KENNEBEC MENTAL HEALTH ASSOCIATES INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- KENNEBEC MENTAL HEALTH ASSOCIATES INC (EIN 61-1419905)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-14
- IRS object ID
- 201921349349301207
- Schema version
- 2017v2.3
- 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 | 2019-05-14T07:40:04-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450512128 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gibson LeClair LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 Capitol Street Suite 3 | AddressLine1Txt |
| City | Augusta | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04330 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 611419905 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kennebec Mental Health Associates | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KENN | BusinessNameControlTxt |
| Phone | 2078732136 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67 Eustis Parkway | AddressLine1Txt |
| City | Waterville | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04901 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Thomas Mcadam | PersonNm |
| Person Title | Chief Executive Officer | PersonTitleTxt |
| Phone | 2078732136 | PhoneNum |
| Signature | 2019-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Stephen L LeClair CPA | PreparerPersonNm |
| PTIN | P01370336 | PTIN |
| Phone | 2076238401 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 208.105.172.154 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-14 | IPDt |
| IP Tm | 08:38:38 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 3CFE443A437E51A40D206120D7094BD7AB26C52F | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 988B03C8BA6CE5E120AC41AF3808969E9C6FE563 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Thomas McAdam | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67 Eustis Parkway | AddressLine1Txt |
| City | Waterville | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,813,320 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | To coordinate, manage and support all of the administrative and other related activities, services and functions with respect to the operation of Kennebec Valley Mental Health Center d/b/a Kennebec Behavioral Health in connection with its delivery of behavioral health and other related services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 47 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $285 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,489,390 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,787,645 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,484 | PYInvestmentIncomeAmt |
| CY Investment Income | $9,272 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,556 | PYOtherRevenueAmt |
| CY Other Revenue | $16,403 | CYOtherRevenueAmt |
| PY Total Revenue | $3,501,715 | PYTotalRevenueAmt |
| CY Total Revenue | $3,813,320 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,330,264 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,502,425 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $84,710 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,098,651 | PYOtherExpensesAmt |
| CY Other Expenses | $1,198,397 | CYOtherExpensesAmt |
| PY Total Expenses | $3,428,915 | PYTotalExpensesAmt |
| CY Total Expenses | $3,700,822 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $72,800 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $112,498 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,910,601 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,040,510 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $631,018 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $648,429 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,279,583 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,392,081 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To coordinate, manage and support all of the administrative and other related activities, services and functions with respect to the operation of Kennebec Valley Mental Health Center (dba Kennebec Behavioral Health) and its related organizations, KMHA Real Estate and KMHA Foundation. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,616,112 | ExpenseAmt |
| Revenue | $3,804,048 | RevenueAmt |
| Desc | The coordination, management and support of administrative and other related activities with respect to Kennebec Valley Mental Health Center d/b/a Kennebec Behavioral Health and its related corporations, KMHA Real Estate and KMHA Foundation, in connection with the delivery of behavioral health and related services. | Desc |
| Total Program Service Expenses | $3,616,112 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | 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 | Yes (1) | 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 | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 47 | 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 | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Josee L Shelley CPA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2078732136 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 67 Eustis Parkway | AddressLine1Txt |
| City | Waterville | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Ronald A Ducharme | ||||||||
| President/Secretary | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Leon A Duff | ||||||||
| Vice President/Treasurer | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Walter Price | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Carol Axtell | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Lisa Gibson Landry | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Rosalie Curtis Williams | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Thomas Longstaff | ||||||||
| Director | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| Thomas McAdam MBA | ||||||||
| Chief Executive Officer | 40.00 | $179,654 | $0 | $52,034 | Yes (X) | |||
| Josee Shelley CPA | ||||||||
| Chief Financial Officer | 40.00 | $132,990 | $0 | $17,813 | Yes (X) | |||
| Robert T Anderson MD | ||||||||
| Medical Director, former | 40.00 | $0 | $219,052 | $13,685 | Yes (X) | |||
| Janine D Taylor MD | ||||||||
| Medical Director | 40.00 | $0 | $214,349 | $29,524 | Yes (X) | |||
| Teresa Hermida MD | ||||||||
| Psychiatrist | 40.00 | $0 | $219,990 | $7,404 | Yes (X) | |||
| Paige McInerney DO | ||||||||
| Psychiatrist | 34.00 | $0 | $163,473 | $26,446 | Yes (X) | |||
| Arlene C Almazan MD | ||||||||
| Psychiatrist | 40.00 | $0 | $213,143 | $18,173 | Yes (X) | |||
