CABIN CREEK HEALTH CENTER INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
CABIN CREEK HEALTH CENTER INC (EIN 55-0709223)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-03-28
IRS object ID
201840879349300249
Schema version
2016v3.0
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)
Return2018-03-28T16:26:37-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

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 Begin2016-07-01TaxPeriodBeginDt

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 Line1104 Alex LaneAddressLine1Txt
CityCharlestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25304ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCraig RobinsonPersonNm
Person TitleCEO / Executive DirectorPersonTitleTxt
Phone3047342040PhoneNum
Signature2018-03-07SignatureDt
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)
IP2018-03-07IPDt
IP Tm16:33:44IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdED91445F74C3710393C15480D13C7A19B0BE5F10AtSubmissionCreationDeviceId
At Submission Filing Device Id9BAAE1AE8F7C799F6A2C05DF6C6A66846D7BC49BAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerCraig RobinsonPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1104 Alex LaneAddressLine1Txt
CityCharlestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25304ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$17,919,150GrossReceiptsAmt
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 Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee162TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,803,249PYContributionsGrantsAmt
CY Contributions Grants$3,994,349CYContributionsGrantsAmt
PY Program Service Revenue$12,852,762PYProgramServiceRevenueAmt
CY Program Service Revenue$13,847,952CYProgramServiceRevenueAmt
PY Investment Income$209PYInvestmentIncomeAmt
CY Investment Income-$6,366CYInvestmentIncomeAmt
PY Other Revenue$242,768PYOtherRevenueAmt
CY Other Revenue$76,641CYOtherRevenueAmt
PY Total Revenue$15,898,988PYTotalRevenueAmt
CY Total Revenue$17,912,576CYTotalRevenueAmt
PY Grants And Similar Paid$9,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$20,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,321,567PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,230,027CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,970,365PYOtherExpensesAmt
CY Other Expenses$6,589,069CYOtherExpensesAmt
PY Total Expenses$14,300,932PYTotalExpensesAmt
CY Total Expenses$15,839,096CYTotalExpensesAmt
PY Revenues Less Expenses$1,598,056PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,073,480CYRevenuesLessExpensesAmt
Total Assets BOY$6,705,344TotalAssetsBOYAmt
Total Assets EOY$10,690,251TotalAssetsEOYAmt
Total Liabilities BOY$986,108TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,897,535TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$5,719,236NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,792,716NetAssetsOrFundBalancesEOYAmt
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$12,891,642ExpenseAmt
Grant$20,000GrantAmt
Revenue$13,924,593RevenueAmt
DescDuring the last year CCHC clinic teams provided care to 17,299 patients, who represented 63,211 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$12,891,642TotalProgramServiceExpensesAmt
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 Liabilities0ReportOtherLiabilitiesInd
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 ContriYes (1)DeductibleNonCashContriInd
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 Document41IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee162EmployeeCnt
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 Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
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 Line1Debra A BoydBusinessNameLine1Txt
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 (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Donna Crowder
Chair1.00Yes (X)Yes (X)$0$0$0
Phil Schenk
Vice Chair1.00Yes (X)Yes (X)$0$0$0
Ann Kingery
Secretary1.00Yes (X)Yes (X)$0$0$0
Nancy Guthrie
Treasurer1.00Yes (X)Yes (X)$0$0$0
Ted Boettner
Director1.00Yes (X)$0$0$0
Nelda Ferrell
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
Craig Robinson
CEO / Executive Director40.00Yes (X)$101,628$0$5,593
Debra Boyd
CFO40.00Yes (X)$83,346$0$14,711
Charles Jacques MD
Medical Director28.00$162,540$0$7,095Yes (X)
Jessica McColley MD
Physician40.00$189,744$0$19,236Yes (X)
Letitia Tierney MD
Physician40.00$179,928$0$13,520Yes (X)
Jami Green MD
Physician40.00$179,643$0$13,308Yes (X)
Sue Westfall MD
Physician40.00$141,760$0$17,187Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,038,589TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$90,650TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K18IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MIRC ConstructionBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 465AddressLine1Txt
CityScott DepotCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25560ZIPCd
FieldValueIRS element (for citing)
ServicesConstruction/RemodelingServicesDesc
Compensation$814,019CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$3,664,140GovernmentGrantsAmt
All Other Contributions$330,209AllOtherContributionsAmt
Noncash Contributions$25,764NoncashContributionsAmt
Total Contributions$3,994,349TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient feesDesc
Business621498BusinessCd
Total Revenue Column$13,847,952TotalRevenueColumnAmt
Related Or Exempt Func Income$13,847,952RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$13,847,952TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$208TotalRevenueColumnAmt
Exclusion$208ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$6,574OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$6,574OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$6,574TotalRevenueColumnAmt
Exclusion-$6,574ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Electronic health records incenti900099$72,250$72,250
Other900099$4,391$4,391
FieldValueIRS element (for citing)
Other Revenue Total$76,641OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,912,576TotalRevenueColumnAmt
Related Or Exempt Func Income$13,924,593RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$6,366ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$20,000TotalAmt
Program Services$20,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$220,046TotalAmt
Program Services$177,357ProgramServicesAmt
Management And General$42,689ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,174,145TotalAmt
Program Services$5,782,361ProgramServicesAmt
Management And General$1,391,784ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$342,260TotalAmt
Program Services$275,861ProgramServicesAmt
Management And General$66,399ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$920,337TotalAmt
Program Services$741,792ProgramServicesAmt
Management And General$178,545ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$573,239TotalAmt
Program Services$462,031ProgramServicesAmt
Management And General$111,208ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$5,607TotalAmt
Management And General$5,607ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$52,398TotalAmt
Management And General$52,398ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,338,475TotalAmt
Program Services$645,569ProgramServicesAmt
Management And General$692,906ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$17,506TotalAmt
Program Services$14,110ProgramServicesAmt
Management And General$3,396ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$659,816TotalAmt
Program Services$530,657ProgramServicesAmt
Management And General$129,159ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$127,811TotalAmt
Program Services$103,016ProgramServicesAmt
Management And General$24,795ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$382,959TotalAmt
Program Services$308,665ProgramServicesAmt
Management And General$74,294ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$62,629TotalAmt
Program Services$50,479ProgramServicesAmt
Management And General$12,150ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$196,491TotalAmt
Program Services$158,372ProgramServicesAmt
Management And General$38,119ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$27,846TotalAmt
Program Services$27,846ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$227,155TotalAmt
Program Services$183,087ProgramServicesAmt
Management And General$44,068ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$85,054TotalAmt
Program Services$68,554ProgramServicesAmt
Management And General$16,500ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical supplies$2,094,426$2,094,426
Bad debts$977,472$977,472
Student loan repayment$126,667$102,094$24,573
Health Promotion$62,037$50,002$12,035

