2018-05-07T15:49:45-05:00 2017-06-30 310800053 CLARK SCHAEFER HACKETT & CO 14 East Main Street Suite 500 Springfield OH 45502 990 2016-07-01 310733984 Columbus Area Integrated Health Services Inc COLU 6142520711 1515 East Broad St Columbus OH 43205 Anthony Penn PRESIDENT/CEO 6142520711 2018-04-27 1 Matthew Shroyer P00737986 9373992000 2018-04-27 2016 2022-09-23 18:48:47Z ANTHONY PENN 1515 East Broad St Columbus OH 43205 15547551 0 X www.columbus-area.com X 1965 OH To provide culturally sensitive and quality mental health and wellness services to the community. 9 9 280 10 0 0 6357329 7295064 8779280 7943275 -141664 1518 -39366 79322 14955579 15319179 0 0 0 0 8617372 8120178 0 0 0 7944961 7397450 16562333 15517628 -1606754 -198449 3897511 3341955 6512736 6155629 -2615225 -2813674 To provide culturally sensitive and quality mental health and wellness services to the community. 0 0 6661371 6261232 Outpatient Therapy: control, reduction, or maintenance of symptomatic behavior which causes the person psychological stress 5783025 206965 Residential/vocational services: provided various levels of support within a residential and/or pre-vocational setting 1382732 1682043 Pharmacy 13827128 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 145 0 1 280 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X ANTHONY PENN 6142520711 1515 E Broad St Columbus OH 43205 Angel Harris Board President 1.00 X X 0 0 0 Robyn Taylor Board Vice President 1.00 X X 0 0 0 Michael Bivens Board Treasurer 1.00 X X 0 0 0 Lori Elmore Board Secretary 1.00 X X 0 0 0 Arthur Holloway Board Member 1.00 X 0 0 0 John Alexander Board Member 1.00 X 0 0 0 John Little Board Member 1.00 X 0 0 0 Michael Madison Board Member 1.00 X 0 0 0 John Rush Board Member 1.00 X 0 0 0 Anthony Penn CEO 40.00 X 188849 0 19303 Dewitt Harrell CFO 40.00 X 121784 0 0 Dr Liberato Basobas Psychiatrist 40.00 X 212760 0 402 Mary Kirkman Deputy Chief Clinical Serv 40.00 X 101368 0 13112 624761 0 32817 4 0 1 0 My Psychiatric Partners LLC 6221 Riverside Dr Suite North One Dublin OH 43017 Psychiatric Services 736000 COMDATA 5301 Maryland Way 1 Brentwood TN 37027 purchase card services 521774 Anda Inc PO Box 930219 Atlanta GA 311930219 Pharmacy Medication Supplier 451759 Hartford on the Lake Apartments 8033 Ridgeway Ave Skokie IL 60076 Shelter Care for clients 381964 Miami-Luken Inc 265 S Pioneer Blvd Springboro OH 450663307 Pharmacy Medication Supplier 351345 19 10410 7144362 140292 7295064 Medicaid (Title XIX) 621400 3506037 3506037 Program service contracts 621400 2417877 2417877 Pharmacy Revenue 446110 1682043 1682043 Program Fees 621400 174449 174449 Patient service fees 621400 162869 162869 7943275 1518 1518 100729 228372 -127643 -127643 -127643 Other income 900099 206965 206965 206965 15319179 8150240 0 -126125 X 329937 32994 296943 6319429 5933722 385707 961451 961451 509361 471235 38126 96302 96302 17855 17855 1558248 1506993 51255 412 412 950983 757130 193853 259197 211394 47803 119924 119924 185580 166383 19197 171100 80 171020 Direct client assistanc 2108002 2099306 8696 Operating Expenses 1740699 1569514 171185 Miscellaneous 116514 43880 72634 repayment due funding s 72634 72634 15517628 13827128 1690500 0 1690047 588778 596695 1442619 139302 58306 73236 51062 4524971 3347470 1375629 1177501 22602 23689 3897511 3341955 1593185 1551128 2147657 1585866 1999695 2074685 772199 943950 6512736 6155629 X -2635782 -2834231 20557 20557 -2615225 -2813674 3897511 3341955 -198449 0 X X 0 1 X 1 1 1 X 6456781 5734864 6616346 6357329 7295064 32460384 6456781 5734864 6616346 6357329 7295064 32460384 32460384 455 471431 543 2511 1518 476458 173719 161371 162270 201565 206965 905890 33842732 38867461 0.95920 0.96160 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 302810 302810 1747442 1365353 382089 31031 31031 0 2337605 1845003 492602 106083 106083 0 1177501 Due to others 106618 Payable due funding source 837332 943950 X 15547551 228372 228372 15319179 0 15319179 15746000 228372 228372 15517628 0 15517628 Part X, Line 2: THE ORGANIZATION HAS RENTAL INCOME ASSOCIATED WITH DEBT FINANCED PROPERTY WHICH IS SUBJECT TO TAX AS UNRELATED BUSINESS INCOME. AT JUNE 30, 2017 AND 2016, THE ORGANIZATION RECORDED A TAX LIABILITY OF $0 ON THIS UNRELATED BUSINESS ACTIVITY DUE TO RECURRING LOSSES ASSOCIATED TO THIS PROPERTY. THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE ORGANIZATION'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS (FORM 990T) FOR 2015, 2016 AND 2017 ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. Part XI, Line 2d - Other Adjustments: Rental Expense 228,372. Part XII, Line 2d - Other Adjustments: Rental Expense 228,372. X X 0 0 0 0 0 0 0 0 0 Anthony Penn CEO 188849 0 0 0 0 0 1600 0 17703 0 208152 0 0 0 Dr Liberato Basobas Psychiatrist 212760 0 0 0 0 0 0 0 402 0 213162 0 0 0 Form 990, Part VI, Section B, line 11b Management reviews a draft copy of the 990 prior to filing. The return is also reviewed by the board, which allows any further inquiries to be discussed. Form 990, Part VI, Section B, line 12c It is the continuing responsibility of the board, officers and management employees to scrutinize their transactions and outside business interest and relationships for potential conflicts and to immediately make such disclosures known. All conflicts should be disclosed to the chief executive officer, or if he is the one with the conflict, then to the board president, who shall bring the matter to the attention of the board or duly constituted committee thereof. The board or duly constituted committee thereof shall determine whether a conflict exists and is the case of an existing conflict, whether the contemplated transaction may be authorized as just, fair and reasonable to Columbus Area Integrated Health Services, Inc. The decision of the board or a duly constituted committee thereof on these matters will rest in their sole discretion, and their concern must be the welfare of Columbus Area Integrated Health Services, Inc. and the advancement of its purpose. Form 990, Part VI, Section B, line 15 Reviewed by the Executive Committee of the Board of Trustees and the full board of Trustees. The overall budget and salaries, including comparability studies, are approved by the board of Trustees. Form 990, Part VI, Section C, line 19 UPON REQUEST Form 990, Part IX, line 11g Contracted Services: Program service expenses 1,495,754. Management and general expenses 51,255. Fundraising expenses 0. Total expenses 1,547,009. Professional Fees: Program service expenses 11,239. Management and general expenses 0. Fundraising expenses 0. Total expenses 11,239. Form 990, Part XII, Line 2c: The process has not changed.