2019-05-01T11:58:47-05:00 2018-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2017-07-01 350811197 FAIRBANKS HOSPITAL INC FAIR 3178498222 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 JANINE R SHOPP VICE PRESIDENT AND CFO 3175729387 2019-04-28 1 MARGOT BURKE CPA P01588992 3176334705 2019-04-28 165.225.0.71 2019-04-28 21:21:23 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B19D0506B86ED19F1A0FD2AFEEB91090E576B51F 2017 2019-02-21 02:37:17Z BARBARA ELLIOTT 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 25035258 0 X WWW.FAIRBANKSCD.ORG X 1946 IN NONPROFIT ORGANIZATION FOCUSED ON RECOVERY FROM ALCOHOL AND OTHER DRUG PROBLEMS. 16 15 451 160 0 25743 477164 829343 21034391 22693792 195830 188893 1169662 1211069 22877047 24923097 280000 233000 0 0 15606173 15843310 0 35700 442303 7617944 8400218 23504117 24512228 -627070 410869 27524705 27619664 2199838 2076778 25324867 25542886 X FAIRBANKS IS A NONPROFIT ORGANIZATION FOCUSED ON RECOVERY FROM ALCOHOL AND OTHER DRUG PROBLEMS, SERVING AS A RESOURCE TO IMPROVE THE WELL-BEING OF INDIVIDUALS, FAMILIES AND COMMUNITIES BY OFFERING HOPE AND SUPPORT THROUGH ITS PROGRAMS AND SERVICES. 0 0 8593157 10043427 ADULT INPATIENT SERVICES CONSISTING OF DETOXIFICATION, REHABILITATION AND RESIDENTIAL SERVICES. THE DETOXIFICATION PHASE IS A MEDICALLY MANAGED LEVEL OF CARE WHERE THE EXTENT OF THE PATIENT'S ADDICTION IS DETERMINED AND THE PHYSICAL AND PSYCHOLOGICAL IMPACT OF THAT ADDICTION IS ASSESSED AND THE APPROPRIATE TREATMENT COURSE IS INITIATED. FOR THE CURRENT FISCAL YEAR, FAIRBANKS HOSPITAL HAD 8,902 ADULT DETOX PATIENT DAYS.THE REHABILITATION PHASE OCCURS WHEN FURTHER INPATIENT STABILIZATION/TREATMENT IS NEEDED AND REQUIRED CONTINUED MEDICAL SUPERVISION. THE TREATMENT PROCESS IS MULTI-DISCIPLINARY AND GROUP ORIENTED. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 1,430 ADULT REHAB PATIENT DAYS. THE RESIDENTIAL PROGRAM IS FOR THE PATIENT WHO REQUIRES A RESTRICTIVE ENVIRONMENT TO ABSTAIN FROM USING BUT WHO IS MEDICALLY STABLE. THE PATIENT PARTICIPATES IN NO LESS THAN FOUR HOURS OF THERAPY DAILY AND NURSING CARE IS PROVIDED, IF NEEDED. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 992 ADULT RESIDENTIAL PATIENT DAYS. 3527515 4122856 ADULT OUTPATIENT SERVICES PROGRAM CONSISTING OF PARTIAL HOSPITALIZATION (PHP) AND INTENSIVE OUTPATIENT PROGRAM (IOP). THE PHP PROGRAM IS SIX TO SEVEN HOURS PER DAY MONDAY THROUGH FRIDAY AND IS A MULTI-DISCIPLINARY AND GROUP ORIENTED TREATMENT PROGRAM. IT WILL CONTAIN EVALUATION AND EDUCATION. IT ALLOWS THE PATIENT TO EXPERIENCE LIFE ON THE "OUTSIDE" WHILE BEING INVOLVED IN A VERY INTENSE LEVEL OF TREATMENT. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 7,422 PHP VISITS.IOP IS AVAILABLE TO THOSE WHOSE ADDICTION IS NOT SO SEVERE AS TO REQUIRE INPATIENT OR PHP SERVICES. THE PATIENTS MUST DEMONSTRATE THE ABILITY TO REMAIN DRUG-FREE DURING THE ENTIRE TREATMENT COURSE AND INDICATE A WILLINGNESS TO BECOME INVOLVED IN A 12-STEP PROGRAM. IOP PATIENTS GENERALLY MEET FOR THREE HOURS, THREE TIMES PER WEEK. IOP OFFERS EDUCATION AND GROUP THERAPY. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 10,747 VISITS.LEVEL 1 OUTPATIENT - IN ALIGNMENT WITH THE AMERICAN SOCIETY FOR ADDICTION MEDICINE (ASAM), FAIRBANKS CONSIDERS PATIENTS WHOSE SEVERITY OF SUBSTANCE USE IS MILD AND CAUSES MINIMAL INTERRUPTION IN THEIR FUNCTIONING AS BEING BEST SUITED FOR LEVEL 1 OP SERVICES. THESE INDIVIDUALS MAY PRESENT WITH MILD, CO-OCCURRING SUBSTANCE ABUSE AND MENTAL HEALTH AND/OR PHYSICAL HEALTH CONDITIONS. THEY MAY ALREADY BE RECEIVING SERVICES FOR THESE OTHER CO-OCCURRING CONDITIONS, BUT NEED MORE EDUCATION, SUPPORT AND TREATMENT FOR ISSUES RELATED TO THEIR SUBSTANCE USE. ADDITIONALLY, LEVEL 1 MAY BE APPROPRIATE