2013-11-04T09:39:03-06:00 2012-12-31 550486667 Arnett Foster Toothman PLLC P O Box 2629 Charleston WV 25329 990 2012-01-01 550539692 West Virginia Medical Institute Inc WEST 3043469864 3001 Chesterfield Avenue Charleston WV 25304 Kathleen D Merrill 3043469864 2013-10-29 1 Dale Carpenter P00189642 3043460441 2012 2016-03-07 17:11:31Z Kathleen D Merrill 3001 Chesterfield Avenue Charleston WV 25304 24771185 0 X www.wvmi.org X 1973 WV To improve the health of the people we serve. 6 5 189 0 0 0 0 0 24538188 24765143 2281 -16 2823 4333 24543292 24769460 200936 18916 0 0 13185212 14041641 0 0 0 10285586 9295874 23671734 23356431 871558 1413029 14869747 15985310 3344953 3045644 11524794 12939666 To improve the health of the people we serve. 0 0 23109756 18916 24769476 The Organization provided educational and quality improvement programs to health care providers participating in medicare, medicaid, veterans affairs and other governmental health care programs, and to other health care related entities. 23109756 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 167 0 189 1 0 0 0 0 0 0 0 0 0 0 X 6 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WV DE X Kathleen D Merrill 3043469864 3001 Chesterfield Avenue Charleston WV 25304 Derrick Latos 1.00 2.00 X 3092 0 0 Robert Rose 1.00 1.00 X 2742 0 0 Daniel Lauffer 1.00 1.00 X 1792 0 0 Minnie Jones 1.00 1.00 X 1642 0 0 Stephen Brown 1.00 1.00 X 1642 0 0 John Wiesendanger 26.00 15.00 X X 403191 0 42743 Kathleen Merrill 28.00 16.00 X 248317 0 39990 Sven Berg 27.00 15.00 X 275118 0 3722 David Lambert 31.00 18.00 X 179292 0 40349 Charles Schade 21.00 10.00 X 185558 0 33041 Mark Stephens 26.00 0.00 X 169701 0 20364 John Marks 30.00 11.00 X 136148 0 29072 Aaron Spurlock 29.00 15.00 X 129192 0 34405 Catherine Browning 14.00 40.00 X 131750 0 21611 1869177 0 265297 15 0 1 0 Leah Buist 194 Butler Street Kingston PA 18704 Consultant 171322 Paul T Kuryla 47 Williamsburg Way Hurricane WV 25526 Consultant 162837 Gay Nicholson dba Focus Clinical Ab 413 W Clinton St Ithaca NY 14850 Consultant 159592 Dixon Hughes Goodman PLLC PO Box 3049 Asheville NC 288023049 Accounting Services 145988 Traci Hoffman dba TLH LLC 443 Kimberly Drive Melbourne FL 23940 Consultant 128275 7 Contract revenue 541900 24765143 24765143 24765143 1709 1709 1725 -1725 -1725 -1725 4333 4333 4333 24769460 24769476 0 -16 X 18916 18916 1250153 1247528 2625 9594642 9574493 20149 1000526 998425 2101 1405880 1402928 2952 790440 788780 1660 71130 71130 127837 127837 5922638 5910197 12441 640945 640484 461 306589 305945 644 543415 542274 1141 749620 748046 1574 96641 96438 203 325924 325240 684 125094 124831 263 Criteria 131957 131680 277 Dues and subscriptions 87953 87768 185 Education 71318 71168 150 Employee relations 56769 56650 119 38044 37965 79 23356431 23109756 246675 0 7163204 5816188 1638251 6383490 4353751 442949 460167 4578301 3373713 1220351 1204588 28769 30611 978000 1134738 14869747 15985310 2847890 2717305 497063 328339 3344953 3045644 X 11524794 12939666 11524794 12939666 14869747 15985310 1413029 1843 0 X 0 1 X 1 1 1 X 21727811 21165291 21905711 24538188 24765143 114102144 21727811 21165291 21905711 24538188 24765143 114102144 0 8430737 7735303 16166040 8430737 7735303 16166040 97936104 135359 10123 5769 5749 1709 158709 135359 10123 5769 5749 1709 158709 3953 6918 4343 2825 4333 22372 21867123 21182332 21915823 24546762 24771185 114283225 0.85700 0.91950 0.00140 0.00460 X Schedule A, Part II, Line 12, Explanation of Other Income: Miscellaneous revenue - 2008 Amount: $ 3,953. 2009 Amount: $ 6,918. 2010 Amount: $ 4,343. 2011 Amount: $ 2,825. 2012 Amount: $ 4,333. 