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$144,720TotalAmt
Program Services$117,891ProgramServicesAmt
Management And General$26,829ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$15,839,096TotalAmt
Program Services$12,891,642ProgramServicesAmt
Management And General$2,947,454ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,087BOYAmt
EOY$78,585EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,554,364BOYAmt
EOY$3,941,564EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$505,286BOYAmt
EOY$150,608EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,030,199BOYAmt
EOY$989,486EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$237,651BOYAmt
EOY$215,266EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$2,350EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,977,213LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,069,821LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,968,757BOYAmt
EOY$4,907,392EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,705,344BOYAmt
EOY$10,690,251EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$868,432BOYAmt
EOY$1,053,530EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$117,576BOYAmt
EOY$97,555EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$100BOYAmt
EOY$1,746,450EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$986,108BOYAmt
EOY$2,897,535EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,719,236BOYAmt
EOY$7,792,716EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,719,236BOYAmt
EOY$7,792,716EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,705,344BOYAmt
EOY$10,690,251EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,073,480ReconcilationRevenueExpnssAmt
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$2,832,404CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,845,034CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,168,895CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,803,249CurrentTaxYearMinus1YearAmt
Current Tax Year$4,020,113CurrentTaxYearAmt
Total$14,669,695TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,832,404CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,845,034CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,168,895CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,803,249CurrentTaxYearMinus1YearAmt
Current Tax Year$4,020,113CurrentTaxYearAmt
Total$14,669,695TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$14,669,695PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$418CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$246CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$208CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$209CurrentTaxYearMinus1YearAmt
Current Tax Year$208CurrentTaxYearAmt
Total$1,289TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$74,828CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$257,400CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$102,708CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$242,768CurrentTaxYearMinus1YearAmt
Current Tax Year$76,641CurrentTaxYearAmt
Total$754,345TotalAmt
FieldValueIRS element (for citing)
Total Support$15,425,329TotalSupportAmt
Gross Receipts Rltd Activities$53,640,268GrossReceiptsRltdActivitiesAmt
Public Support CY1700.95100PublicSupportCY170Pct
Public Support PY1700.95160PublicSupportPY170Pct
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 - 2012 Amount: $ 2,578. 2013 Amount: $ 27,900. 2014 Amount: $ 94,208. 2015 Amount: $ 64,268. 2016 Amount: $ 4,391. Electronic health records incentive revenue - 2012 Amount: $ 72,250. 2013 Amount: $ 229,500. 2014 Amount: $ 8,500. 2015 Amount: $ 178,500. 2016 Amount: $ 72,250.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$220,700OtherCostOrOtherBasisAmt
Book Value$220,700BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,829,030OtherCostOrOtherBasisAmt
Depreciation$22,484DepreciationAmt
Book Value$1,806,546BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,999,570OtherCostOrOtherBasisAmt
Depreciation$793,113DepreciationAmt
Book Value$1,206,457BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,659,537OtherCostOrOtherBasisAmt
Depreciation$1,254,224DepreciationAmt
Book Value$405,313BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,268,376OtherCostOrOtherBasisAmt
Book Value$1,268,376BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,907,392TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$15,683,219TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$15,683,219RevenueSubtotalAmt
Other Revenues Not Included$2,229,357OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,229,357RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$17,912,576TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$13,583,975TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$13,583,975ExpensesSubtotalAmt
Other Expenses Not Included$2,255,121OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,255,121ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$15,839,096TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 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 4b - Other Adjustments:Cost of goods sold included in expenses on Form 990 1,251,884. Bad debt expense included in expenses on Form 990 977,473.
Part XII, Line 4b - Other Adjustments:Bad debt expense offsetting revenue on financial statements 977,473. Cost of goods sold offsetting income on financial statement 1,251,884. Cost of donated pharmaceuticals offsetting income on financial statements 25,764.

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 TypeDisaster relief funds were distributed to assist in the cost of living expenses for those displaced from a major flood.GrantTypeTxt
Recipient8RecipientCnt
Cash Grant$20,000CashGrantAmt

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 (5 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$132,403$0$30,137$0$0$0$6,620$0$1,393$0$170,553$0$0$0
Jessica McColley MD
Physician$182,744$0$7,000$0$0$0$9,137$0$11,065$0$209,946$0$0$0
Letitia Tierney MD
Physician$172,908$0$7,020$0$0$0$8,645$0$5,841$0$194,414$0$0$0
Jami Green MD
Physician$175,476$0$4,167$0$0$0$8,774$0$4,534$0$192,951$0$0$0
Sue Westfall MD
Physician$127,671$0$14,089$0$0$0$7,088$0$11,043$0$159,891$0$0$0

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$25,764NoncashContributionsRptF990Amt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

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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