FOR INDIVIDUALS WHO ARE NOT INTERESTED IN RECOVERY, BUT ARE MANDATED INTO TREATMENT. THEY MAY OR MAY NOT HAVE COMPLETED AN EDUCATION COURSE, BUT APPEAR TO NEED MORE THAN JUST EDUCATION AS INDICATED BY THEIR USE OR SERVICE HISTORY. INDIVIDUALS WHO NEED MORE THAN JUST EDUCATION TO ENHANCE THEIR MOTIVATION OR TO CREATE AMBIVALENCE MAY ALSO BENEFIT FROM THIS LEVEL OF CARE. AT THE SAME TIME, INDIVIDUALS WHO ARE IN EARLY RECOVERY AND VIEW TREATMENT AS POTENTIALLY HELPFUL AND ARE ENTERING TREATMENT FOR THE FIRST TIME WILL BENEFIT FROM LEVEL 1. PATIENTS IN THIS LEVEL OF CARE MAY BE RECEIVING MEDICATION ASSISTED TREATMENT (MAT) SERVICES AND/OR OTHER THERAPIES DUE TO THEIR SUBSTANCE USE INCLUDING PATIENTS WHO NEED A STEP DOWN FROM IOP WHOM THE TREATMENT TEAM FINDS HAVE CONTINUED THERAPEUTIC NEEDS BEYOND THE SUPPORT OF AN AFTERCARE PROGRAM. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 887 ADULT LEVEL 1 VISITS. 1440096 1683142 YOUNG ADULT INPATIENT SERVICES CONSISTING OF DETOXIFICATION, REHABILITATION, AND RESIDENTIAL SERVICES FOR MALES BETWEEN THE AGES OF 19-23. THE DETOXIFICATION PHASE IS A MEDICALLY MANAGED LEVEL OF CARE WHERE THE EXTENT OF THE PATIENT'S ADDICTION IS DETERMINED AND THE PHYSICAL AND PSYCHOLOGICAL IMPACT OF THAT ADDICTION IS DETERMINED AND THE APPROPRIATE TREATMENT COURSE IS INITIATED. YOUNG ADULT GUIDANCE SPECIALISTS ARE MEMBERS OF THE TREATMENT TEAM. DURING THIS PHASE OF CARE, VARIOUS MULTI-DISCIPLINARY EVALUATIONS ARE COMPLETED. FAMILIES AND OTHER SUPPORT INDIVIDUALS (SCHOOL, PROBATION, CASEWORKERS, ETC.) ARE INVOLVED. FOR THE CURRENT FISCAL YEAR, FAIRBANKS HOSPITAL HAD 1,013 YOUNG ADULT DETOX PATIENT DAYS. 5856041 233000 7008037 ADOLESCENT INPATIENT SERVICES CONSISTING OF DETOXIFICATION, REHABILITATION, AND RESIDENTIAL SERVICES. THE DETOXIFICATION PHASE IS A MEDICALLY MANAGED LEVEL OF CARE WHERE THE EXTENT OF THE PATIENT'S ADDICTION IS DETERMINED AND THE PHYSICAL AND PSYCHOLOGICAL IMPACT OF THAT ADDICTION IS ASSESSED AND THE APPROPRIATE TREATMENT COURSE IS INITIATED. ADOLESCENT GUIDANCE SPECIALISTS ARE MEMBERS OF THE TREATMENT TEAM. DURING THIS PHASE OF CARE, VARIOUS MULTI-DISCIPLINARY EVALUATIONS ARE COMPLETED. FAMILIES AND OTHER SUPPORT INDIVIDUALS (SCHOOL, PROBATION, CASEWORKERS, ETC) ARE INVOLVED. FOR THE CURRENT FISCAL YEAR, FAIRBANKS HOSPITAL HAD 183 ADOLESCENT DETOX PATIENT DAYS.THE ADOLESCENT REHAB PHASE IS FOR PATIENTS NEEDING FURTHER INPATIENT STABILIZATION/TREATMENT AND REQUIRES MEDICAL SUPERVISION. THIS TREATMENT PROCESS IS MULTI-DISCIPLINARY AND GROUP-ORIENTED. ADOLESCENTS RECEIVE INFORMATION ON DEVELOPING SOCIAL SKILLS, COMMUNICATION, HOW TO GAIN INTERNAL CONTROL OVER FEELINGS, HOW TO DEAL WITH ANGER, HOW TO DEAL WITH PEER PRESSURE, AND OTHER DEVELOPMENT NEEDS. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 101 ADOLESCENT REHAB PATIENT DAYS AND 1,850 ADOLESCENT RESIDENTIAL PATIENT DAYS.THE YOUNG ADULT REHAB PHASE IS FOR PATIENTS NEEDING FURTHER INPATIENT STABILIZATION/TREATMENT AND REQUIRE MEDICAL SUPERVISION. THIS TREATMENT PROCESS IS MULTI-DISCIPLINARY AND GROUP ORIENTED. AN IMPORTANT PART OF THE PROGRAM INCLUDES FAMILY MEMBERS OF THE PATIENT. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 183 YOUNG ADULT REHAB PATIENT DAYS.THE RESIDENTIAL PHASE IS FOR YOUNG ADULTS IN NEED OF STABILIZATION AND TREATMENT. TREATMENT IS MULTI-DISCIPLINARY AND GROUP ORIENTED. YOUNG ADULTS RECEIVE INFORMATION ON DEVELOPING SOCIAL SKILLS, COMMUNICATION, HOW TO GAIN INTERNAL CONTROL OVER FEELING, HOW TO DEAL WITH ANGER, HOW TO DEAL WITH PEER PRESSURE, AND OTHER DEVELOPMENT NEEDS. FOR THE CURRENT FISCAL YEAR, THE HOSPITAL HAD 1,428 YOUNG ADULT RESIDENTIAL PATIENT DAYS.ADOLESCENT OUTPATIENT SERVICES PROGRAM SERVED 561 PHP VISITS AND 995 IOP VISITS