2018-03-05T16:24:38-06:00 2017-06-30 351178661 Blue & Co LLC 500 N Meridian St Suite 200 Indianapolis IN 46204 990 2016-07-01 351328806 Cummins Behavioral Health Systems Inc CUMM 8887141927 5101 East US 36 Avon IN 46123 SHAWNA GOTTLIEB Chief Financial Officer 8887141927 2018-02-25 1 Amber Kocher CPA P01286298 3176334705 2018-02-25 71.44.233.83 2018-02-25 09:43:39 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B19D0506B86ED19F1A0FD2AFEEB91090E576B51F 2016 2021-01-29 14:40:06Z AMY MACE 5101 East US 36 Avon IN 46123 24954191 0 X www.cumminsbhs.org X 1972 IN To inspire the hope of recovery; to achieve excellence in all aspects of care; and to make the goals and aspirations of those we serve our highest priority. 7 7 480 7 0 0 7658480 7662915 16008021 16793334 28150 295264 102175 109407 23796826 24860920 0 0 0 0 19185799 20326355 0 0 0 3760555 3574559 22946354 23900914 850472 960006 11762658 12701143 2913408 2891887 8849250 9809256 X To inspire the hope of recovery; to achieve excellence in all aspects of care; and to make the goals and aspirations of those we serve our highest priority. 0 0 10628119 10537684 Youth Services - Approximately 4,500 persons under the age of 18 were served during the past year. Services to children and adolescents include individual, group and family therapies, case management, medication management, crisis intervention, and training in activities of daily living. 2536338 879066 Adult Services - Approximately 3,400 adults received traditional outpatient services to address behavioral health issues. Treatment modalities included therapy, family therapy, group therapy, medication management, employment services, and other related services. 2102376 1925739 RECOVERY SERVICES - INTENDED TO PROVIDE ADULTS WITH SERIOUS MENTAL ILLNESS OPPORTUNITIES FOR MAINTAINING A LEVEL OF FUNCTIONING THAT PROMOTES INDEPENDENT LIVING WITHIN THE COMMUNITY. SERVICES INCLUDE TRAINING IN ACTIVITIES OF DAILY LIVING, EMPLOYMENT SERVICES, CASE MANAGEMENT, AND MEDICATION MANAGEMENT. OTHER SERVICES INCLUDE GATEKEEPING FOR STATE OPERATED FACILITIES AND OTHER INPATIENT CARE. WE PROVIDED APPROXIMATELY 36,000 HOURS OF SERVICES TO CONSUMERS IN OUR RECOVERY PROGRAMS. 3765728 3560252 Medical services, addiction services, residential services, and other. 3765728 3560252 19032561 1 1 0 1 0 0 0 0 1 0 1 0 0 0 0 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 33 0 1 480 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X Shawna Gottlieb Chief Financial Of 8887141927 5101 East US 36 Avon IN 46123 William J Lynch Chairperson 2.00 X X 0 0 0 Eric Morse Vice Chairperson 2.00 X X 0 0 0 Teresa Batto Secretary & Treasurer 2.00 X X 0 0 0 Misty Edwards Board Member (term Beg. Aug'16) 2.00 X 0 0 0 Tom Iles Board Member 2.00 X 0 0 0 DIANE MCKNIGHT Board Member 2.00 X 0 0 0 Jay Sutton Board Member 2.00 X 0 0 0 ANN BORDERS President/CEO 40.00 X 293822 0 20701 Amy Mace Chief Financial Officer 40.00 X 139671 0 24659 Steven Fekete Medical Director 40.00 X 256316 0 31960 Stuart Mannon Senior Staff Psychiatrist 40.00 X 183304 0 28088 Kimberly Retzner Chief Operations Officer 40.00 X 132631 0 14258 William Enlow Chief Clinical Officer 40.00 X 110054 0 11741 1115798 0 131407 6 0 1 0 0 7661240 1675 7662915 Patient Service Revenu 621400 16793334 16793334 16793334 2977 2977 385558 93271 292287 292287 292287 Other Revenue 621400 109407 109407 109407 24860920 16902741 0 295264 764539 588695 175844 15519971 12839550 2680421 392546 289592 102954 2465657 2145005 320652 1183642 984998 198644 78533 