2013-05-14T11:49:19-05:00 2012-12-31 550486667 ARNETT FOSTER TOOTHMAN PLLC PO BOX 908 BRIDGEPORT WV 26330 990 2012-01-01 550768457 SUSAN DEW HOFF MEMORIAL CLINIC INC SUSA 3047453700 925 LIBERTY AVENUE WEST MILFORD WV 26451 SISTER MARY REBECCA FIDLER 3047453700 2013-05-09 1 STACIE MILLER P00247848 3046245471 2013-05-09 2012 2016-02-24 21:20:13Z SUSAN DEW HOFF MEMORIAL CLINIC SISTER MARY REBECCA FIDLE 925 LIBERTY AVENUE WEST MILFORD WV 26451 173269 0 X N/A X OTHER 1999 WV PROVIDE HEALTH AND DENTAL CARE TO THE UNINSURED WORKING POOR. 22 22 0 58 0 0 178695 164705 0 0 -9291 8564 9843 0 179247 173269 2762 1431 0 0 0 0 0 0 0 151615 170643 154377 172074 24870 1195 676893 631458 4462 17681 672431 613777 TO PROVIDE HEALTH ASSESSMENT, PROMOTION AND REFERRAL SERVICES TO THE WORKING POOR WHO LACK MEDICAL AND DENTAL INSURANCE. 0 0 161569 1431 THE CLINIC PROVIDED IN-CLINIC PROCEDURES WHICH INCLUDED 1,749 DENTAL VISITS RESULTING IN 1,875 RESTORATIVE OR PREVENTATIVE PROCEDURES AND 28 REFERRALS TO OTHER DENTISTS FOR PROCEDURES THE CLINIC COULD NOT ADEQUATELY PERFORM. THESE IN-CLINIC PROCEDURES INCLUDED 81 X-RAYS, 100 CLEANINGS, 753 FILLINGS, 86 PARTIALS AND/OR DENTURES, AND 873 EXTRACTIONS. 161569 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 3 0 0 0 0 0 0 0 0 0 0 0 X 22 22 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 925 LIBERTY STREET WEST MILFORD WV 26451 X JAMES YOHE 1.00 X 0 0 0 NANCY GALL 1.00 X 0 0 0 GINA SHARPS 1.00 X 0 0 0 VALARIE DUNLEVY 1.00 X 0 0 0 BERNICE JEAN LUCAS 1.00 X 0 0 0 DINO COLOMBO DDS 1.00 X 0 0 0 THOMAS CONDRON DDS 1.00 X 0 0 0 SANDY GANS 1.00 X 0 0 0 PAUL GANS 1.00 X 0 0 0 ROBERT HAROLD 1.00 X 0 0 0 REV LEON LYDON 1.00 X 0 0 0 MARY LOU VARGO 1.00 X 0 0 0 JOHN S WILSON 1.00 X 0 0 0 DR ROBERT WRANKER DDS 1.00 X 0 0 0 FRANK NUZUM ACCOUNTANT 1.00 X 0 0 0 SISTER BEATRICE BURKLE 1.00 X 0 0 0 PASTOR CHRIS MULLETT 1.00 X 0 0 0 HERBERT UNDERWOOD 1.00 X 0 0 0 MAGGIE FISHER 1.00 X 0 0 0 VICTOR FOLIO 1.00 X 0 0 0 ANGIE CAVANAUGH 6.00 X 0 0 0 SISTER MARY REBECCA FIDLER 70.00 X 0 0 0 0 0 0 0 0 0 0 0 164705 164705 8564 8564 173269 0 0 8564 1431 1431 10505 10505 200 200 863 863 4688 4688 2722 2722 7283 7283 9752 9752 CONTRACTED DENTAL SERVI 50858 50858 DENTAL LAB WORK 36451 36451 OTHER CONTRACTED SERVIC 21492 21492 LOAN GUARANTEE EXPENSE 10000 10000 15829 15829 172074 161569 10505 0 102277 108436 467008 388938 11288 16068 13498 7075 7161 170634 68497 84465 102137 676893 631458 4462 7681 0 10000 4462 17681 X 672431 613777 672431 613777 676893 631458 1195 -59849 0 X X 0 1 X 1 0 X 130842 122409 232851 178695 164705 829502 130842 122409 232851 178695 164705 829502 829502 11462 6200 7017 7421 8564 40664 12729 2193 7972 9843 32737 902903 0.91870 0.90910 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 35323 6629 28694 135311 61868 73443 102137 LOAN GUARANTEE PAYABLE 10000 10000 X 331783 158514 158514 173269 0 173269 330588 158514 158514 172074 0 172074 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ACCOUNTING STANDARDS CODIFICATION TOPIC 740-10 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN WHERE THERE IS UNCERTAINTY ABOUT WHETHER A TAX POSITION WILL ULTIMATELY BE SUSTAINED UPON EXAMINATION. THE CLINIC DOES NOT BELIEVE ITS FINANCIAL STATEMENTS INCLUDE (OR REFLECT) ANY UNCERTAIN TAX POSITIONS. CLARKSBURG MISSION COMMON OFFICER 10000 THE ORGANIZATION WAS A LOAN GUARANTOR FOR ANOTHER ORGANIZATION IN WHICH THEY SHARE A COMMON OFFICER. A LOAN GUARANTEE PAYABLE WAS RECORDED AT YEAR END. 0 FORM 990, PART VI, SECTION B, LINE 11 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 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.