DURING THE CURRENT FISCAL YEAR. YOUNG ADULT OUTPATIENT SERVICES PROGRAM SERVED 1,018 PHP VISITS AND 1,467 IOP VISITS DURING THE CURRENT FISCAL YEAR. ADULT HALFWAY HOUSE SERVED 26 PATIENT DAYS DURING THE CURRENT FISCAL YEAR. FAIRBANKS HOSPITAL PROVIDED 4,329 PATIENT DAYS AT LA VERNA LODGE FOR MEN, 1,807 DAYS AT LA VERNA LODGE FOR WOMEN, AND 26,600 PATIENT DAYS AT SUPPORTED LIVINGS FACILITIES DURING THE CURRENT FISCAL YEAR. 5856041 233000 7008037 19416809 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 57 0 1 451 1 1 1 0 0 0 0 1 1 0 0 0 0 X 16 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 IN X JANINE R SHOPP 3175729387 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 X TOM FLOWERS VICE CHAIR TO CHAIR-APR'18 1.00 0.00 X X 0 0 0 JOHN RYAN BOARD MEMBER TO VICE CHAIR-APR'18 1.00 0.00 X 0 0 0 KEVIN MURPHY TREASURER 1.00 0.00 X X 0 0 0 CAROL BROWN LUKEMEYER SECRETARY 1.00 0.00 X X 0 0 0 JOHN ADAMS IV BOARD MEMBER 1.00 0.00 X 0 0 0 PATRICK CARR BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID CORBITT BOARD MEMBER 1.00 0.00 X 0 0 0 GREG FULK BOARD MEMBER 1.00 0.00 X 0 0 0 MICHAEL HERTEL BOARD MEMBER-TERM BEGAN APR'18 1.00 0.00 X 0 0 0 MARISSA MANLOVE BOARD MEMBER 1.00 0.00 X 0 0 0 ANN MERKEL BOARD MEMBER 1.00 0.00 X 0 0 0 MATTHEW NEFF BOARD MEMBER 1.00 0.00 X 0 0 0 ELIZABETH SMITH BOARD MEMBER-TERM BEGAN APR'18 1.00 0.00 X 0 0 0 ADRIENNE TAKACS BOARD MEMBER 1.00 0.00 X 0 0 0 RONDA SHREWSBURY WEYBRIGHT BOARD MEMBER 1.00 0.00 X 0 0 0 FARAZ ABBASI CHAIRMAN-TERM ENDED APR'18 1.00 0.00 X X 0 0 0 WILLIAM MCKAY II BOARD MEMBER-TERM ENDED APR'18 1.00 1.00 X 0 0 0 BARBARA ELLIOT PRESIDENT/CEO 36.00 4.00 X X 248300 0 36312 JANINE SHOPP CFO 32.40 3.60 X 126733 0 17218 DR DARRIN MANGIACARNE MEDICAL DIRECTOR 40.00 0.00 X 308117 0 39575 DRJAMES MEACHAM PHYSICIAN 40.00 0.00 X 206658 0 14852 DR JENNIFER BELL PHYSICIAN 40.00 0.00 X 136769 0 7835 SHARON BAKER DIRECTOR OF SUPPORT SERVIC 40.00 0.00 X 126008 0 11384 DR CLAUDIA JIMENEZ PHYSICIAN 40.00 0.00 X 132259 0 957 ROBIN PARSONS CCO 40.00 0.00 X 107789 0 23631 KENT BROWN FORMER PRESIDENT 0.00 0.00 X 235577 0 0 1628210 0 151764 9 1 1 0 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURG PA 15251 FOOD SERVICE MANAGEMENT & STAFF 1154524 CALDWELL VANRIPER INC 701 E NEW YORK STREET INDIANAPOLIS IN 46202 MARKETING 589954 ABBASPOUR INC 7320 E 82ND STREET INDIANAPOLIS IN 46256 PHARMACY SERVICES 413988 SOUTH BEND MEDICAL FOUNDATION PO BOX 2030 MISHAWAKA IN 46546 LAB SERVICES 320439 NETSMART TECHNOLOGIES PO BOX 823519 PHILADELPHIA PA 19182 IT SERVICES 183714 6 74841 754502 829343 PATIENT SERVICE REVENUE 621300 22693792 22693792 22693792 188193 188193 144600 0 144600 144600 144600 700 0 700 700 700 184772 74841 112161 72611 72611 ASSISTED LIVING PROGRAM 624229 681848 681848 GIFT SHOP & CAFETERIA REVENUE 624100 88796 88796 223214 19070 204144 993858 24923097 22857462 0 1236292 X 233000 233000 670344 308117 362227 11553173 9598113 1653559 301501 341655 283839 48900 8916 2345338 1923343 362112 59883 932800 774949 133508 24343 139613 139613 64370 64370 35700 35700 26562 26562 3461896 2127198 1334698 535585 496614 38971 996688 847860 137806 11022 1407468 1333783 73685 57385 55879 981 525 35239 20726 14100 413 12528 12528 1183088 1092720 90368 286793 221394 65399 193003 60184 132819 24512228 19416809 4653116 442303 1096426 975633 5645055 4582461 125 0 3809668 4330541 630881 642816 25385103 13639336 12327893 11745767 3814893 5227488 199764 114958 27524705 27619664 1624759 1554909 316077 271077 259002 250792 2199838 2076778 X 25137351 25226612 187516 316274 25324867 25542886 27524705 27619664 X 410869 59768 -252618 X X 0 1 X 1 0 X SCHEDULE A, PART 1, LINE 3: FAIRBANKS HOSPITAL, INC. HAS BEEN DETERMINED BY THE IRS TO BE A PUBLIC CHARITY