CABIN CREEK HEALTH CENTER INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- CABIN CREEK HEALTH CENTER INC (EIN 55-0709223)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-03-23
- IRS object ID
- 201720829349300502
- Schema version
- 2015v3.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-03-23T08:13:47-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 550486667 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Arnett Carbis Toothman LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 2629 | AddressLine1Txt |
| City | Charleston | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25329 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 550709223 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cabin Creek Health Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CABI | BusinessNameControlTxt |
| Phone | 3047342040 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 70 | AddressLine1Txt |
| City | Dawes | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25054 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Craig Robinson | PersonNm |
| Person Title | CEO / Executive Director | PersonTitleTxt |
| Phone | 3047342040 | PhoneNum |
| Signature | 2017-03-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Dolores Rose | PreparerPersonNm |
| PTIN | P01286262 | PTIN |
| Phone | 3043460441 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Craig Robinson | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 70 | AddressLine1Txt |
| City | Dawes | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25054 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,898,988 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | http://www.cabincreekhealth.com/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | 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. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 149 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,168,895 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,803,249 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,844,743 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,852,762 | CYProgramServiceRevenueAmt |
| PY Investment Income | $208 | PYInvestmentIncomeAmt |
| CY Investment Income | $209 | CYInvestmentIncomeAmt |
| PY Other Revenue | $102,708 | PYOtherRevenueAmt |
| CY Other Revenue | $242,768 | CYOtherRevenueAmt |
| PY Total Revenue | $13,116,554 | PYTotalRevenueAmt |
| CY Total Revenue | $15,898,988 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $9,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,453,523 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,321,567 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,791,345 | PYOtherExpensesAmt |
| CY Other Expenses | $5,970,365 | CYOtherExpensesAmt |
| PY Total Expenses | $12,244,868 | PYTotalExpensesAmt |
| CY Total Expenses | $14,300,932 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $871,686 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,598,056 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,896,492 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,705,344 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $775,312 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $986,108 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,121,180 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,719,236 | NetAssetsOrFundBalancesEOYAmt |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $11,771,182 | ExpenseAmt |
| Grant | $9,000 | GrantAmt |
| Revenue | $13,095,530 | RevenueAmt |
| Desc | During the last year CCHC clinic teams provided care to 16,177 patients, who represented 59,083 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 | $11,771,182 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 42 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 149 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Debra A Boyd | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3047342040 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 70 | AddressLine1Txt |
| City | Dawes | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25054 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Donna Crowder | |||||||
| Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Phil Schenk | |||||||
| Vice Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Ann Kingery | |||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Nancy Guthrie | |||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Ted Boettner | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Nelda Ferrell | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Barbara Hatfield | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Cecil Roberts | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Pat Taylor | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Helen Matheny | |||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Craig Robinson | |||||||
| CEO / Executive Director | 40.00 | Yes (X) | $61,011 | $0 | $3,508 | ||
| Debra Boyd | |||||||
| CFO | 40.00 | Yes (X) | $75,616 | $0 | $15,703 | ||
| Marelise Nieuwenhuizen | |||||||
| Physician | 40.00 | $180,107 | $0 | $21,519 | Yes (X) | ||
| Grace Falbo | |||||||
| Physician | 40.00 | $157,557 | $0 | $7,168 | Yes (X) | ||
| Sue Westfall | |||||||
| Physician | 32.00 | $138,517 | $0 | $18,462 | Yes (X) | ||
| Letitia Tierney | |||||||
| Physician | 40.00 | $133,228 | $0 | $10,730 | Yes (X) | ||
| Charles Jacques | |||||||
| Medical Director | 28.00 | $155,021 | $0 | $6,650 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $901,057 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $83,740 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Athenahealth Inc | |||||
| PO Box 415615 | Boston | MA | 02241 | Information Tech Services | $461,434 |
| Melton Construction LLC | |||||
| 1231 Strawberry Road | St Albans | WV | 25177 | Construction/Remodeling | $173,294 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,588,332 | GovernmentGrantsAmt |
| All Other Contributions | $214,917 | AllOtherContributionsAmt |
| Total Contributions | $2,803,249 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient fees | Desc |
| Business | 621498 | BusinessCd |
| Total Revenue Column | $12,852,762 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,852,762 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,852,762 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $209 | TotalRevenueColumnAmt |
| Exclusion | $209 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Electronic health records incenti | 900099 | $178,500 | $178,500 |
| Insurance Reimbursement | 900099 | $55,414 | $55,414 |
| Other | 900099 | $8,854 | $8,854 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $242,768 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,898,988 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,095,530 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $209 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,000 | TotalAmt |
| Program Services | $9,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,748 | TotalAmt |
| Program Services | $158,079 | ProgramServicesAmt |
| Management And General | $35,669 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,501,685 | TotalAmt |
| Program Services | $5,304,725 | ProgramServicesAmt |
| Management And General | $1,196,960 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $292,057 | TotalAmt |
| Program Services | $238,289 | ProgramServicesAmt |
| Management And General | $53,768 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $827,019 | TotalAmt |
| Program Services | $674,765 | ProgramServicesAmt |
| Management And General | $152,254 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $507,058 | TotalAmt |
| Program Services | $413,709 | ProgramServicesAmt |
| Management And General | $93,349 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,852 | TotalAmt |
| Management And General | $66,852 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000,152 | TotalAmt |
| Program Services | $423,437 | ProgramServicesAmt |
