2023-02-04T20:52:32-06:00 2022-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2021-07-01 351057889 THE OTIS R BOWEN CENTER FOR HUMAN SERVICES INC OTIS 5742677169 2621 E JEFFERSON ST WARSAW IN 46581 JAY BAUMGARTNER SENIOR VP - FINANCIAL SERVICES 5742677169 2023-01-29 1 JAY BAUMGARTNER 999009999 ANGELA N CRAWFORD CPA P00573197 3176334705 2023-01-29 3 AAL1 IAL1 2021 2023-03-07 01:45:13Z JAY BAUMGARTNER 2621 E JEFFERSON ST WARSAW IN 46581 115657602 0 X WWW.BOWENCENTER.ORG X 1960 IN TO STRENGTHEN OUR COMMUNITIES & IMPROVE THE HEALTH & WELL-BEING OF THOSE WE ARE PRIVILEGED TO SERVE. 15 15 1971 16 0 0 14475589 17914420 98498355 96332745 647283 757229 221228 306362 113842455 115310756 27900 27900 0 0 75745289 81092900 0 0 0 17557695 19949574 93330884 101070374 20511571 14240382 107274465 127423736 24495936 32471663 82778529 94952073 X BOWEN CENTER'S MISSION IS TO STRENGTHEN OUR COMMUNITIES AND TO IMPROVE THE HEALTH AND WELL-BEING OF THOSE WE ARE PRIVILEGED TO SERVE. 0 0 82430954 27900 96332745 THE OTIS R. BOWEN FOR HUMAN SERVICES, INC. (THE CENTER), IS A COMMUNITY MENTAL HEALTH CENTER AND FQHC LOOKALIKE WITH THE PURPOSE OF PROVIDING A FULL RANGE OF BEHAVIORAL HEALTH SERVICES AND PRIMARY CARE. SERVICES PROVIDED INCLUDE: PSYCHIATRIC, OUTPATIENT COUNSELING, INPATIENT, CRISIS INTERVENTION, SUBSTANCE ABUSE, REHABILITATION, RESIDENTIAL, AND CONSULTATIVE SERVICES. THE CENTER PROVIDES SERVICES IN 30 COUNTIES IN NORTHERN INDIANA WITH OFFICES IN THE FOLLOWING COUNTIES - ALLEN, DEKALB, HUNTINGTON, KOSCIUSKO, LAGRANGE, MARSHALL, NOBLE, STEUBEN, WABASH, AND WHITLEY. [CONTINUES ON SCHEDULE O]THE CENTER HAD EMPLOYED AN AVERAGE OF 1,283 EMPLOYEES DURING FY 2022, AND PROVIDED THE FOLLOWING SERVICES TO OUR PATIENTS:INPATIENT: 4,061 DAYSRESIDENTIAL CARE: 11,215 DAYSOUTPATIENT CARE: 759,093 HOURSHEALTH CLINIC: 4,298 VISITSOPIOID TREATMENT FACILITY: 163,188 VISITSMEDICAL VISITS: 79,372 82430954 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 105 0 1 1971 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X JAY BAUMGARTNER 5742677169 2621 E JEFFERSON ST PO BOX 497 WARSAW IN 465810497 BETH PINKERTON CHAIRPERSON 1.00 0.00 X X 0 0 0 CINDY BRADY VICE CHAIRPERSON 1.00 0.00 X X 0 0 0 DAN WOODS SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 JIM FLECK IMM. PAST CHAIR 1.00 0.00 X X 0 0 0 TANNER BABB BOARD MEMBER 1.00 0.00 X 0 0 0 RYAN BAKER BOARD MEMBER 1.00 0.00 X 0 0 0 DEBRA BRICE BOARD MEMBER 1.00 0.00 X 0 0 0 BARBARA BURDGE BOARD MEMBER 1.00 0.00 X 0 0 0 MATT DITZLER BOARD MEMBER 1.00 0.00 X 0 0 0 JON GARBER BOARD MEMBER 1.00 0.00 X 0 0 0 SHIRLEY GIDLEY BOARD MEMBER 1.00 0.00 X 0 0 0 KEITH GILLENWATER BOARD MEMBER 1.00 0.00 X 0 0 0 ROXANNE GONAZLES BOARD MEMBER 1.00 0.00 X 0 0 0 ERIC HELFRICH BOARD MEMBER 1.00 0.00 X 0 0 0 CAROL HOCHSTETLER BOARD MEMBER-TERM BEGAN OCT'21 1.00 0.00 X 0 0 0 SHARON METZGER BOARD MEMBER-TERM ENDED SEP'21 1.00 0.00 X 0 0 0 DAVID BAILEY BOARD MEMBER-TERM ENDED SEP'21 1.00 0.00 X 0 0 0 KURT CARLSON PRESIDENT AND CEO 40.00 0.00 X 922649 0 6112 JAY BAUMGARTNER SENIOR VP-FINANCIAL SVC 40.00 0.00 X 678200 0 18637 ROBERT RYAN SENIOR VP-OPERATIONS 40.00 0.00 X 855758 0 135085 DR HANI AHMAD STAFF PSYCHIATRIST 40.00 0.00 X 529924 0 22138 DR CAROLYN GREER STAFF PSYCHIATRIST 40.00 0.00 X 407131 0 21665 SHANNON HANNON VP-INTEGRATIVE CARE 40.00 0.00 X 392280 0 74488 DR SANTOSH MAHARJAN STAFF PSYCHIATRIST 40.00 0.00 X 446176 0 33715 DR KISHORE SRIRAM MEDICAL DIRECTOR 