UNDER IRS CODE SECTION 170(B)(1)(A)(III). PER SCHEDULE H INSTRUCTIONS ONLY ORGANIZATIONS THAT OPERATE AT LEAST ONE FACILITY THAT IS, OR IS REQUIRED TO BE, LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED BY A STATE AS A HOSPITAL IS REQUIRED TO COMPLETE THIS SCHEDULE. FAIRBANK HOSPITAL, INC. IS A PRIVATE MENTAL HEALTH INSTITUTION AND CERTIFIED AS AN ADDICTIONS SERVICE PROVIDER. FAIRBANKS HOSPITAL IS NOT LICENSED BY THE INDIANA STATE DEPARTMENT OF HEALTH AS A HOSPITAL, BUT IS RECOGNIZED BY THE CENTERS FOR MEDICAID AND MEDICARE AS AN ACUTE CARE HOSPITAL. THE COMPLETION OF SCHEDULE H IS NOT REQUIRED; HOWEVER, FAIRBANKS' MANAGEMENT HAS DECIDED TO COMPLETE SCHEDULE H TO PROVIDE INFORMATION TO THE COMMUNITY REGARDING ITS FINANCIAL ASSISTANCE, COMMUNITY BENEFITS, AND FACILITY INFORMATION. 964196 736558 615236 1085518 1013434 268722 317960 964196 949663 324621 260850 1013434 861341 434001 345679 949663 898546 405239 442444 861341 0.70860 0.29140 0 0 138876 138876 16529748 7783947 8745801 8716479 5855389 2861090 11745767 ESTIMATED THIRD PARTY SETTLEMENTS 250792 250792 X 25095026 59768 59768 25035258 -112161 -112161 24923097 24624389 112161 112161 24512228 0 24512228 PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE THOSE ASSETS WHOSE USE HAS BEEN LIMITED BY DONORS FOR A SPECIFIC OPERATING OR CAPITAL PURPOSE. BOARD DESIGNATED FUNDS ARE SET ASIDE BY THE BOARD FOR SPECIFIC PURPOSES INCLUDING CHARITY CARE. PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY FAIRBANKS AND THE SCHOOL AND RECOGNIZE A TAX LIABILITY IF FAIRBANKS OR THE SCHOOL 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 FAIRBANKS AND THE SCHOOL, AND HAS CONCLUDED THAT AS OF JUNE 30, 2018 AND 2017, 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. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EVENT ACTIVITY -112,161. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT ACTIVITY 112,161. X X X X X 1 HEDGES & ASSOCIATES 2105 N MERIDIAN ST 101 INDIANAPOLIS IN 46202 GRANT WRITING 0 180000 35700 144300 180000 35700 144300 IN CIRCLE OF HOPE DINNER 259613 74841 184772 11735 42036 10000 48390 259613 74841 184772 11735 42036 10000 48390 112161 72611 1 1 X 0 1 X 0 1 0 1 0 750029 750029 0.03060 4997831 5293967 0 0.00000 5747860 5293967 750029 0.03060 1260023 1260023 0.05140 153000 153000 0.00620 1413023 1413023 0.05760 7160883 5293967 2163052 0.08820 1 2144984 2005050 1750438 254612 X 1 1 1 1 FAIRBANKS HOSPITAL INC 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 WWW.FAIRBANKSCD.ORG 83-5-1-PI-P X LICENSED PRIVATE MENTAL HEALTH INSTITUTION FAIRBANKS HOSPITAL INC 1 0 0 1 X X X X X X X X 15 1 0 0 1 X HTTP://WWW.FAIRBANKSCD.ORG X X 1 16 1 SEE PART V, PAGE 7 0 1 X 0.000000000000 250.000000000000 X X X 1 1 X X X X 1 X SEE PART V, SECTION D X SEE PART V, SECTION D X HTTP://WWW.FAIRBANKSCD.ORG/PROGRAMS/CATEGORY/COST-AND-INSURANCE/ X X X X X X 1 X 0 X X X X 0 X X 0 0 FAIRBANKS HOSPITAL, INC PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENTED THE COMMUNITY IT SERVED INCLUDING THOSE WITH SPECIAL KNOWLEDGE THROUGH FOUR FOCUS GROUPS. THE GROUPS WERE DETERMINED THROUGH DISCUSSION WITH ACADEMIC AND HEALTHCARE EXPERTS WHO HAVE KNOWLEDGE OF THE SUBSTANCE IMPACTED POPULATION IN THE INDIANAPOLIS METROPOLITAN AREA. THE FIRST GROUP CONSISTED OF ADDICTION SERVICE PROVIDERS FOR LOW INCOME AND MINORITY POPULATIONS AND COMMUNITY STAKEHOLDERS FROM THE STATE CRIMINAL JUSTICE DEPARTMENT, TASK FORCE ON DRUG FREE MARION COUNTY, HALFWAY HOUSES, PRIMARY MEDICAL CARE COALITION, AND EMPLOYEE ASSISTANCE PROGRAMS. ADOLESCENTS ATTENDING THE RECOVERY HIGH SCHOOL COMPRISED THE SECOND GROUP; FAMILY MEMBERS OF THOSE WHO RECEIVED ADDICTION TREATMENT SERVICES WERE IN THE THIRD GROUP, AND THE FOURTH GROUP CONSISTED OF ADULT PATIENTS