2012-10-24T10:13:04-07:00 2012-06-30 990 2011-07-01 550597803 CAMERON COMMUNITY HEALTH CARE CENTER INC CAME 3046863376 RD 4 Box 19 Wilson Drive Cameron WV 26033 Jay Prager 3046863376 2012-11-12 2011 2016-02-24 21:20:13Z Richard Fletcher RD 4 Box 19 Wilson Drive Cameron WV 26033 442913 0 X X 1980 WV To provide primary health care services to a medically underserved population 9 9 8 0 0 0 70893 70894 239645 256542 246826 115477 0 0 557364 442913 0 0 0 0 228947 248997 91153 0 0 0 119562 320100 368559 237264 74354 1907903 1973073 91783 82599 1816120 1890474 To provide health care services to a medically underserved population 0 0 302079 70894 255534 Ambulatory and Primary Health Care: Program activity consists of outpatient medical services to individuals in a federally edsignated health professions shortage are (HPSA), and medically underserved area (MUA). Services are provided without regard of patients' ability to pay for them. During this period, the health center treated 4,139 patients. 0 0 0 302079 1 1 0 0 0 0 0 0 0 0 1 1 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 0 0 0 0 0 0 0 0 0 0 0 1 2 0 1 8 1 0 0 0 0 0 0 X 9 9 1 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 WV X Jay Prager 3046863376 RD 4 Box 19 Wilson Drive Cameron WV 26033 Victor Antill 1 X X 0 0 0 Ila Mae McConaughey 1 X X 0 0 0 David McConaughey 1 X 0 0 0 Susie Davis 1 X 0 0 0 Celeste Evans 1 X 0 0 0 Deloris Williams 1 X 0 0 0 Richard Fletcher 1 X X 0 0 0 Edward Phillips 1 X 0 0 0 Sherilyn McCracken 1 X 0 0 0 Kelly Barki DO 40 X X 110000 0 0 110000 0 0 1 0 0 0 0 0 0 0 0 70894 0 0 70894 Medical Services to Patients 621000 255534 255534 0 0 1008 1008 256542 115477 115477 0 0 0 0 0 0 442913 372019 0 0 219846 175716 44130 11623 9417 2206 17528 13982 3546 5500 5500 309 309 53027 50871 2156 17720 15062 2658 1270 1270 10002 8502 1500 27883 23700 4183 Legal and Professional 601 0 601 0 Miscellaneous Expense 3250 3250 0 0 368559 302079 66480 0 36288 39585 39635 48919 14249 15563 7338 7663 440372 334635 107019 105737 1703374 1755606 1907903 1973073 21783 32599 70000 50000 91783 82599 X 112747 134868 0 0 1703373 1755606 1816120 1890474 1907903 1973073 74354 0 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12000 0 12000 297272 0 215061 82211 0 0 0 0 131100 0 119574 11526 0 0 0 0 105737 0 0 Beneficial Interest in Perpetual Trust 1755606 F 1755606 0 Federal income taxes 0 Line of Credit 50000 50000 442913 368559 74354 0 0 0 0 0 0 74354 442913 0 0 0 0 0 442913 0 0 0 442913 368559 0 0 0 0 0 368559 0 0 0 368559 SchD_P10_S00_L02 Schedule D, Part X, Line 2 There is no FIN 48 footnote to the audited financial statements. F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 Board members Ila Mae McConoughey and David McConoughey have a family relationship. F990_P06_S0A_L03 Form 990, Part VI, Section A, Line 3 The Cameron Community Health Center has held a management contract with a local acute care hospital, Reynolds Memorial, since 1982. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b The IRS 990 filing is completed by management, using the results of the independent financial audit. A copy is provided to the board members prior to filing. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c New board members are oriented to conflict of interest policies; and they are periodically reminded to disclose any potential conflicts. Also, the corporation's bylaws contain a provision for the immediate removal of a board member for violation of conflict of interest. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 All public documents associated with the health center are available for viewing at the facility, upon request.