CABIN CREEK HEALTH CENTER INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
CABIN CREEK HEALTH CENTER INC (EIN 55-0709223)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-04-26
IRS object ID
201931169349300003
Schema version
2017v2.3
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

FieldValueIRS element (for citing)
Return2019-04-26T08:00:39-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN550486667PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Arnett Carbis Toothman LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1P O Box 2629AddressLine1Txt
CityCharlestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25329ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550709223EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Cabin Creek Health Center IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCABIBusinessNameControlTxt
Phone3047342040PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 70AddressLine1Txt
CityDawesCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25054ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCraig RobinsonPersonNm
Person TitleCEO / Executive DirectorPersonTitleTxt
Phone3047342040PhoneNum
Signature2019-04-22SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDolores RosePreparerPersonNm
PTINP01286262PTIN
Phone3043460441PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address216.12.119.47IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-04-22IPDt
IP Tm12:11:47IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id1AE310E52F96E47D5602A907093C55705F251665AtSubmissionCreationDeviceId
At Submission Filing Device IdA05ED1624C612F0018B32C72AA8970DF40D8CC81AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCraig RobinsonPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 70AddressLine1Txt
CityDawesCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25054ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$18,900,987GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttp://www.cabincreekhealth.com/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1973FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionCabin Creek Health Systems is a Federally Qualified Health Center that provides primary care services, promotes health education for students in health care specialties, and provides health education to the residents of Kanawha and surrounding counties in West Virginia.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee183TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,994,349PYContributionsGrantsAmt
CY Contributions Grants$4,192,991CYContributionsGrantsAmt
PY Program Service Revenue$13,847,952PYProgramServiceRevenueAmt
CY Program Service Revenue$14,732,124CYProgramServiceRevenueAmt
PY Investment Income-$6,366PYInvestmentIncomeAmt
CY Investment Income-$17,564CYInvestmentIncomeAmt
PY Other Revenue$76,641PYOtherRevenueAmt
CY Other Revenue-$26,406CYOtherRevenueAmt
PY Total Revenue$17,912,576PYTotalRevenueAmt
CY Total Revenue$18,881,145CYTotalRevenueAmt
PY Grants And Similar Paid$20,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$6,500CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$9,230,027PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,584,486CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,589,069PYOtherExpensesAmt
CY Other Expenses$6,872,978CYOtherExpensesAmt
PY Total Expenses$15,839,096PYTotalExpensesAmt
CY Total Expenses$17,463,964CYTotalExpensesAmt
PY Revenues Less Expenses$2,073,480PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,417,181CYRevenuesLessExpensesAmt
Total Assets BOY$10,690,251TotalAssetsBOYAmt
Total Assets EOY$12,608,202TotalAssetsEOYAmt
Total Liabilities BOY$2,897,535TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,398,305TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,792,716NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$9,209,897NetAssetsOrFundBalancesEOYAmt
MissionTo work with the community to improve the quality of life by assuring access to quality primary health services, outreach, and education for all persons regardless of their ability to pay.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$14,256,931ExpenseAmt
Grant$6,500GrantAmt
Revenue$14,705,718RevenueAmt
DescDuring the last year CCHC clinic teams provided care to 18,637 patients, who represented 69,312 clinic visits. Our clinical teams include physicians, mid-level providers, medical assistants, behavioral health consultants, and health coaches. These teams offer our patients a comprehensive set of primary care services including adult and geriatric care, pediatrics, family planning, women's health and prenatal services, 340-B pharmacy, behavioral health and dental services.Desc
Total Program Service Expenses$14,256,931TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document53IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee183EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Zhanna CrabtreeBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3047342040PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 70AddressLine1Txt
CityDawesCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25054ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Donna Crowder
President1.00Yes (X)Yes (X)$0$0$0
Phil Schenk
Vice President1.00Yes (X)Yes (X)$0$0$0
Ann Kingery
Secretary1.00Yes (X)Yes (X)$0$0$0
Nelda Ferrell
Treasurer1.00Yes (X)Yes (X)$0$0$0
Ted Boettner
Director1.00Yes (X)$0$0$0
Nancy Guthrie
Director1.00Yes (X)$0$0$0