WHO HAD SUCCESSFULLY COMPLETED INPATIENT TREATMENT. FOCUS GROUP QUESTIONS INCLUDED IDENTIFICATION OF STRENGTHS AND WEAKNESSES IN THE ADDICTION TREATMENT SYSTEM, BARRIERS TO SERVICES, GAPS IN SERVICES, AND RECOMMENDATIONS FOR THE SYSTEM OF CARE. FAIRBANKS HOSPITAL, INC PART V, SECTION B, LINE 7D: THE HOSPITAL FACILITY'S CHNA IS AVAILABLE TO THE PUBLIC ON THE HOSPITAL'S WEBSITE AT WWW.FAIRBANKSCD.ORG UNDER "FOR PROFESSIONALS AND CLICK ON "ADDITIONAL RESOURCES OR ENTER THE FOLLOWING WEB ADDRESS INTO THE BROWSER: HTTPS://WWW.FAIRBANKSCD.ORG/WP-CONTENT/UPLOADS/2018/07/COMMUNITY-NEEDS-ASSESSMENT-2016.PDF FAIRBANKS HOSPITAL, INC PART V, SECTION B, LINE 11: THE HOSPITAL FACILITY COMPLETED ITS MOST RECENT CHNA AS OF 6/30/16 (TAX YEAR 2015) AND HAS IDENTIFIED SIX SIGNIFICANT NEEDS FOR ITS IMPLEMENTATION STRATEGY COVERING THE TAX YEARS 2016 - 2018 AND APPROVED IN TAX YEAR 2016. THE HOSPITAL HAS SUCCESSFULLY IMPLEMENTED STRATEGIES TO ADDRESS EACH OF THE NEEDS IDENTIFIED IN THE ASSESSMENT.1. EXPAND MAT (MEDICATION ASSISTANCE TREATMENT) PROGRAMMING. - IN SEPTEMBER OF 2016, FAIRBANKS HOSPITAL OPENED A MEDICATION ASSISTED TREATMENT PROGRAM.2. DEVELOP SUBSTANCE ABUSE PREVENTION PROGRAMMING FOR HIGH SCHOOL AND MIDDLE SCHOOL STUDENTS. - EXPANDED REACH OF PREVENTION AND EDUCATION PROGRAMS FOR ADOLESCENTS THROUGH COLLABORATIONS WITH HIGH SCHOOLS. 3. INCREASE ACCESS AND AVAILABILITY TO PEER RECOVERY COACHING. - IN SCHOOL YEAR 2016/17 FAIRBANKS BEGAN PROVIDING A PEER RECOVERY COACH ON CAMPUS AT IUPUI. WE HAVE BEEN AN INTERN SITE FOR PEER RECOVERY COACH TRAINING AND WE HAVE IMPLEMENTED A FREE APP FOR CLIENTS TO USE FOR ON-GOING SUPPORT POST DISCHARGE FROM TREATMENT. 4. INCREASE THE NUMBER OF SUPPORT MEETINGS FOR YOUNG PEOPLE IN RECOVERY. - IN THE 2016/17 SCHOOL YEAR IMPLEMENTED AN AFTERSCHOOL YOUNG PEOPLES 12 STEP MEETING LOCATED AT HOPE ACADEMY. 5. CONTINUE EFFORTS TO EDUCATE THE COMMUNITY ON THE DISEASE OF ADDICTION THROUGH CONTENT DEVELOPMENT, MEDIA OPPORTUNITIES, EDUCATION EVENTS AND PUBLIC SPEAKING. - DEVELOPED AN EDITORIAL BOARD CONSISTING OF CLINICAL AND ADMINISTRATION WHICH MEETS BIWEEKLY TO CREATE USEFUL CONTENT FOR SOCIAL MEDIA, PUBLIC RELATIONS, WEBSITE RESOURCES, EDUCATIONAL EVENTS, AND SPEAKING OPPORTUNITIES. THIS HAS RESULTED IN GREATER COVERAGE IN THE MEDIA AND PROVIDED FAIRBANKS THE OPPORTUNITY TO PROVIDE EVIDENCE-BASED INFORMATION ON A VARIETY OF RECOVERY TOPICS AND ISSUES. IN ADDITION, A FAIRBANKS PODCAST, "RECOVERY TALKS," HAS BEEN LAUNCHED TO PROVIDE INFORMATION ON ADDICTION TO AN EVEN WIDER AUDIENCE. FAIRBANKS HAS PRESENTED AT MULTIPLE CONFERENCES AND OTHER SPEAKING EVENTS TO INCLUDE ATTORNEY GENERALS RX DRUG CONFERENCE, SHRM, CHAMBER EVENTS AND EMPLOYER HEALTH FAIRS. WE HAVE BEEN FEATURED ON TV, RADIO AND NEWSPAPERS. WE HOST AN ANNUAL CONFERENCE EACH YEAR. 6. IN CONCERT WITH OTHER RECOVERY ORGANIZATION, ADVOCATE FOR LEGISLATION THAT IMPROVES ACCESS TO TREATMENT. -HAVE WORKED THROUGH LOBBYIST TO ADVOCATE FOR LEGISLATION THAT ADDRESS TREATMENT ACCESS. FAIRBANKS IS ACTIVELY INVOLVED WITH SEVERAL NEIGHBORING COUNTIES SYSTEMS OF CARE GROUPS AS WELL AS STATE AND PRIVATE COUNCILS FOCUSING ON REDUCING STIGMA AND PROMOTING ACCESS TO CARE. FAIRBANKS HOSPITAL, INC PART V, SECTION B, LINE 13B: FAIRBANKS HAS FUNDS AVAILABLE BASED ON THE PATIENT PARTICIPATION IN AND DISPLAYED COMMITMENT TO THE RECOVERY PROCESS, AND IF THE PATIENT HAS PROVEN A GENUINE FINANCIAL NEED. FAIRBANKS HOSPITAL, INC. SCHEDULE H, PART V, LINE 16A, FAP WEBSITE:HTTPS://WWW.FAIRBANKSCD.ORG/WP-CONTENT/UPLOADS/2019/04/FAIRBANKS-CHARITY-CARE-POLICY-4-2-19.PDFFAIRBANKS HOSPITAL, INC.SCHEDULE H, PART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.FAIRBANKSCD.ORG/WP-CONTENT/UPLOADS/2019/04/FAIRBANKS-CHARITY-CARE-POLICY-4-2-19.PDF 