2022-04-14T13:38:22-05:00 2021-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2020-07-01 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 2022-04-10 1 JAY BAUMGARTNER 999009999 ANGELA N CRAWFORD CPA P00573197 3176334705 2022-04-10 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z JAY BAUMGARTNER 2621 E JEFFERSON ST WARSAW IN 46581 114424396 0 X WWW.BOWENCENTER.ORG X 1960 IN TO STRENGTHEN OUR COMMUNITIES & IMPROVE THE HEALTH & WELL-BEING OF THOSE WE ARE PRIVILEGED TO SERVE. 16 16 1936 16 0 0 11885639 14475589 79179739 98498355 587406 647283 144914 221228 91797698 113842455 15000 27900 0 0 65708311 75745289 0 0 0 16927070 17557695 82650381 93330884 9147317 20511571 77516965 107274465 19397344 24495936 58119621 82778529 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 72991141 27900 98498355 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 27 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 1,366 EMPLOYEES DURING FY 2021, AND PROVIDED THE FOLLOWING SERVICES TO OUR PATIENTS:INPATIENT: 4,472 DAYSRESIDENTIAL CARE: 11,391 DAYSOUTPATIENT CARE: 869,180 HOURSMEDICAL VISITS: 83,541 72991141 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 91 0 1 1936 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 16 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 JIM FLECK CHAIRPERSON 1.00 X X 0 0 0 BETH PINKERTON VICE CHAIRPERSON 1.00 X X 0 0 0 DAN WOODS SECRETARY/TREASURER 1.00 X X 0 0 0 TANNER BABB BOARD MEMBER 1.00 X 0 0 0 DAVID BAILEY BOARD MEMBER 1.00 X 0 0 0 RYAN BAKER BOARD MEMBER 1.00 X 0 0 0 CINDY BRADY BOARD MEMBER 1.00 X 0 0 0 DEBRA BRICE BOARD MEMBER 1.00 X 0 0 0 BARBARA BURDGE BOARD MEMBER 1.00 X 0 0 0 MATT DITZLER BOARD MEMBER 1.00 X 0 0 0 JON GARBER BOARD MEMBER 1.00 X 0 0 0 SHIRLEY GIDLEY BOARD MEMBER 1.00 X 0 0 0 KEITH GILLENWATER BOARD MEMBER 1.00 X 0 0 0 ROXANNE GONAZLES BOARD MEMBER-TERM BEGAN JUL'20 1.00 X 0 0 0 ERIC HELFRICH BOARD MEMBER 1.00 X 0 0 0 SHARON METZGER BOARD MEMBER 1.00 X 0 0 0 KURT CARLSON PRESIDENT AND CEO 40.00 X 688811 0 110381 JAY BAUMGARTNER SENIOR VP-FINANCIAL SVC 40.00 X 497500 0 99472 ROBERT RYAN SENIOR VP-OPERATIONS 40.00 X 630896 0 119346 DR HANI AHMAD STAFF PSYCHIATRIST 40.00 X 682608 0 27862 DR SHIVAM DUBEY STAFF PSYCHIATRIST 40.00 X 357740 0 41536 DR SANTOSH MAHARJAN STAFF PSYCHIATRIST 40.00 X 449272 0 41412 DR KISHORE SRIRAM MEDICAL DIRECTOR 40.00 X 506046 0 41412 DR CAROLYN GREER STAFF PSYCHIATRIST 40.00 X 412160 0 12961 4225033 0 494382 32 0 1 0 PRIME TIME HEALTHCARE LLC 15380 WEIR ST OMAHA NV 68137 NURSE STAFFING AGENCY 721964 WJ CAREY CONSTRUCTION PO BOX 534 7004 W 350 S SOUTH WHITLEY IN 46787 GENERAL CONTRACTOR 381614 JW CLEANING SERVICE 851 N TIMBERLINE CIRCLE W WARSAW IN 46582 JANITORIAL SERVICES 252986 RSM US LLP 331 WEST 3RD ST SUITE 200 DAVENPORT IA 52801 IT SECURITY SERVICES 249598 SUPERIOR JANITORIAL 7004 E 1000 N SUITE B SYRACUSE IN 46567 JANITORIAL SERVICES 244273 12 74507 14178545 222537 14475589 NET PATIENT SERVICE RE 621110 91895780 91895780 MEDICAID FUNDS RECOVER 900099 6502575 6502575 DISPROPORTIONATE SHARE 900099 100000 100000 98498355 521027 521027 323139 209996 113143 113143 113143 498201 371945 126256 126256 126256 108085 108085 108085 113842455 98498355 0 868511 