETWORK OF WV | |||
| OFFICER/DIRECTOR | $211,963 | CONTRACTED SERVICES | false |
| COMMUNITY HEALTH NETWORK OF WV | |||
| OFFICER/DIRECTOR | $15,206 | OFFICE RENT | false |
| CSI SOLUTIONS LLC | |||
| OFFICER/DIRECTOR | $318,837 | CONTRACTED SERVICES | false |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 11b | THE FORM 990 IS SUBMITTED TO THE OFFICERS AND DIRECTORS |
| Pt VI, Line 11b | FOR REVIEW PRIOR TO FILING. |
| Pt VI, Line 12c | OFFICERS AND DIRECTORS ANNUALLY SIGN A STATEMENT CONFIRMING |
| Pt VI, Line 12c | COMPLIANCE WITH CONFLICT OF INTEREST POLICY. |
| Pt VI, Line 12c | PERIODIC COMPLIANCE REVIEWS ARE CONDUCTED. |
| Pt VI, Line 19 | UPON REQUEST |
| Form 990, Part III, Line 4d | MEDICAID ASSISTANCE PROGRAM 54916. 0. 54916. |
| Form 990, Part IX, Line 24f | DUES & SUBSCRIPTIONS 525. 525. 0. 0. BAD DEBT 14. 14. 0. 0. OTHER 701. 475. 226. 0. |