3 1 - LAVERNA LODGE 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 DRUG & ALCOHOL RESIDENTIAL REHAB - SEPARATE LOCATION FOR MEN & WOMEN 2 - SUPPORTED LIVING PROGRAM 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 ADULT HALFWAY HOUSE & DRUG & ALCOHOL SUPPORTED LIVING 3 - PLAINFIELD ADDICTIONS TREATMENT FACILITY 6100 CLARKS CREEK RD STE 102 104 PLAINFIELD IN 46168 OUTPATIENT CENTER PART I, LINE 3C: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES MEDICAL INDIGENCY AND INSURANCE STATUS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 7: FAIRBANKS USES THE IRS WORKSHEETS PROVIDED IN THE INSTRUCTIONS FOR FORM 990, SCHEDULE H TO CALCULATE A SINGLE COST TO CHARGE RATIO WHICH IS APPLIED TO THE CHARGES FOR FINANCIAL ASSISTANCE AND OTHER BENEFITS TO PROVIDE AMOUNTS AT COST. PART I, LN 7 COL(F): EFFECTIVE JULY 1, 2012, FAIRBANKS ADOPTED ACCOUNTING STANDARDS UPDATE (ASU)2011-07, HEALTHCARE ENTITIES (TOPIC 954), "PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTHCARE ENTITIES," WHICH REQUIRES CERTAIN HEALTHCARE ENTITIES TO PRESENT THE PROVISION FOR BAD DEBTS RELATING TO PATIENT SERVICE REVENUE AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS RATHER THAN AS AN OPERATING EXPENSE. ADOPTION OF THIS STANDARD HAS NO IMPACT ON ITS FINANCIAL POSITION, RESULTS OF OPERATIONS, OR CASH FLOWS. PART III, LINE 2: OUTSTANDING ACCOUNTS RECEIVABLE BALANCES ARE WORKED BY OUR COLLECTIONS AND STATEMENT VENDOR STAFF FOR 120 DAYS. WRITE-OFFS MAY BE DETERMINED AND MADE TO SPECIFIC ACCOUNTS AT THAT TIME. AT THE END OF EACH MONTH, FAIRBANKS ACCRUES 100% OF THE BALANCES EQUAL TO/GREATER THAN 180 DAYS OLD.IF SUBSEQUENT RECOVERIES ARE MADE, FAIRBANKS REDUCES THE AMOUNT OF THE BAD DEBT ACCOUNT. PART III, LINE 4: BAD DEBT EXPENSE FOOTNOTE TO AUDITED FINANCIAL STATEMENTS IS LOCATED ON PAGES 7 AND 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS UNDER THE HEADING "ALLOWANCE FOR DOUBTFUL ACCOUNTS". PART III, LINE 8: MEDICARE ALLOWABLE COSTS ARE CALCULATED BY USING THE RATIO OF COST TO CHARGES. THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, MEDICARE HAS BEEN PROVIDED FROM THE YEAR ENDED JUNE 30, 2018: HOSPITAL STATEMENT OF REIMBURSABLE COST. PART III, LINE 9B: WHEN AN ACCOUNT IS IDENTIFIED AS UNCOLLECTIBLE, IT BECOMES BAD DEBT. IF THE FINANCIAL POSITION OF THE IDENTIFIED INDIVIDUAL'S ACCOUNT HAS BEEN VERIFIED AS BEING IN A FINANCIAL POSITION OF 250% FEDERAL POVERTY LEVEL, THE ACCOUNT WILL BE RECLASSED AS CHARITY CARE. PART VI, LINE 2: FAIRBANKS ENGAGED THE SERVICES OF THE INDIANA UNIVERSITY CENTER FOR HEALTH POLICY TO CONDUCT COMMUNITY FOCUS GROUPS. THE GROUPS WERE DETERMINED THROUGH DISCUSSION WITH ACADEMIC AND HEALTHCARE EXPERTS WHO HAVE KNOWLEDGE OF THE SUBSTANCE IMPACTED POPULATION IN THE INDIANAPOLIS METROPOLITAN AREA. FIVE SEPARATE FOCUS GROUPS WERE DEVELOPED. THE FIRST GROUP CONSISTED OF ADDICTION SERVICE PROVIDERS FOR LOW INCOME AND MINORITY POPULATIONS; THE SECOND GROUP WAS COMPOSED OF COMMUNITY STAKEHOLDERS FROM THE STATE CRIMINAL JUSTICE DEPARTMENT, TASK FORCE ON DRUG FREE MARION COUNTY, HALFWAY HOUSES, PRIMARY MEDICAL CARE COALITION, AND EMPLOYEE ASSISTANCE PROGRAMS. ADOLESCENTS ATTENDING THE RECOVERY HIGH SCHOOL COMPRISED THE THIRD GROUP; PARENTS OF ADOLESCENTS WHO HAD RECEIVED ADDICTION TREATMENT SERVICES WERE IN THE FOURTH, AND THE FIFTH GROUP CONSISTED OF ADULT PATIENTS WHO HAD SUCCESSFULLY COMPLETED INPATIENT TREATMENT. FOCUS GROUP QUESTIONS INCLUDED IDENTIFICATION OF STRENGTHS AND WEAKNESSES IN THE ADDICTION TREATMENT SYSTEM, BARRIERS TO SERVICES, GAPS IN SERVICES, AND RECOMMENDATIONS FOR THE SYSTEM OF CARE. PART VI, LINE 3: THOSE INDIVIDUALS SEEKING ADMISSION TO FAIRBANKS HAVE THE OPPORTUNITY TO MEET WITH A FINANCIAL COUNSELOR TO DETERMINE