27900 27900 2146405 2146405 60485662 51810403 8675259 8935251 7193130 1742121 4177971 3507567 670404 122038 122038 92225 4101 88124 1458236 414899 1043337 166766 78733 88033 6418852 1627374 4791478 3012933 2564664 448269 2095039 2032477 62562 88807 44494 44313 15289 15289 2560553 2147417 413136 PATIENT EXPENSES 785208 780944 4264 HOSPITAL ASSESSMENT FEE 741749 741749 93330884 72991141 20339743 0 26061863 29408400 4642871 3458276 6950933 9696702 238362 208362 997103 1415680 52778619 22116030 29835758 30662589 6960216 29397426 1599564 2831551 230295 195479 77516965 107274465 8115780 10705724 21000 3661 325000 325000 10935564 13461551 19397344 24495936 X 58119621 82778529 58119621 82778529 77516965 107274465 20511571 4147337 0 X X 0 1 X 1 1 1 X 8198954 8273657 8324625 11885639 14475589 51158464 49582268 59391591 73466821 79179739 98498355 360118774 57781222 67665248 81791446 91065378 112973944 411277238 0 2119429 2636216 3978268 4380551 4227282 17341746 2119429 2636216 3978268 4380551 4227282 17341746 393935492 246748 413288 619008 843877 844166 2967087 246748 413288 619008 843877 844166 2967087 100024 121162 124346 134547 108085 588164 58127994 68199698 82534800 92043802 113926195 414832489 0.94960 0.94930 0.00720 0.00660 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2016 AMOUNT: $ 100,024. 2017 AMOUNT: $ 121,162. 2018 AMOUNT: $ 124,346. 2019 AMOUNT: $ 134,547. 2020 AMOUNT: $ 108,085. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2436 2436 0 PART II-B, LINE 1: PORTION OF TRADE ORGANIZATION'S ANNUAL DUES ALLOCATED TO LOBBYING EFFORTS. 1 174072 1148613 1106022 216663 0 362000 3384259 3746259 33578914 12976341 20602573 15192786 9139689 6053097 260660 260660 30662589 THIRD PARTY PAYABLE 10600000 DEFERRED COMPENSATION 2861551 13461551 X 118199788 4147337 4147337 114052451 -209996 -209996 113842455 93540880 209996 209996 93330884 0 93330884 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, 2021 AND 2020, 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 -209,996. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 209,996. 0 HEALTH & HOSPITAL CORPORATION 3838 N RURAL STREET INDIANAPOLIS IN 46205 356005697 N/A 27900 ASSIST INDIVIDUALS IN THE COMMUNITY WITH NAVIGATION SERVICES 1 X X X X 0 1 0 0 0 0 0 0 0 KURT CARLSON PRESIDENT AND CEO 528767 0 150000 0 10044 0 105110 0 5271 0 799192 0 0 0 ROBERT RYAN SENIOR VP-OPERATIONS 488036 0 142500 0 360 0 100310 0 19036 0 750242 0 0 0 DR HANI AHMAD STAFF PSYCHIATRIST 238933 0 413435 0 30240 0 10000 0 17862 0 710470 0 0 0 JAY BAUMGARTNER SENIOR VP-FINANCIAL SVC 384060 0 112500 0 940 0 81610 0 17862 0 596972 0 0 0 DR KISHORE SRIRAM MEDICAL DIRECTOR 287101 0 218705 0 240 0 23550 0 17862 0 547458 0 0 0 DR SANTOSH MAHARJAN STAFF PSYCHIATRIST 394732 0 53800 0 740 0 23550 0 17862 0 490684 0 0 0 DR CAROLYN GREER STAFF PSYCHIATRIST 213980 0 197940 0 240 0 2223 0 10738 0 425121 0 0 0 DR SHIVAM DUBEY STAFF PSYCHIATRIST 233540 0 123840 0 360 0 22500 0 19036 0 399276 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 2020: -KURT CARLSON -JAY BAUMGARTNER -ROBERT RYAN -DR. MAHARJAN -DR. SRIRAM -DR. DUBEY DR HANI AHMAD SEE PART V SEE PART V X 328362 208362 0 1 1 208362 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0