0 0 0 0 0 0 0 0 1 61966 61966 0 Explanation of Lobbying Activities: Part II-B, Line 1: A portion of WVMI's AHQA (The American Health Quality Association) membership dues, in the amount of $6,814.50, was for lobbying expenses. Also, a portion of WVMI's WV Chamber of Commerce membership dues $127.50 and Charleston Area Alliance membership dues $23.63 were for lobbying expenses. In addition, WVMI paid $55,000 to an independent lobbyist, Larry Swann. WVMI retained Larry Swann in September 2007. Mr. Swann provides governmnent relations consulting in all health related topics with a goal of developing strategic new business initiatives for WVMI within the state of West Virginia. Mr. Swann also works with WVMI's CEO to build strong relationships with West Virginia public officials including key legislators and administrative officials. 150005 150005 1966391 1361921 604470 55772 52243 3529 1672321 1313989 358332 733812 645560 88252 1204588 Intercompany receivables 1134738 1134738 X 24773028 1843 1843 24771185 -1725 -1725 24769460 23358156 1725 1725 23356431 0 23356431 Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: The Organization has determined that it does not have any material unrecognized tax benefits or obligations as of December 31, 2012 and 2011. Part XI, Line 4b - Other Adjustments: Loss included in revenue on Form 990 -1,725. Part XII, Line 2d - Other Adjustments: Loss included in expenses on financial statement 1,725. 1 Health Choice Network 9064 NW 13 Terrace Miami FL 33172 650504316 501(C)(3) 6750 Provide education, outreach, and direct technical assistance to assist health care providers to adopt and make meaningful use of electronic health record (EHR) University Physicians & Surgeons 1600 Medical Center Drive Huntington WV 25701 550564945 501(C)(3) 10506 Provide education, outreach, and direct technical assistance to assist health care providers to adopt and make meaningful use of electronic health record (EHR) 2 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Subrecipients are required to comply with all applicable guidelines of the federal award for which funds are granted, as well as those governing their institutions in other aspects of business. We request documentation of said compliance, where necessary, and review organization audit reports effecting this award when the reports are completed (if required). Additionally, invoices received undergo a desk audit following our own internal policies and procedures before any federal funds are paid. 0 0 0 0 0 0 0 0 0 John Wiesendanger 384312 0 0 0 18879 0 30000 0 14407 0 447598 0 0 0 Kathleen Merrill 223317 0 25000 0 0 0 27247 0 14407 0 289971 0 0 0 Sven Berg 275118 0 0 0 0 0 2750 0 2635 0 280503 0 0 0 David Lambert 179292 0 0 0 0 0 22469 0 19410 0 221171 0 0 0 Charles Schade 185558 0 0 0 0 0 23579 0 10092 0 219229 0 0 0 Mark Stephens 169701 0 0 0 0 0 20364 0 606 0 190671 0 0 0 John Marks 136148 0 0 0 0 0 16929 0 13433 0 166510 0 0 0 Aaron Spurlock 129192 0 0 0 0 0 16400 0 19305 0 164897 0 0 0 Catherine Browning 124075 0 7675 0 0 0 15150 0 7628 0 154528 0 0 0 Part I, Line 3 The Compensation Committee of Quality Insights Holdings, Inc., the sole member of the Organization approves compensation for the filing Organization's CEO. Form 990, Part VI, Section A, line 6 Quality Insights Holdings, Inc. is the sole member of West Virginia Medical Institute, Inc. Form 990, Part VI, Section A, line 7a Quality Insights Holdings, Inc. shall appoint all members of the Organization's Board of Directors. Form 990, Part VI, Section A, line 7b Quality Insights Holdings, Inc. shall have sole authority and power with respect to amending the certificate of incorporation, amending the bylaws, adopting an agreement of merger or consolidation, approving the sale, lease or exchange of all or substantially all of the Organization's property and assets, or approving the dissolution of the Organization or a revocation of a dissolution. Form 990, Part VI, Section B, line 11 The completed Form 990 is provided electronically for review by the Organization's board. Additionally, the Controller and the Chief Financial Officer perform a detailed review and verify all financial