WHAT RESOURCES ARE AVAILABLE. IN ADDITION, AN INFORMATION BOOKLET IS GIVEN TO THE FAMILIES DURING THE ADMISSION PROCESS WHICH NOTES THAT CHARITY CARE IS AVAILABLE. LASTLY, SIGNS ARE VISIBLE TO PATIENTS IN THE ACCESS DEPARTMENT WHERE ADMISSIONS TAKE PLACE. FAIRBANKS USES THE LOCAL MEDIA TO ASSIST IN EDUCATING THE PUBLIC CONCERNING PREVENTION, INTERVENTION AND TREATMENT. ALSO, FAIRBANKS PARTICIPATES IN NATIONAL ALCOHOL AWARENESS MONTH, RECOVERY MONTH COMMUNITY ACTIVITIES, AND PROVIDES COMMUNITY EDUCATION THROUGH THE SUSAN LI CONFERENCE. PART VI, LINE 4: FOR THE FISCAL YEAR ENDED JUNE 30, 2018, 24,393 LIVES WERE TOUCHED; 65% FROM UNITED WAY OF CENTRAL INDIANA COUNTIES, 21% SURROUNDING COUNTIES, 11% REMAINING INDIANA COUNTIES, AND 3% OUT OF STATE. OTHER INFORMATION RELATED TO THE COMMUNITY AREA SERVED:GENDER: 67% MALE, 33% FEMALE; AGE: 8% AGES UNDER 20, 54% AGES 20-39, 29% AGES 40-59, AND 9% AGE 60 YEARS OR OLDER; MARITAL STATUS: 54% MARRIED, 23% SINGLE, 14% DIVORCED, 9% OTHER;ETHNICITY: 83% CAUCASIAN, 10% AFRICAN AMERICAN, AND 7% OTHER; EDUCATION: 27% HIGH SCHOOL GRADUATES, 46% COLLEGE GRADUATES, 4% POST GRADUATES, AND 23% OTHER. PART VI, LINE 5: THE ORGANIZATION FURTHERS ITS EXEMPT PURPOSE BY PROMOTING HEALTH OF THE COMMUNITY THROUGH THE FOLLOWING: THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF A MAJORITY OF INDEPENDENT PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. SURPLUS OF FUNDS WHEN AVAILABLE ARE USED TO IMPROVE THE PATIENT CARE AND MEDICAL EDUCATION OF THE STAFF; AND A PERCENTAGE OF OPERATING INCOME IS RESTRICTED FOR PATIENT SCHOLARSHIP FUNDS. FAIRBANKS USES THE LOCAL MEDIA TO ASSIST IN EDUCATING THE PUBLIC CONCERNING PREVENTION, INTERVENTION AND TREATMENT. THE ORGANIZATION ALSO PARTICIPATES IN NATIONAL ALCOHOL AWARENESS MONTH, RECOVERY MONTH COMMUNITY ACTIVITIES AND PROVIDES COMMUNITY EDUCATION THROUGH THE SUSAN LI CONFERENCE. PART VI, LINE 6: N/A - ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. 1 HOPE ACADEMY 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 203094377 501C3 233000 GENERAL SUPPORT 1 PART I, LINE 2: THERE WERE NO CASH GRANT FUNDS GREATER THAN $5,000 AWARDED DURING THE YEAR. ASSISTANCE WAS PROVIDED ONLY TO A 501(C)(3) PUBLIC CHARITY FOR GENERAL SUPPORT. X X X X 1 0 0 0 0 0 0 0 0 BARBARA ELLIOT PRESIDENT/CEO 248300 0 0 0 0 0 14234 0 22078 0 284612 0 0 0 DR DARRIN MANGIACARNE MEDICAL DIRECTOR 308117 0 0 0 0 0 17469 0 22106 0 347692 0 0 0 DRJAMES MEACHAM PHYSICIAN 206658 0 0 0 0 0 0 0 14852 0 221510 0 0 0 KENT BROWN FORMER PRESIDENT 0 0 0 0 235577 0 0 0 0 0 235577 0 0 0 PART I, LINE 4A UNDER A QUALIFYING TERMINATION AGREEMENT (DEFINED AS AN INVOLUNTARY SEPARATION FROM SERVICE OTHER THAN FOR CAUSE) DATED DECEMBER 6, 2016, KENT BROWN WAS ENTITLED TO SEVERANCE PAY BASED HIS EMPLOYMENT AGREEMENT DATED JUNE 1, 2015. THE TERMS AND CONDITIONS TO RECEIVE SEVERANCE PAYMENTS REQUIRED THE EMPLOYEE TO SIGN A RELEASE OF CLAIMS FORM THAT COVERS ALL SITUATIONS SURROUNDING THE EMPLOYEE'S EMPLOYMENT AND SEPARATION FROM FAIRBANKS HOSPITAL. SEVERANCE PAYMENTS WERE MADE DURING CALENDAR YEAR 2017 TO THE FOLLOWING LISTED PERSON IN PART VII: KENT BROWN $235,577. SCHEDULE J, PART II MR. KENT BROWN WAS COMPENSATED BY FAIRBANKS HOSPITAL, INC. FOR HIS DUTIES AS FORMER PRESIDENT/CEO OF THE HOSPITAL. A PORTION OF HIS SEVERANCE COMPENSATION RECEIVED FROM FAIRBANKS HOSPITAL, INC. IS ALLOCATED TO HOPE ACADEMY FOR FORMER DUTIES PROVIDED. FOR CALENDAR YEAR 2017, 4% OF MR. BROWNS' SEVERANCE PAY TOTALING $9,423 WAS ALLOCATED TO HOPE ACADEMY. MS. BARBARA ELLIOTT IS COMPENSATED BY FAIRBANKS HOSPITAL, INC. FOR HER DUTIES AS PRESIDENT/CEO OF THE HOSPITAL. A PORTION OF HER COMPENSATION RECEIVED FROM FAIRBANKS HOSPITAL, INC. IS ALLOCATED TO HOPE ACADEMY FOR DUTIES PROVIDED. FOR THE CALENDAR YEAR 2017, 4.0% OF MS. ELLIOTT'S SALARIES AND BENEFITS TOTALING $11,384 WERE ALLOCATED TO HOPE ACADEMY. