2011-10-24T16:23:54-07:00 2011-06-30 990 2010-07-01 550597803 CAMERON COMMUNITY HEALTH CARE CENTER INC CAME 3046863376 RD 4 Box 19 Wilson Drive Cameron WV 26033 Jay Prager 3046863376 2011-10-26 2010 2016-03-07 17:11:31Z Richard Fletcher RD 4 Box 19 Wilson Drive Cameron WV 26033 557364 0 X X 1980 WV To provide primary health care services to a medically underserved population 9 9 7 0 0 0 135159 70893 218121 239645 113851 246826 0 0 467131 557364 0 0 0 0 250953 228947 0 0 0 91388 91153 342341 320100 124790 237264 1706214 1907903 127358 91783 1578856 1816120 To provide primary health care services to a medically underserved population 0 0 257119 70705 230493 Ambulatory and Primary Health Care: Program activity consists of outpatient medicalservices to individuals in a federally edsignated health professions shortage area (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 4,030 patients. 0 0 0 257119 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 1 0 1 7 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 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 70705 188 70893 Medical Services to Patients 621000 230493 230493 0 0 9152 9152 0 0 239645 246826 246826 0 0 0 0 0 0 0 557364 486471 0 0 201698 159892 41806 11065 8975 2090 0 16184 12830 3354 5300 5300 324 324 21638 20186 1452 21731 18472 3259 4009 4009 8844 7517 1327 27835 23660 4175 Legal and Professional 218 0 218 0 Medicaid Tax 104 104 0 0 Miscellaneous Expense 1150 1150 0 0 320100 257119 62981 0 34969 36288 28462 39635 11911 14249 7527 7338 431652 324633 113249 107019 1510096 1703374 1706214 1907903 27358 21783 100000 70000 127358 91783 X 68760 112747 0 0 1510096 1703373 1578856 1816120 1706214 1907903 237264 0 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12000 0 12000 297272 0 207286 89986 0 0 0 0 122380 0 117347 5033 0 0 0 0 107019 0 0 Beneficial Interest in Perpetual Trust 1703374 F 1703374 0 Line of Credit 70000 70000 557364 320100 237264 0 0 0 0 0 0 237264 557364 0 0 0 0 0 557364 0 0 0 557364 320100 0 0 0 0 0 320100 0 0 0 320100 SchD_P10_S00_L00 Schedule D, Part X There is no FIN 48 footnote to the audited financial statements. 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_L11a Form 990, Part VI, Section B, Line 11a 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.