| Management And General | $576,715 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,467 | TotalAmt |
| Program Services | $23,226 | ProgramServicesAmt |
| Management And General | $5,241 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $572,947 | TotalAmt |
| Program Services | $466,312 | ProgramServicesAmt |
| Management And General | $106,635 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,516 | TotalAmt |
| Program Services | $90,170 | ProgramServicesAmt |
| Management And General | $20,346 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $400,879 | TotalAmt |
| Program Services | $327,077 | ProgramServicesAmt |
| Management And General | $73,802 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,909 | TotalAmt |
| Program Services | $43,984 | ProgramServicesAmt |
| Management And General | $9,925 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,617 | TotalAmt |
| Program Services | $106,570 | ProgramServicesAmt |
| Management And General | $24,047 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,841 | TotalAmt |
| Program Services | $148,364 | ProgramServicesAmt |
| Management And General | $33,477 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,071 | TotalAmt |
| Program Services | $32,694 | ProgramServicesAmt |
| Management And General | $7,377 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $2,178,767 | $2,178,767 | |
| Bad debts | $927,426 | $927,426 | |
| Student loan repayment | $148,333 | $121,025 | $27,308 |
| Dues, memberships, subs | $49,390 | $40,297 | $9,093 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,198 | TotalAmt |
| Program Services | $43,266 | ProgramServicesAmt |
| Management And General | $36,932 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,300,932 | TotalAmt |
| Program Services | $11,771,182 | ProgramServicesAmt |
| Management And General | $2,529,750 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,391 | BOYAmt |
| EOY | $4,087 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,793,032 | BOYAmt |
| EOY | $2,554,364 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,601 | BOYAmt |
| EOY | $505,286 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $846,780 | BOYAmt |
| EOY | $1,030,199 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $205,905 | BOYAmt |
| EOY | $237,651 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,817,177 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,848,420 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,582,783 | BOYAmt |
| EOY | $1,968,757 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $405,000 | BOYAmt |
| EOY | $405,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,896,492 | BOYAmt |
| EOY | $6,705,344 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $687,667 | BOYAmt |
| EOY | $868,432 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,609 | BOYAmt |
| EOY | $117,576 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $100 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,036 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $775,312 | BOYAmt |
| EOY | $986,108 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,121,180 | BOYAmt |
| EOY | $5,719,236 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,121,180 | BOYAmt |
| EOY | $5,719,236 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,896,492 | BOYAmt |
| EOY | $6,705,344 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,598,056 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,843,970 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,832,404 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,845,034 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,168,895 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,803,249 | CurrentTaxYearAmt |
| Total | $13,493,552 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,843,970 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,832,404 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,845,034 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,168,895 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,803,249 | CurrentTaxYearAmt |
| Total | $13,493,552 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $13,493,552 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $525 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $418 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $246 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $208 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $209 | CurrentTaxYearAmt |
| Total | $1,606 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,355 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $74,828 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $257,400 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $102,708 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $242,768 | CurrentTaxYearAmt |
| Total | $684,059 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $14,179,217 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $48,111,527 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.95160 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99800 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part II, Line 10, Explanation of Other Income: | FormAndLineReferenceDesc |
| Explanation | Other income - 2011 Amount: $ 6,355. 2012 Amount: $ 2,578. 2013 Amount: $ 27,900. 2014 Amount: $ 94,208. 2015 Amount: $ 64,268. Electronic health records incentive revenue - 2012 Amount: $ 72,250. 2013 Amount: $ 229,500. 2014 Amount: $ 8,500. 2015 Amount: $ 178,500. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $220,700 | OtherCostOrOtherBasisAmt |
| Book Value | $220,700 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,896,884 | OtherCostOrOtherBasisAmt |
| Depreciation | $692,349 | DepreciationAmt |
| Book Value | $1,204,535 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,320,435 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,156,071 | DepreciationAmt |
| Book Value | $164,364 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $379,158 | OtherCostOrOtherBasisAmt |
| Book Value | $379,158 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,968,757 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $405,000 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $405,000 | TotalBookValueSecuritiesAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $13,558,391 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,558,391 | RevenueSubtotalAmt |
| Other Revenues Not Included | $2,340,597 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,340,597 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,898,988 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,960,335 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $11,960,335 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,340,597 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,340,597 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $14,300,932 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 1,413,171. Bad debt expense included in expenses on Form 990 927,426. |
| Part XII, Line 4b - Other Adjustments: | Bad debt expense included in revenue on financial statements 927,426. Cost of goods sold included in income on financial statement 1,413,171. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Educational scholarships for 1,500 each. | GrantTypeTxt |
| Recipient | 6 | RecipientCnt |
| Cash Grant | $9,000 | CashGrantAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Marelise Nieuwenhuizen | ||||||||||||||
| Physician | $175,032 | $0 | $5,075 | $0 | $0 | $0 | $8,868 | $0 | $13,617 | $0 | $202,592 | $0 | $0 | $0 |
| Grace Falbo | ||||||||||||||
| Physician | $143,354 | $0 | $14,203 | $0 | $0 | $0 | $7,168 | $0 | $749 | $0 | $165,474 | $0 | $0 | $0 |
| Sue Westfall | ||||||||||||||
| Physician | $120,656 | $0 | $17,861 | $0 | $0 | $0 | $6,150 | $0 | $13,257 | $0 | $157,924 | $0 | $0 | $0 |
| Charles Jacques | ||||||||||||||
| Medical Director | $124,938 | $0 | $30,083 | $0 | $0 | $0 | $6,247 | $0 | $1,317 | $0 | $162,585 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 11 | 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. |