information against the Organization's audited financial statements and supporting accounting records. Form 990, Part VI, Section B, line 12c The Organization regularly and consistently monitors and enforces compliance with its conflict disclosure policies. All board members, officers and employees complete and sign a conflict disclosure form that lists affiliations and compensation arrangements for themselves and family members that could create a potential conflict of interest. This is accomplished as part of annual compliance training. The training itself addresses conflicts of interest. Conflict disclosure forms are reviewed by the CEO (in the case of board members) and the Corporate Compliance Officer. Established procedures require a board member to recuse herself/himself from evaluation of a proposed business arrangement if the board member has a potential conflict. In the case of employees, the Corporate Compliance Officer works with the employee's supervisor to determine whether a potential conflict may be mitigated. Form 990, Part VI, Section B, line 15 Compensation arrangements are established based on information obtained from different data sources and outside consultants for similarly situated taxable or tax exempt organizations providing similar services. The compensation plan is reviewed and approved by the Compensation Committee of Quality Insights Holdings, Inc.'s board on an annual basis. This process is the same for both the CEO and all officers and key employees. Form 990, Part VI, Section C, line 19 The Organization makes its governing documents, conflict of interest policy and financial statements available to the public, upon request, on a case-by-case basis. Other Fees Form 990, Part IX, line 11g Consultant Expenses: Program service expenses 8,386,858. Management and general expenses 0. Fundraising expenses 0. Total expenses 8,386,858. Program Service Expenses: Program service expenses 501,308. Management and general expenses 12,441. Fundraising expenses 0. Total expenses 513,749. Temporary Help Expenses: Program service expenses 131,058. Management and general expenses 0. Fundraising expenses 0. Total expenses 131,058. Less Intercompany Expenses: Program service expenses -985,261. Management and general expenses 0. Fundraising expenses 0. Total expenses -985,261. Less WVMI Corp Allocation: Program service expenses -2,123,766. Management and general expenses 0. Fundraising expenses 0. Total expenses -2,123,766. Quality Insights Holdings Inc 3001 Chesterfield Avenue Charleston WV 25304 262480548 Holding company for healthcare quality improvement organizations WV 501(c)(3) Line 11d, III-O N/A 0 Quality Insights of Delaware Inc 3411 Silverside Road Wilmington DE 19810 541967588 To improve the health of the people the organization serves DE 501(c)(6) Quality Insights Holdings Inc 0 Quality Insights Renal Network Inc 3001 Chesterfield Avenue Charleston WV 25304 270333640 To improve the health of the people the organization serves WV 501(c)(3) Line 9 Quality Insights Holdings Inc 0 Quality Insights of Pennsylvania Inc 2601 Market Place Street Harrisburg PA 17110 743051725 To improve the health of the people the organization serves PA 501(c)(6) quality Insights Holdings Inc 0 Mid-Atlantic Renal Coalition Inc 300 Arboretum Place Suite 310 Richmond VA 23236 541431984 To improve the health of the people the organization serves VA 501(c)(3) Line 9 Quality Insights Holdings Inc 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 Quality Insights of Delaware Inc L 1046420 Intercompany accounting Quality Insights of Delaware Inc M 98228 Intercompany accounting Quality Insights of Delaware Inc Q 677443 Intercompany accounting Quality Insights of Pennsylvania Inc L 4251087 Intercompany accounting Quality Insights of Pennsylvania Inc M 894544 Intercompany accounting Quality Insights of Pennsylvania Inc Q 3427732 Intercompany accounting