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW OF THE FORM 990 AND REQUIRED SCHEDULES BY THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND BOARD FINANCE COMMITTEE. EACH VOTING MEMBER OF THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 AT THE BOARD OF DIRECTOR MEETING PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS MUST COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. BOARD MEMBERS WHO HAVE A POTENTIAL FOR CONFLICT MUST RECUSE THEMSELVES FROM VOTING ON SUBJECTS THAT MIGHT POSE A CONFLICT. THE CORPORATE COMPLIANCE OFFICER REVIEWS ANY POTENTIAL CONFLICTS THAT ARE REPORTED. FORM 990, PART VI, SECTION B, LINE 15A ALL CURRENT MEMBERS OF THE BOARD OF DIRECTORS ARE GIVEN A WRITTEN EVALUATION FORM TO RATE THE CEO. ALL INFORMATION IS THEN COMPILED IN A FINAL REPORT AND PRESENTED BY THE BOARD CHAIR TO THE CEO. FOR COMPENSATION, WE COMPILE DATA PROVIDED BY OUR INDEPENDENT AUDITORS FROM THE INDIANA HOSPITAL ASSOCIATION, OTHER MENTAL HEALTH PROVIDERS, AND NAATP (NATIONAL ASSOCIATION OF ADDICTION TREATMENT PROVIDERS) TO ENSURE THE SALARY IS COMPETITIVE AND REASONABLE. MEMBERS OF THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS MEET TO DISCUSS AND REVIEW THAT DATA AND MAKE A FINAL DECISION REGARDING COMPENSATION THAT IS THEN REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND DETAILED FINANCIAL STATEMENT INFORMATION IS AVAILABLE TO THE PUBLIC UPON REQUEST. THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990 PER REGULATION 1.6033-2(A)(2)(II)(L)(1). ADDITIONALLY, SUMMARY FINANCIAL STATEMENT INFORMATION IS AVAILABLE IN THE ANNUAL REPORTS ON THE ORGANIZATION'S WEBSITE. FORM 990, PART VII, SECTION A, LINE 1A: RELATED ORGANIZATION HOURS MR. KENT BROWN WAS COMPENSATED BY FAIRBANKS HOSPITAL, INC. FOR HIS DUTIES AS FORMER PRESIDENT/CEO OF THE HOSPITAL. A PORTION OF HIS SEVERANCE COMPENSATION RECEIVED FROM FAIRBANKS HOSPITAL, INC. IS ALLOCATED TO HOPE ACADEMY FOR FORMER DUTIES PROVIDED. FOR CALENDAR YEAR 2017, 4% OF MR. BROWNS' SEVERANCE PAY TOTALING $9,423 WAS ALLOCATED TO HOPE ACADEMY. MS. BARBARA ELLIOTT IS COMPENSATED BY FAIRBANKS HOSPITAL, INC. FOR HER DUTIES AS PRESIDENT/CEO OF THE HOSPITAL. A PORTION OF HER COMPENSATION RECEIVED FROM FAIRBANKS HOSPITAL, INC. IS ALLOCATED TO HOPE ACADEMY FOR DUTIES PROVIDED. FOR THE CALENDAR YEAR 2017, 4.0% OF MS. ELLIOTT'S SALARIES AND BENEFITS TOTALING $11,384 WERE ALLOCATED TO HOPE ACADEMY. MS. JANINE SHOPP IS COMPENSATED BY FAIRBANKS HOSPITAL, INC. FOR HER DUTIES AS VICE PRESIDENT AND CFO OF THE HOSPITAL. A PORTION OF HER COMPENSATION RECEIVED FROM FAIRBANKS HOSPITAL, INC. IS ALLOCATED TO HOPE ACADEMY FOR DUTIES PROVIDED. FOR CALENDAR YEAR 2017, 10% OF MS. SHOPP'S SALARIES AND BENEFITS TOTALING $14,395 WERE ALLOCATED TO HOPE ACADEMY. FORM 990, PART IX, LINE 11G PURCHASE SERVICES: PROGRAM SERVICE EXPENSES 2,127,198. MANAGEMENT AND GENERAL EXPENSES 1,334,698. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,461,896. FORM 990, PART XI, LINE 9: NET ASSETS TRANSFERRED TO HOPE ACADEMY -252,618. FORM 990, PART XI, LINE 2C: AUDIT OVERSIGHT THE ORGANIZATION UTILIZES THE AUDIT AND FINANCE COMMITTEE OF THE BOARD OF DIRECTORS TO OVERSEE THE AUDIT PROCEDURES AND SELECTION OF THE INDEPENDENT ACCOUNTING FIRM. THE RECOVERY HIGH SCHOOL AT FAIRBANKS INC DBA HOPE ACADEMY 8102 CLEARVISTA PARKWAY INDIANAPOLIS IN 46256 203094377 CHARTER SCHOOL IN 501(C)(3) LINE 2 FAIRBANKS HOSPITAL INC 1 0 1 0 1 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 THE RECOVERY HIGH SCHOOL AT FAIRBANKS INC DBA HOPE ACADEMY B 485618 COST THE RECOVERY HIGH SCHOOL AT FAIRBANKS INC DBA HOPE ACADEMY J 144600 COST