Cecil Roberts
Director1.00Yes (X)$0$0$0
Pat Taylor
Director1.00Yes (X)$0$0$0
Helen Matheny
Director1.00Yes (X)$0$0$0
Barbara Hatfield
Director1.00Yes (X)$0$0$0
Craig Robinson
CEO / Executive Director40.00Yes (X)$105,047$0$5,376
Debra Boyd
CFO termed 4/6/1840.00Yes (X)$89,363$0$14,535
Elizabeth Boyd
CFO 5/16/18-11/21/1840.00Yes (X)$0$0$0
Charles Jacques MD
Medical Director28.00$151,490$0$6,841Yes (X)
Jessica McColley MD
Physician40.00$201,360$0$19,584Yes (X)
Letitia Tierney MD
Physician40.00$187,460$0$13,817Yes (X)
Jami Green MD
Physician40.00$192,745$0$14,035Yes (X)
Ryan Morrison MD
Physician40.00$185,083$0$18,716Yes (X)
Donald Ta MD
Physician40.00$173,610$0$13,425Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,286,158TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$106,329TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K16IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MIRC Construction
PO Box 465Scott DepotWV25560Construction/Remodeling$2,216,315
Advantage Technology
950 Kanawha Blvd E 100CharlestonWV25301Computer support/services$198,189
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$3,914,957GovernmentGrantsAmt
All Other Contributions$278,034AllOtherContributionsAmt
Total Contributions$4,192,991TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient FeesDesc
Business621498BusinessCd
Total Revenue Column$14,732,124TotalRevenueColumnAmt
Related Or Exempt Func Income$14,732,124RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$14,732,124TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,278TotalRevenueColumnAmt
Exclusion$2,278ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$19,842OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$19,842OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$19,842TotalRevenueColumnAmt
Exclusion-$19,842ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescEHR incentive repaymentDesc
Business900099BusinessCd
Total Revenue Column-$26,406TotalRevenueColumnAmt
Related Or Exempt Func Income-$26,406RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total-$26,406OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,881,145TotalRevenueColumnAmt
Related Or Exempt Func Income$14,705,718RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$17,564ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$6,500TotalAmt
Program Services$6,500ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$366,636TotalAmt
Program Services$299,542ProgramServicesAmt
Management And General$67,094ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,138,641TotalAmt
Program Services$6,649,270ProgramServicesAmt
Management And General$1,489,371ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$389,568TotalAmt
Program Services$318,277ProgramServicesAmt
Management And General$71,291ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,054,413TotalAmt
Program Services$861,455ProgramServicesAmt
Management And General$192,958ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$635,228TotalAmt
Program Services$518,981ProgramServicesAmt
Management And General$116,247ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$9,058TotalAmt
Management And General$9,058ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$55,513TotalAmt
Management And General$55,513ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,271,458TotalAmt
Program Services$524,391ProgramServicesAmt
Management And General$747,067ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$20,704TotalAmt
Program Services$16,915ProgramServicesAmt
Management And General$3,789ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$599,935TotalAmt
Program Services$490,560ProgramServicesAmt
Management And General$109,375ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$215,736TotalAmt
Program Services$176,256ProgramServicesAmt
Management And General$39,480ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$595,668TotalAmt
Program Services$486,661ProgramServicesAmt
Management And General$109,007ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$54,622TotalAmt
Program Services$44,626ProgramServicesAmt
Management And General$9,996ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$124,785TotalAmt
Program Services$101,949ProgramServicesAmt
Management And General$22,836ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$46,058TotalAmt
Program Services$46,058ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$435,240TotalAmt
Program Services$355,591ProgramServicesAmt
Management And General$79,649ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$79,690TotalAmt
Program Services$65,107ProgramServicesAmt
Management And General$14,583ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical supplies$2,212,204$2,212,204
Bad debts$779,840$779,840
Provider Tax & Other ta$123,547$100,938$22,609
Student loan repayment$76,649$62,622$14,027

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$172,271TotalAmt
Program Services$139,188ProgramServicesAmt
Management And General$33,083ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,463,964TotalAmt
Program Services$14,256,931ProgramServicesAmt
Management And General$3,207,033ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$78,585BOYAmt
EOY$75,517EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,941,564BOYAmt
EOY$4,821,962EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$150,608BOYAmt
EOY$263,724EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$989,486BOYAmt