40.00 0.00 X 513021 0 33715 4745139 0 345555 44 0 1 0 PRIME TIME HEALTHCARE LLC 15380 WEIR ST OMAHA NV 68137 NURSE STAFFING AGENCY 1238422 WJ CAREY CONSTRUCTION PO BOX 534 7004 W 350 S SOUTH WHITLEY IN 46787 GENERAL CONTRACTOR 585352 MM CUSTOM CLEANING PO BOX 429 AUBURN IN 46706 JANITORIAL SERVICES 293852 SUPERIOR JANITORIAL 7004 E 1000 N SUITE B SYRACUSE IN 46567 JANITORIAL SERVICES 268195 DM TRUMP CONSTRUCTION LLC 8193 E 150 S PIERCETON IN 46562 GENERAL CONTRACTOR 204610 8 77834 17706550 130036 17914420 NET PATIENT SERVICE RE 621110 87220977 87220977 MEDICAID FUNDS RECOVER 900099 9000001 9000001 DISPROPORTIONATE SHARE 900099 111767 111767 96332745 810271 810271 463445 293804 169641 169641 169641 53042 -53042 -53042 -53042 136721 136721 136721 115310756 96332745 0 1063591 27900 27900 2616441 2616441 64385731 56773707 7612024 9666057 8497247 1168810 4424671 3937268 487403 65660 8435 57225 91671 6027 85644 1269498 731070 538428 461396 123689 337707 7154759 2067591 5087168 3470728 3168657 302071 2420633 2360852 59781 103129 67539 35590 44587 44587 2934948 2683922 251026 HOSPITAL ASSESSMENT FEE 1099919 1099919 PATIENT EXPENSES 832646 832544 102 101070374 82430954 18639420 0 29408400 31915809 3458276 6724512 9696702 6025855 208362 178362 1415680 1252801 67138086 24938792 30662589 42199294 29397426 37494368 2831551 1441026 195479 191709 107274465 127423736 10705724 11718159 3661 115278 325000 9500000 13461551 11138226 24495936 32471663 X 82778529 94952073 82778529 94952073 107274465 127423736 14240382 -2066838 0 X X 0 1 X 1 1 1 X 8273657 8324625 11885639 14475589 17836586 60796096 59391591 73466821 79179739 98498355 96332745 406869251 67665248 81791446 91065378 112973944 114169331 467665347 0 2636216 3978268 4380551 4227282 7844203 23066520 2636216 3978268 4380551 4227282 7844203 23066520 444598827 413288 619008 843877 844166 1273716 3994055 413288 619008 843877 844166 1273716 3994055 121162 124346 134547 108085 136721 624861 68199698 82534800 92043802 113926195 115579768 472284263 0.94140 0.94960 0.00850 0.00720 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2017 AMOUNT: $ 121,162. 2018 AMOUNT: $ 124,346. 2019 AMOUNT: $ 134,547. 2020 AMOUNT: $ 108,085. 2021 AMOUNT: $ 136,721. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2597 2597 0 PART II-B, LINE 1: PORTION OF TRADE ORGANIZATION'S ANNUAL DUES ALLOCATED TO LOBBYING EFFORTS. 1 216663 925368 1025763 116268 0 362000 5915791 6277791 43607191 14186472 29420719 16225624 10752320 5473304 1027480 1027480 42199294 THIRD PARTY PAYABLE 9630000 DEFERRED COMPENSATION 1508226 11138226 X 113537722 -2066838 -2066838 115604560 -293804 -293804 115310756 101364178 293804 293804 101070374 0 101070374 PART IV, LINE 1B: THE ORGANIZATION IS AN AGENT FOR CLIENT/RESIDENT FUNDS, THE PAYEE ACCOUNTS. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT AS OF JUNE 30, 2022 AND 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -293,804. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 293,804. 