2019-04-26T08:00:39-05:00 2018-06-30 550486667 Arnett Carbis Toothman LLP P O Box 2629 Charleston WV 25329 990 2017-07-01 550709223 Cabin Creek Health Center Inc CABI 3047342040 PO Box 70 Dawes WV 25054 Craig Robinson CEO / Executive Director 3047342040 2019-04-22 1 Dolores Rose P01286262 3043460441 216.12.119.47 2019-04-22 12:11:47 ED P 1AE310E52F96E47D5602A907093C55705F251665 A05ED1624C612F0018B32C72AA8970DF40D8CC81 2017 2019-02-21 02:37:17Z Craig Robinson PO Box 70 Dawes WV 25054 18900987 0 X http://www.cabincreekhealth.com/ X 1973 WV Cabin 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. 10 10 183 0 0 0 3994349 4192991 13847952 14732124 -6366 -17564 76641 -26406 17912576 18881145 20000 6500 0 0 9230027 10584486 0 0 0 6589069 6872978 15839096 17463964 2073480 1417181 10690251 12608202 2897535 3398305 7792716 9209897 To 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. 0 0 14256931 6500 14705718 During 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. 14256931 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 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 53 0 183 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Zhanna Crabtree 3047342040 PO Box 70 Dawes WV 25054 Donna Crowder President 1.00 X X 0 0 0 Phil Schenk Vice President 1.00 X X 0 0 0 Ann Kingery Secretary 1.00 X X 0 0 0 Nelda Ferrell Treasurer 1.00 X X 0 0 0 Ted Boettner Director 1.00 X 0 0 0 Nancy Guthrie Director 1.00 X 0 0 0 Cecil Roberts Director 1.00 X 0 0 0 Pat Taylor Director 1.00 X 0 0 0 Helen Matheny Director 1.00 X 0 0 0 Barbara Hatfield Director 1.00 X 0 0 0 Craig Robinson CEO / Executive Director 40.00 X 105047 0 5376 Debra Boyd CFO termed 4/6/18 40.00 X 89363 0 14535 Elizabeth Boyd CFO 5/16/18-11/21/18 40.00 X 0 0 0 Charles Jacques MD Medical Director 28.00 X 151490 0 6841 Jessica McColley MD Physician 40.00 X 201360 0 19584 Letitia Tierney MD Physician 40.00 X 187460 0 13817 Jami Green MD Physician 40.00 X 192745 0 14035 Ryan Morrison MD Physician 40.00 X 185083 0 18716 Donald Ta MD Physician 40.00 X 173610 0 13425 1286158 0 106329 16 0 1 0 MIRC Construction PO Box 465 Scott Depot WV 25560 Construction/Remodeling 2216315 Advantage Technology 950 Kanawha Blvd E 100 Charleston WV 25301 Computer support/services 198189 2 3914957 278034 4192991 Patient Fees 621498 14732124 14732124 14732124 2278 2278 19842 -19842 -19842 -19842 EHR incentive repayment 900099 -26406 -26406 -26406 18881145 14705718 0 -17564 6500 6500 366636 299542 67094 8138641 6649270 1489371 389568 318277 71291 1054413 861455 192958 635228 518981 116247 9058 9058 55513 55513 1271458 524391 747067 20704 16915 3789 599935 490560 109375 215736 176256 39480 595668 486661 109007 54622 44626 9996 124785 101949 22836 46058 46058 435240 355591 79649 79690 65107 14583 Medical supplies 2212204 2212204 Bad debts 779840 779840 Provider Tax & Other ta 123547 100938 22609 Student loan repayment 76649 62622 14027 172271 139188 33083 17463964 14256931 3207033 0 78585 75517 3941564 4821962 150608 263724 989486 1051023 215266 254657 2350 2850 8190532 2457063 4907392 5733469 405000 405000 0 10690251 12608202 1053530 1215195 97555 171238 1746450 1790953 0 220919 2897535 3398305 X 7792716 9209897 7792716 9209897 10690251 12608202 1417181 0 X 0 1 X 1 1 1 X 2845034 2168895 2803249 4020113 4190585 16027876 2845034 2168895 2803249 4020113 4190585 16027876 16027876 246 208 209 208 2279 3150 257400 102708 242768 76641 -26406 653111 16684137 60528311 0.96070 0.95100 X Schedule A, Part II, Line 10, Explanation of Other Income: Other 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. 687514 687514 2018307 191626 1826681 2321539 906088 1415451 1763819 1359349 404470 1399353 1399353 5733469 Due to third party payors 220919 220919 X 16837191 26406 26406 16810785 2070360 2070360 18881145 15420010 26406 26406 15393604 2070360 2070360 17463964 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. 1 Healthcare education scholarships 7 6500 X X X X 0 0 0 0 0 0 0 0 0 Charles Jacques MD Medical Director 80981 0 16665 0 53844 0 6751 0 90 0 158331 0 0 0 Jessica McColley MD Physician 151357 0 13157 0 36846 0 9550 0 10034 0 220944 0 0 0 Letitia Tierney MD Physician 175254 0 12206 0 0 0 8825 0 4992 0 201277 0 0 0 Jami Green MD Physician 117963 0 12219 0 62563 0 9084 0 4951 0 206780 0 0 0 Ryan Morrison MD Physician 121657 0 16951 0 46475 0 8539 0 10177 0 203799 0 0 0 Donald Ta MD Physician 129102 0 6224 0 38284 0 8432 0 4993 0 187035 0 0 0 Form 990, Part I, Line 1 The 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 11b Audit 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 12c The 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 15 The 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 19 The 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.