EOY$1,051,023EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$215,266BOYAmt
EOY$254,657EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,350BOYAmt
EOY$2,850EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$8,190,532LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,457,063LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,907,392BOYAmt
EOY$5,733,469EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$405,000BOYAmt
EOY$405,000EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,690,251BOYAmt
EOY$12,608,202EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,053,530BOYAmt
EOY$1,215,195EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$97,555BOYAmt
EOY$171,238EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$1,746,450BOYAmt
EOY$1,790,953EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$220,919EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,897,535BOYAmt
EOY$3,398,305EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,792,716BOYAmt
EOY$9,209,897EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,792,716BOYAmt
EOY$9,209,897EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,690,251BOYAmt
EOY$12,608,202EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,417,181ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,845,034CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,168,895CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,803,249CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,020,113CurrentTaxYearMinus1YearAmt
Current Tax Year$4,190,585CurrentTaxYearAmt
Total$16,027,876TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,845,034CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,168,895CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,803,249CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,020,113CurrentTaxYearMinus1YearAmt
Current Tax Year$4,190,585CurrentTaxYearAmt
Total$16,027,876TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$16,027,876PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$246CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$208CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$209CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$208CurrentTaxYearMinus1YearAmt
Current Tax Year$2,279CurrentTaxYearAmt
Total$3,150TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$257,400CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$102,708CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$242,768CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$76,641CurrentTaxYearMinus1YearAmt
Current Tax Year-$26,406CurrentTaxYearAmt
Total$653,111TotalAmt
FieldValueIRS element (for citing)
Total Support$16,684,137TotalSupportAmt
Gross Receipts Rltd Activities$60,528,311GrossReceiptsRltdActivitiesAmt
Public Support CY1700.96070PublicSupportCY170Pct
Public Support PY1700.95100PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part II, Line 10, Explanation of Other Income:FormAndLineReferenceDesc
ExplanationOther income - 2013 Amount: $ 27,900. 2014 Amount: $ 94,208. 2015 Amount: $ 64,268. 2016 Amount: $ 4,391. Electronic health records incentive revenue - 2013 Amount: $ 229,500. 2014 Amount: $ 8,500. 2015 Amount: $ 178,500. 2016 Amount: $ 72,250. 2017 Amount: $ -26,406.ExplanationTxt

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$687,514OtherCostOrOtherBasisAmt
Book Value$687,514BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,018,307OtherCostOrOtherBasisAmt
Depreciation$191,626DepreciationAmt
Book Value$1,826,681BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,321,539OtherCostOrOtherBasisAmt
Depreciation$906,088DepreciationAmt
Book Value$1,415,451BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,763,819OtherCostOrOtherBasisAmt
Depreciation$1,359,349DepreciationAmt
Book Value$404,470BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,399,353OtherCostOrOtherBasisAmt
Book Value$1,399,353BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,733,469TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDue to third party payorsDesc
Amt$220,919Amt
FieldValueIRS element (for citing)
Total Liability$220,919TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$16,837,191TotalRevEtcAuditedFinclStmtAmt
Other Revenue$26,406OtherRevenueAmt
Revenue Not Reported$26,406RevenueNotReportedAmt
Revenue Subtotal$16,810,785RevenueSubtotalAmt
Other Revenues Not Included$2,070,360OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,070,360RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$18,881,145TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$15,420,010TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$26,406OtherExpensesIncludedAmt
Expenses Not Reported$26,406ExpensesNotReportedAmt
Expenses Subtotal$15,393,604ExpensesSubtotalAmt
Other Expenses Not Included$2,070,360OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,070,360ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$17,463,964TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X, Line 2:Accounting principles generally accepted in the United States of America require the management of the Organization to evaluate tax positions taken by the Organization. Management has evaluated the Organization's tax positions and concluded that the Organization had maintained its tax exempt status and had taken no uncertain tax positions that require recognition or disclosure in the financial statements. Therefore, no provision or liability for income taxes has been included in the financial statements.