0 HEALTH & HOSPITAL CORPORATION 3838 N RURAL STREET INDIANAPOLIS IN 46205 356005697 N/A 27900 0 ASSIST INDIVIDUALS IN THE COMMUNITY WITH NAVIGATION SERVICES 1 X X X X X 0 1 0 0 0 0 0 0 0 ROBERT RYAN SENIOR VP-OPERATIONS 552918 0 291000 0 11840 0 116280 0 18805 0 990843 0 0 0 KURT CARLSON PRESIDENT AND CEO 589646 0 308685 0 24318 0 0 0 6112 0 928761 0 0 0 JAY BAUMGARTNER SENIOR VP-FINANCIAL SVC 434860 0 231500 0 11840 0 0 0 18637 0 696837 0 0 0 DR HANI AHMAD STAFF PSYCHIATRIST 237456 0 252468 0 40000 0 0 0 22138 0 552062 0 0 0 DR KISHORE SRIRAM MEDICAL DIRECTOR 288036 0 213145 0 11840 0 15000 0 18715 0 546736 0 0 0 DR SANTOSH MAHARJAN STAFF PSYCHIATRIST 387636 0 46200 0 12340 0 15000 0 18715 0 479891 0 0 0 SHANNON HANNON VP-INTEGRATIVE CARE 233235 0 154000 0 5045 0 61200 0 13288 0 466768 0 0 0 DR CAROLYN GREER STAFF PSYCHIATRIST 222221 0 179970 0 4940 0 0 0 21665 0 428796 0 0 0 PART I, LINE 4B ELIGIBLE EMPLOYEES PARTICIPATE IN A 457(F) DEFERRED COMPENSATION PLAN. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII PARTICIPATED IN THE PLAN IN 2021: -KURT CARLSON -ROBERT RYAN -JAY BAUMGARTNER -DR. SRIRAM -DR. MAHARJAN -SHANNON HANNON DR HANI AHMAD SEE PART V SEE PART V X 328362 178362 0 1 1 178362 SCHEDULE L, PART II, LOAN TO AND FROM INTERESTED PERSONS: (A) NAME OF PERSON: DR. HANI AHMAD(B) RELATIONSHIP WITH ORGANIZATION: HIGHEST COMPENSATED EMPLOYEE(C) PURPOSE OF LOAN: PHYSICIAN RECRUITMENT FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE TAX RETURN WAS EMAILED TO ALL BOARD OF DIRECTORS PRIOR TO FILING. THE 990 WAS THEN DISCUSSED WITH THE BOARD OF DIRECTORS DURING A REGULARLY SCHEDULED BOARD MEETING AND FINAL APPROVAL BY THE BOARD WAS REQUIRED BEFORE FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD OF DIRECTORS AND EXECUTIVE STAFF (PRESIDENT/CEO AND ALL VPS) ARE REQUIRED TO DISCLOSE ANY CONFLICT OF INTEREST THEY MAY HAVE WITH THE CENTER. INFORMATION IS FULLY DISCLOSED AND SHARED WITH OTHERS INVOLVED IN DECISION-MAKING. BOARD OF DIRECTORS ARE PROHIBITED FROM VOTING ON AGREEMENTS WHERE THEY HAVE A CONFLICT OF INTEREST. CONTRACTS ARE MONITORED TO DETERMINE WHETHER ANY POTENTIAL UNDISCLOSED CONFLICT OF INTEREST MAY OCCUR. THESE ARE FULLY INVESTIGATED AND DISCUSSED WITH THE PERSON IN QUESTION TO ENSURE EITHER NO CONFLICT OF INTEREST EXISTS, OR THAT THE CONFLICT OF INTEREST IS FULLY DISCLOSED. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR HANDLING THE CONTRACT AND COMPENSATION FOR THE PRESIDENT/CEO. THEY WILL EACH YEAR CONDUCT A PERFORMANCE EVALUATION ON THE PRESIDENT/CEO AND PRESENT THEIR REVIEW TO THE FULL BOARD OF DIRECTORS FOR THEIR ARRANGEMENT/APPROVAL. AFTER THE EVALUATION IS COMPLETED, A REVIEW OF THE COMPENSATION FOR THE PRESIDENT/CEO IS CONDUCTED. INFORMATION IS PROVIDED TO THE BOARD OF DIRECTORS BY THE SENIOR VICE PRESIDENT-FINANCIAL SERVICES OF THE BOWEN CENTER. AN OUTSIDE CONSULTANT IS UTILIZED TO HELP GATHER AND PREPARE THIS INFORMATION. INFORMATION PROVIDED INCLUDES THE INDIANA COUNCIL SALARY AND BENEFIT SURVEY OF COMMUNITY MENTAL HEALTH CENTERS AND A REVIEW OF COMPENSATION OF OTHER PRESIDENT/CEO'S OF COMMUNITY MENTAL HEALTH CENTERS BY REVIEWING THEIR 990 RETURNS. THE PRESIDENT/CEO IS RESPONSIBLE FOR DETERMINING THE COMPENSATION FOR ALL OTHER KEY EMPLOYEES OF THE CENTER. COMPARATIVE DATA SUCH AS INDIANA'S COUNCIL'S SALARY AND BENEFIT SURVEY IS UTILIZED WHEN DETERMINING THEIR COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR AUDIT OVERSIGHT AND NO PROCESSES HAVE CHANGED FROM THE PRIOR YEAR. BOWEN APARTMENTS 2621 E JEFFERSON ST WARSAW IN 465810497 351908138 HOUSING TO HANDICAPPED IN 501(C)(3) LINE 10 N/A 0 BOWEN RESIDENTIAL 2621 E JEFFERSON ST WARSAW IN 465810497 351815690 HOUSING TO HANDICAPPED IN 501(C)(3) LINE 10 N/A 0 HOUSING FOR HOPE 2621 E JEFFERSON ST WARSAW IN 465810497 352024026 HOUSING FOR LOWER INCOME IN 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0