2018-05-15T00:03:35-05:00 2017-06-30 351178661 Blue & Co LLC 500 N Meridian St Suite 200 Indianapolis IN 46204 990 2016-07-01 351534713 Adult & Child Mental Health Center Inc ADUL 3178825122 222 E Ohio St Indianapolis IN 46204 Joseph Breyer CFO 3178825122 2018-05-14 1 Amber Kocher CPA P01286298 3176334705 2018-05-11 2016 2022-09-23 18:48:47Z Adult & Child Health Allen Brown 222 E Ohio Street Indianapolis IN 46204 48496941 0 X www.adultandchild.org X 1982 IN PROVIDE STATE-OF-THE-ART MENTAL HEALTH, primary care and child welfare SERVICES TO RESIDENTS OF central indiana. 13 13 870 13 99193 0 6796125 6778998 34565193 38378003 166187 396061 495753 563701 42023258 46116763 0 0 0 0 31597441 36891421 0 0 0 10205504 11769898 41802945 48661319 220313 -2544556 34418984 34085152 12643461 14453036 21775523 19632116 We provide state-of-the-art services that empower adults and children to reach their full potential while effectively and efficiently managing community and center resources. 0 0 38601460 33264843 The organization is a licensed community mental health center, certified federally qualified health center look alike and a licensed child placement agency with the purpose of health and wellness by establishing, maintaining and promoting a community organization that provides high quality health care and social services to an underserved population. The services provided by the organization include primary care, psychiatric care, therapeutic care, school based services, supportive housing, supportive employment, therapeutic foster care, medically fragile foster care and addictive disease services. The organization accepts patients regardless of their individual ability to pay, their race, age, sex, creed, sexual orientation or national origin. 2091885 5001181 Theraputic Foster Care 225955 111979 A&C Residential--Adult & Transitional Living 40919300 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 45 0 1 870 1 1 1 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X Joseph Breyer CFO 3178825122 222 E Ohio Street INDIANAPOLIS IN 46204 SUE COLLINS RN PRESIDENT 1.00 X X 0 0 0 Steve Wohlford VICE PRESIDENT 1.00 X X 0 0 0 Dawn Shimp Secretary 1.00 X X 0 0 0 Dustin Huddleston TreASURER 1.00 X X 0 0 0 Baindu Bayon Member term began Sep'2016 1.00 X 0 0 0 Tom Gaunt MEMBER 1.00 X 0 0 0 Margarita Hart Member term began Oct'2016 1.00 X 0 0 0 Robert Hurley MEMBER 1.00 X 0 0 0 Robert Marshall MEMBER 1.00 X 0 0 0 Carole McKinney MeMBER 1.00 X 0 0 0 Kellie Meyer MEMBER 1.00 X 0 0 0 Tony Roscetti Member term began Jan'2017 1.00 X 0 0 0 Joe Villanueva memBER 1.00 X 0 0 0 Isaiah Horne Member term Aug-Sep'2016 1.00 X 0 0 0 Judy Ware membER term end Oct'2016 1.00 X 0 0 0 Allen Brown Chief Executive Officer 40.00 X 203746 0 25500 Joseph Breyer Chief Financial Officer 40.00 X 112868 0 22609 Stephanie Yoder Chief Operating Officer 40.00 X 115991 0 22129 Charles Coats MD Medical Director 40.00 X 210477 0 26812 Terri Pellow MD Psychiatrist 40.00 X 175045 0 18415 Matt Oliver Chief Clinical/Info Office 40.00 X 116063 0 19303 Yolanda Bray APRN Behavioral Health 40.00 X 119763 0 12624 Dan Arens Director Primare Care/Bus. 40.00 X 108186 0 20100 Steven Berger Psychiatrist 40.00 X 119734 0 1192 Rhonda Palmer APRN Behavioral Health 40.00 X 101416 0 17638 1383289 0 186322 10 0 1 0 LocumTenenscom PO Box 405547 Atlanta GA 30384 Contract prescibers i.e. Psychiatrists, 511381 Envista LLC PO Box 857004 Minneapolis MN 55485 IT Services 297504 2 6774386 4612 6778998 Net Patient Revenue 900099 31133214 31133214 Medicare/Medicaid Pmts 900099 4744987 4744987 Behavioral Health, Primary Care, 900099 2387823 2387823 A&C Residential 900099 111979 111979 38378003 128792 128792 887511 38440 839134 38651 48377 -211 48166 29520 18646 1769662 1502393 267269 267269 267269 Miscellaneous Revenue 900099 445862 445862 Property Management 531310 69673 69673 515535 46116763 38378003 99193 860569 933593 933593 27651374 23964532 3686842 666060 550166 115894 5380396 4444207 936189 2259998 1866758 393240 82669 82669 51082 51082 2033076 1679321 353755 97498 80533 16965 1537330 1269835 267495 30 25 5 1448177 1196194 251983 70358 58116 12242 895365 739571 155794 163036 134668 28368 1381968 1141506 240462 360768 297994 62774 Residential services 2091885 2091885 Staff Recruitment and D 477312 394260 83052 Client Expenses 453305 453305 A&C Res. 225955 225955 400084 330469 69615 48661319 40919300 7742019 0 466412 467831 3613316 1800892 885869 471530 3705622 3462104 408025 430559 33602680 14016052 17510067 19586628 5143377 3819871 120000 120000 2566296 3925737 34418984 34085152 2870372 3700158 1886 500 5598997 6578687 47539 90422 2082820 2103473 2041847 1979796 12643461 14453036 X 21775523 19632116 21775523 19632116 34418984 34085152 X -2544556 81178 319971 X X 0 1 X 1 1 1 X Part I, line 3 Adult & Child Mental Health Center, Inc. has been determined by the IRS to be a public charity under IRS code section 170(B)(1)(A)(III). The organization provides a comprehensive network of preventative, diagnostic, therapeutic and rehabilitative medical and mental health services, but does not maintain an inpatient unity, and is not required to be licensed as a hospital for the state of Indiana. Schedule H is not required as only organizations that operate at least one facility that is, or is required to be, licensed, registered, or similarly recognized by the state as a hospital. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 2896000 385053 3281053 11618262 9725333 8703601 12639994 372593 368935 3658 1394414 7211025 4943516 3661923 19586628 Rent Receivable 140118 457 Plan Assets 89035 Other Receivables 1289616 Rent Receivable 2307639 Other assets 99329 3925737 Deferred compensation 89035 Estimated third party settlements 1890761 1979796 X 47395697 81178 319971 401149 46994548 -877785 -877785 46116763 49539104 877785 877785 48661319 0 48661319 Part IV, Line 2b: The organization is an agent for Social Security Funds held for patients - representative payee accounts. There is a corresponding asset reported in Form 990, Part X. Part X, Line 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE COMPANY AND RECOGNIZE A TAX LIABILITY IF THE COMPANY 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 COMPANY, AND HAS CONCLUDED THAT AS OF JUNE 30, 2017 AND 2016, 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 COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. Part XI, Line 2d - Other Adjustments: Unrealized Loss on Derivative 293,922. Related Party Contribution 26,049. Part XI, Line 4b - Other Adjustments: Rental Expenses -877,785. Part XII, Line 2d - Other Adjustments: Rental expenses 877,785. X X X 0 0 0 0 0 0 0 0 0 Allen Brown Chief Executive Officer 155869 0 30024 0 17853 0 6112 0 19388 0 229246 0 0 0 Charles Coats MD Medical Director 189007 0 0 0 21470 0 7357 0 19455 0 237289 0 0 0 Terri Pellow MD Psychiatrist 163169 0 0 0 11876 0 6020 0 12395 0 193460 0 0 0 A Indiana Finance Authority 351602316 2016-02-25 6835000 See Part VI 0 0 0 A 6835000 90620 6744380 0 0 0 1 A 0 1 1 1 0 0.14040 0.06970 0.21010 0 0 0 A 0 1 0 0 1 1 PNC 10.000000000000 0 0 0 0 1 A 1 Part I, Line A, Column F The proceeds of the Project Bonds will be loaned to the Borrower for the purpose of financing, refinancing or reimbursing all or a portion of: (i) the acquisition, construction, renovation and equipping of approximately 77,145 square foot health care facility located at 603 E. Washington Street, Indianapolis, IN 46204, together with the purchase of equipment and furnishings to be located herein; (ii) the renovation of approximately 5,550 square feet of an approximately 56,400 square foot health care facility located at 222 E. Ohio Street, Indianapolis, IN 46204 together with the purchase of equipment and furnishings to be located herein; (iii) the renovation of approximately 7,434 square feet of an approximately 14,900 square foot health care facility located at 1860 and 1866 Northwood Plaza Drive, Franklin, IN 46131 together with the purchase of equipment and furnishings to be located herein. Form 990, Part I, Item C DBA: adult and Child Center Form 990, Part VI, Section B, line 11b THE PROCESS OF REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW OF THE FORMS AND REQUESTED SCHEDULES BY THE CHIEF FINANCIAL OFFICER. ADDITIONALLY, EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY is provided with a copy of the FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, for review AND APPROVAL PRIOR TO FILING. Form 990, Part VI, Section B, line 12c Each Board member and officer are required to submit annually information regarding conflicts of interest and possible conflicts of interest. Form 990, Part VI, Section B, line 15 The compensation package for the CEO is set by the Executive Committee of the Board of Directors and approved by the entire Board. The Executive Committee uses the annual salary survey conducted by the Indiana Council of Community Mental Health Centers and other applicable salary surveys. Salaries of other officers and key employees are set in a similar fashion by the CEO. Form 990, Part VI, Section C, line 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST. THE ORGANIZATION'S ANNUAL REPORT IS AVAILABLE ON ITS WEB PAGE AT WWW.ADULTANDCHILD.ORG IN "ANNUAL REPORTS" SECTION UNDER THE "ABOUT US DROP DOWN MENU. THE ARTICLES OF INCORPORATION CAN BE VIEWED ON THE INDIANA SECRETARY OF STATE WEBPAGE. Form 990, Part XI, line 9: Unrealized Loss on Derivative 293,922. Related Party Contribution 26,049. Form 990, Part XII, Line 2c, Oversight of Audit: The budget and finance committee assumes responsibility for oversight of the financial statements audit and provides recommendations to the board of directors for approval. Likewise the committee assumes responsibilty for the selection of the independent auditors by reviewing possible proposals and making recommendations for approval to the board of directors. No processes have changed from prior year. Adult & Child Residential Properties LLC 222 E Ohio Street Ste 400 Indianapolis IN 46204 475591352 Residential Rental Property IN -114726 1862442 Adult & Child Mental Health Center