Part XI, Line 2d - Other Adjustments:EHR Incentive Repayment 26,406.
Part XI, Line 4b - Other Adjustments:Cost of goods sold included in expenses on Form 990 1,290,520. Bad debt expense included in expenses on Form 990 779,840.
Part XII, Line 2d - Other Adjustments:EHR Incentive Repayment 26,406.
Part XII, Line 4b - Other Adjustments:Bad debt expense offsetting revenue on financial statements 779,840. Cost of goods sold offsetting income on financial statement 1,290,520.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeHealthcare education scholarshipsGrantTypeTxt
Recipient7RecipientCnt
Cash Grant$6,500CashGrantAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Charles Jacques MD
Medical Director$80,981$0$16,665$0$53,844$0$6,751$0$90$0$158,331$0$0$0
Jessica McColley MD
Physician$151,357$0$13,157$0$36,846$0$9,550$0$10,034$0$220,944$0$0$0
Letitia Tierney MD
Physician$175,254$0$12,206$0$0$0$8,825$0$4,992$0$201,277$0$0$0
Jami Green MD
Physician$117,963$0$12,219$0$62,563$0$9,084$0$4,951$0$206,780$0$0$0
Ryan Morrison MD
Physician$121,657$0$16,951$0$46,475$0$8,539$0$10,177$0$203,799$0$0$0
Donald Ta MD
Physician$129,102$0$6,224$0$38,284$0$8,432$0$4,993$0$187,035$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part I, Line 1The Cabin Creek Health Center, Inc. (CCHC) is a federally qualified health center with a network of five primary care centers and four school based health centers located in Kanawha County, WV. The network consists of the Cabin Creek Health Center located in Dawes; the Riverside Health Center located on the campus of Riverside High School which also serves as a school based health center; the Clendenin Health Center located in Clendenin; the Sissonville Health Center located in Sissonville; and the Kanawha City Health Center located in Charleston. Each of these health centers is operational five days a week. In addition CCHC operates part time school based health centers at the Sissonville, Herbert Hoover, and Riverside High Schools and East Bank Middle School. The communities served by CCHC have some of the highest rates in the nation of adult and child poverty and chronic medical conditions, including diabetes, chronic pain, COPD, obesity, and heart disease. West Virginia has the highest rate of disability in the country and southern WV is higher than the rest of the state. WV also has among the highest rates of the nation for behavioral risk factors, e.g. tobacco use, lack of physical activity, and poor nutrition. CCHC cares for a high number of patients with complex poorly controlled health problems along with high rates of behavioral risk.
Form 990, Part VI, Section B, line 11bAudit firm prepares the Form 990, the CFO reviews the return and then the CEO reviews the return and signs it. The Board reviews the return prior to filing.
Form 990, Part VI, Section B, line 12cThe members are required to complete a conflict of interest form within two weeks of having been made a member of the Board. Each board member is required to complete the conflict of interest policy annually on November 15th each year. The forms are filed and maintained by the Director of Human Resources.
Form 990, Part VI, Section B, line 15The Board determines the salaries by working with an outside CPA using a survey of comparative nonprofits, especially FQHC's. The CPA helps analyze the data with the compensation committee to determine the salaries.
Form 990, Part VI, Section C, line 19The organizing documents are maintained at the administration office and are readily available to the public upon request. The conflict of interest policy is obtainable from any CCHS location. Financial statements are obtainable from the administration office and are filed with various Federal and state agencies.

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