| Bukher Emil NP | ||||||||
| Nurse Practitioner Psychia | 40.00 | $0 | $190,786 | $19,998 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $312,644 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,220,793 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $185,077 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | 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 |
|---|---|---|---|---|---|
| Verizon Wireless | |||||
| PO Box 15062 | Albany | NY | 122125062 | Communications | $151,708 |
| Firstlight | |||||
| PO Box 11019 | Lewiston | ME | 042439470 | Network services | $112,871 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Management Fee Income | Desc |
| Business | 561000 | BusinessCd |
| Total Revenue Column | $3,787,645 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,787,645 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,787,645 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,272 | TotalRevenueColumnAmt |
| Exclusion | $9,272 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Miscellaneous income | Desc |
| Business | 561000 | BusinessCd |
| Total Revenue Column | $16,403 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,403 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $16,403 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,813,320 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,804,048 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $9,272 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $340,121 | TotalAmt |
| Program Services | $309,974 | ProgramServicesAmt |
| Fundraising | $30,147 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,643,852 | TotalAmt |
| Program Services | $1,618,357 | ProgramServicesAmt |
| Fundraising | $25,495 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,006 | TotalAmt |
| Program Services | $32,416 | ProgramServicesAmt |
| Fundraising | $590 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $325,194 | TotalAmt |
| Program Services | $318,810 | ProgramServicesAmt |
| Fundraising | $6,384 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,252 | TotalAmt |
| Program Services | $156,218 | ProgramServicesAmt |
| Fundraising | $4,034 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,950 | TotalAmt |
| Program Services | $2,950 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,006 | TotalAmt |
| Program Services | $7,006 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,257 | TotalAmt |
| Program Services | $2,195 | ProgramServicesAmt |
| Fundraising | $1,062 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,669 | TotalAmt |
| Program Services | $41,521 | ProgramServicesAmt |
| Fundraising | $4,148 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,283 | TotalAmt |
| Program Services | $121,004 | ProgramServicesAmt |
| Fundraising | $5,279 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,816 | TotalAmt |
| Program Services | $61,489 | ProgramServicesAmt |
| Fundraising | $4,327 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,053 | TotalAmt |
| Program Services | $25,538 | ProgramServicesAmt |
| Fundraising | $515 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89 | TotalAmt |
| Program Services | $89 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $301,015 | TotalAmt |
| Program Services | $301,015 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,278 | TotalAmt |
| Program Services | $55,075 | ProgramServicesAmt |
| Fundraising | $1,203 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| Communications | $312,419 | $312,419 | |
| Equipment expenses | $126,393 | $126,393 | |
| Maintenance and repair | $97,583 | $97,583 | |
| Dues and fees | $14,799 | $13,871 | $928 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,787 | TotalAmt |
| Program Services | $12,189 | ProgramServicesAmt |
| Fundraising | $598 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,700,822 | TotalAmt |
| Program Services | $3,616,112 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $84,710 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $715,514 | BOYAmt |
| EOY | $791,881 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250,706 | BOYAmt |
| EOY | $245,031 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,551 | BOYAmt |
| EOY | $12,961 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,970 | BOYAmt |
| EOY | $42,833 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,895,572 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,324,234 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $597,515 | BOYAmt |
| EOY | $571,338 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $283,345 | BOYAmt |
| EOY | $376,466 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,910,601 | BOYAmt |
| EOY | $2,040,510 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $596,898 | BOYAmt |
| EOY | $609,669 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,120 | BOYAmt |
| EOY | $38,760 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $631,018 | BOYAmt |
| EOY | $648,429 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,279,583 | BOYAmt |
| EOY | $1,392,081 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,279,583 | BOYAmt |
| EOY | $1,392,081 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,910,601 | BOYAmt |
| EOY | $2,040,510 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $112,498 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 3 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (3 entries)
| EINEIN | Organization TypeOrganizationTypeCd | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| Kennebec Behavioral Health | ||||
| 010265559 | 7 | Yes (1) | $3,299,467 | $0 |
| KMHA Real Estate Inc | ||||
| 611419906 | 7 | Yes (1) | $462,854 | $0 |
| KMHA Foundation Inc | ||||
| 611419904 | 7 | Yes (1) | $25,324 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 3 | SupportedOrganizationsTotalCnt |
| Support Sum | $3,787,645 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,895,572 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,324,234 | DepreciationAmt |
| Book Value | $571,338 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $571,338 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due From Affiliates | Desc |
| Book Value | $376,466 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $376,466 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due to Affiliates | Desc |