54779 23754 674827 251034 423793 32674 16095 16579 690381 390920 299461 36455 5387 31068 425458 372105 53353 344769 299878 44891 52922 39781 13141 652741 314940 337801 394044 344183 49861 Operations 113702 89177 24525 Dues and Subscriptions 22832 1195 21637 Board Expense 21863 21863 33358 5247 28111 23900914 19032561 4868353 0 1939045 3003535 904211 906018 3034837 3087915 281202 268377 11979129 6543831 5603363 5435298 11762658 12701143 1517113 1932341 1396295 959546 2913408 2891887 X 8849250 9809256 8849250 9809256 11762658 12701143 960006 0 X X 0 1 X 1 0 X 1890 5924 1695 1810 1675 12994 6970682 7325502 7312278 7656670 7661240 36926372 6972572 7331426 7313973 7658480 7662915 36939366 36939366 1020 666 2639 2871 2977 10173 99928 59246 553490 102175 109407 924246 37873785 71501362 0.97530 0.97420 X Schedule A, part II, line 10, Explanation for Other income: Miscellaneous revenue includes: miscellaneous contract revenue, fees for photocopies of health records, meaningful use revenue; and other miscellaneous revenue. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1680 1680 0 Part II-B, Line 1: PORTION OF TRADE ORGANIZATION ANNUAL DUES ALLOCATED TO LOBBYING EFFORTS. 1 3996 18122 18005 4113 0 421060 421060 7543702 3310835 4232867 4014367 3232996 781371 5435298 X 24860920 0 24860920 0 24860920 23900914 0 23900914 0 23900914 Part IV, Line 1b: Cummins Behavioral Health, Inc. serves as a payee on behalf of its consumers' 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 BE 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, 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 CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. X X X X 0 0 0 0 0 0 0 0 0 ANN BORDERS President/CEO 238524 0 35623 0 19675 0 14604 0 6097 0 314523 0 0 0 Amy Mace Chief Financial Officer 129488 0 406 0 9777 0 8599 0 16060 0 164330 0 0 0 Steven Fekete Medical Director 252376 0 410 0 3530 0 15900 0 16060 0 288276 0 0 0 Stuart Mannon Senior Staff Psychiatrist 170688 0 203 0 12413 0 11049 0 17039 0 211392 0 0 0 Form 990, Part VI, Section B, line 11b THE PROCESS FOR REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW BY THE ORGANIZATION'S CHIEF FINANCIAL OFFICER AND CHIEF EXECUTIVE OFFICER. THE FORM 990 AND REQUIRED SCHEDULES WERE PRESENTED TO THE BOARD OF DIRECTORS at the February 2018 meeting. THE BOARD OF DIRECTORS APPROVED THE 990 FOR FILING WITH THE IRS. Form 990, Part VI, Section B, line 12c All Board Directors shall complete written conflict of interest statements annually. When an issue comes before the Board that presents an existing or potential conflict of interest to any Director, that Director is responsible for making that conflict known. When a conflict has been identified, the Director may enter into discussion of the issue with the consent from a two-thirds majority of the others present, but in no instance may this Director vote concerning the issue. Form 990, Part VI, Section B, line 15 In February 2018, the Board of Directors reviewed the salaries for the executive staff and other highly compensated employees. The salaries are determined based on comparability studies of similar organizations. The Chief Human Resources Officer prepared this information for the Board. Form 990, Part VI, Section C, line 19 The organization makes these documents available to the public upon request. Form 990, Part XII, Line 2c, Audit Oversight: The Board of Directors serves as the audit committee. The procedures utilized by the audit committee have not changed in the past year.