| Amt | $38,760 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $38,760 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $3,813,320 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,813,320 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $3,813,320 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,700,822 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $3,700,822 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $3,700,822 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | Income Tax Status - All of the Organizations are exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code. However, income from certain activities not directly related to the Organizations' tax-exempt purpose is subject to taxation as unrelated business income. In addition, the Organizations qualify for the charitable contribution deduction under Section 170(b)(1)(A). KBH has been classified as an organization that is not a private foundation under Section 509(a)(1). KMHA, KMHA Foundation, and KMHA Real Estate, Inc. have non-private foundation status as a supporting organization under IRC 509(a)(3). Management believes it has no uncertain tax positions with the Internal Revenue Service that require disclosure in its financial statements. The Organization's federal Returns of Organization Exempt from Income Tax (Forms 990) and Exempt Organization Business Income Tax Return (Form 990-T) for 2017, 2016, and 2015 are subject to examination by the IRS, generally for three years after they were filed. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Thomas McAdam MBA | ||||||||||||||
| Chief Executive Officer | $153,809 | $0 | $10,000 | $0 | $15,845 | $0 | $28,546 | $0 | $23,488 | $0 | $231,688 | $0 | $13,077 | $0 |
| Josee Shelley CPA | ||||||||||||||
| Chief Financial Officer | $124,823 | $0 | $8,000 | $0 | $167 | $0 | $3,409 | $0 | $14,404 | $0 | $150,803 | $0 | $0 | $0 |
| Robert T Anderson MD | ||||||||||||||
| Medical Director, former | $0 | $212,944 | $0 | $6,000 | $0 | $108 | $0 | $5,537 | $0 | $8,148 | $0 | $232,737 | $0 | $0 |
| Janine D Taylor MD | ||||||||||||||
| Medical Director | $0 | $188,950 | $0 | $10,000 | $0 | $15,399 | $0 | $4,875 | $0 | $24,649 | $0 | $243,873 | $0 | $0 |
| Teresa Hermida MD | ||||||||||||||
| Psychiatrist | $0 | $202,377 | $0 | $5,000 | $0 | $12,613 | $0 | $4,789 | $0 | $2,615 | $0 | $227,394 | $0 | $0 |
| Paige McInerney DO | ||||||||||||||
| Psychiatrist | $0 | $158,306 | $0 | $5,000 | $0 | $167 | $0 | $4,399 | $0 | $22,047 | $0 | $189,919 | $0 | $0 |
| Arlene C Almazan MD | ||||||||||||||
| Psychiatrist | $0 | $192,019 | $0 | $6,000 | $0 | $15,124 | $0 | $5,166 | $0 | $13,007 | $0 | $231,316 | $0 | $0 |
| Bukher Emil NP | ||||||||||||||
| Nurse Practitioner Psychia | $0 | $176,247 | $0 | $1,000 | $0 | $13,539 | $0 | $4,622 | $0 | $15,376 | $0 | $210,784 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 7 | FormAndLineReferenceDesc |
| Explanation | The key employees and some of the highest compensated employees received compensation based on personal productivity standards contained within their employment contracts. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | A copy of the 990 is provided to the Finance Committee prior to filing with the Internal Revenue Service. The Finance Committee meets bi-monthly and, at its discretion, can add discussion and review of the organization's 990 to its agenda. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy requires that each Board member annually sign a statement that they will abide by the policy. Any potential conflict of interest is required to be disclosed by a Board member at a Board meeting with procedures for investigation and resolution being managed by the Board. On an annual basis the Board is reminded of the policy by senior staff. |
| Form 990, Part VI, Section B, line 15 | The compensation of the CEO is established by the Board of Directors based on industry-specific wage survey data. The CEO's performance is reviewed annually by the Board President and any increase in compensation is approved within the framework of salary adjustments approved by the Board for all staff. Compensation of senior managers of the organization is managed by the CEO using current wage survey data and within the framework of salary adjustments approved by the Board for all staff during the annual budget approval process. |
| Form 990, Part VI, Section C, line 18 | All governing documents, policies and audited financial statements are available to be viewed at the organization's administrative offices. An annual report reflecting a summary of its audited financial statements is available in printed format and on the website of Kennebec Behavioral Health (www.kbhmaine.org). |
| Form 990, Part VI, Section C, line 19 | The organization's annual form 990 return is available for viewing at the organization's administrative offices and also on www.guidestar.org. Form 1023 is available for public inspection at the administrative offices of the organization. |
| Form 990, Part VII | All employees of KMHA and KBH are eligible to participate in a Vacation Buy-out program, which is taxable income and increases base compensation. Included in Mr. McAdam's, Dr. Almazan's, Dr. Taylor's, Dr. Hermida's, and Dr. Bukher's reportable compensation are $6,538, $14,957, $15,232, $12,446 and $13,372 respectively in vacation buy-out. |
| Form 990, Part XI, Line 2c | The process of oversight of the audit has not changed from the previous year. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Kennebec Behavioral Health | |||||||||
| 67 Eustis Parkway | Waterville | ME | 04901 | 010265559 | Promote the well-being of children, families and adults | ME | 501(c)(3) | 170(b)(1)(A) | 0 |
| KMHA Real Estate Inc | |||||||||
| 67 Eustis Parkway | Waterville | ME | 04901 | 611419906 | Hold title to, manage and maintain properties for Kennebec Behavioral Health | ME | 501(c)(3) | 509(a)(3) Type I Org | 0 |
| KMHA Foundation Inc | |||||||||
| 67 Eustis Parkway | Waterville | ME | 04901 | 611419904 | Hold, manage and invest funds and gifts for Kennebec Behavioral Health | ME | 501(c)(3) | 509(a)(3) Type I Org | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Kennebec Behavioral Health - management agreement | ||
| L | $3,211,722 | Amount paid |
| KMHA Foundation Inc - management agreement | ||
| L | $25,324 | amount paid |
| KMHA Real Estate Inc - Rental agreement for office space | ||
| K | $126,283 | Amount paid |
| KMHA Real Estate Inc - management agreement | ||
| L | $462,854 | Amount paid |
| Kennebec Behavioral Health | ||
| L | $87,745 | Amount paid |
Comments