2017-05-15T14:44:13-05:00 2016-06-30 310800053 CLARK SCHAEFER HACKETT & CO 14 EAST MAIN STREET SUITE 500 SPRINGFIELD OH 45502 990 2015-07-01 310733984 COLUMBUS AREA INTEGRATED HEALTH SERVICES INC COLU 6142520711 1515 EAST BROAD ST COLUMBUS OH 43205 ANTHONY PENN PRESIDENT/CEO 6142520711 2017-05-10 1 MATTHEW SHROYER P00737986 9373992000 2017-05-10 2015 2021-01-29 14:40:06Z ANTHONY PENN 1515 EAST BROAD ST COLUMBUS OH 43205 18174330 0 X WWW.COLUMBUS-AREA.COM X 1965 OH TO PROVIDE CULTURALLY SENSITIVE AND QUALITY MENTAL HEALTH AND WELLNESS SERVICES TO THE COMMUNITY. X 10 10 317 10 -240931 0 6616346 6357329 8077551 8779280 4606 -141664 -192278 -39366 14506225 14955579 0 0 0 0 8569384 8617372 0 0 0 5695339 7944961 14264723 16562333 241502 -1606754 6542806 3897511 7551277 6512736 -1008471 -2615225 TO PROVIDE CULTURALLY SENSITIVE AND QUALITY MENTAL HEALTH AND WELLNESS SERVICES TO THE COMMUNITY. 0 0 5858468 5673266 OUTPATIENT THERAPY: CONTROL, REDUCTION, OR MAINTENANCE OF SYMPTOMATIC BEHAVIOR WHICH CAUSES THE PERSON PSYCHOLOGICAL STRESS 5407572 201565 RESIDENTIAL/VOCATIONAL SERVICES: PROVIDED VARIOUS LEVELS OF SUPPORT WITHIN A RESIDENTIAL AND/OR PRE-VOCATIONAL SETTING 2980790 3106014 PHARMACY 14246830 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 1 0 0 0 0 0 1 0 0 0 0 0 1 144 0 1 317 1 1 1 0 0 0 0 0 0 0 0 0 X 10 10 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 ARTHUR HOLLOWAY BOARD MEMBER 1.00 X 0 0 0 DEBBIE HUGHES 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 LORI ELMORE BOARD SECRETARY 1.00 X X 0 0 0 MICHAEL BIVENS BOARD TREASURER 1.00 X X 0 0 0 MICHAEL MADISON BOARD MEMBER 1.00 X 0 0 0 ROBYN TAYLOR BOARD VICE PRESIDENT 1.00 X X 0 0 0 TRACIE TAYLOR BOARD MEMBER 1.00 X 0 0 0 ANTHONY PENN CEO 40.00 X 188849 0 19303 DEWITT HARRELL CFO 40.00 X 121785 0 0 DORIAN WINGARD COO 1.00 X 4615 0 3152 DR LIBERATO BASOBAS PSYCHIATRIST 40.00 X 212760 0 403 MARY KIRKMAN DEPUTY CHIEF CLINICAL SERVICES 40.00 X 101368 0 13122 629377 0 35980 4 0 1 0 ANDA INC 2915 WESTON RD WESTON FL 33331 PHARMACY MEDICATION SUPPLIER 795182 HARTFORD ON THE LAKE APARTMENTS 2400 W SHORE BLVD COLUMBUS OH 43232 SHELTER CARE FOR CLIENTS 288157 COMDATA 5301 MARYLAND WAY BRENTWOOD TN 37027 PURCHASE CARD SERVICES 213621 RENEWED PROPERTIES INC 7820 PALMER ROAD SW REYNOLDSBURG OH 43068 LANDLORD FOR 813 BRYDEN ROAD 184250 LENCHO ABASHAMO 6616 RETTON ROAD REYNOLDSBURG OH 43068 PHARMACY MANAGEMENT 162939 5 20191 6191518 145620 6357329 PHARMACY REVENUE 446110 3106014 3106014 MEDICAID (TITLE XIX) 621400 2852212 2852212 PROGRAM SERVICE CONTRACTS 621400 2131060 2131060 PATIENT SERVICE FEES 621400 599752 599752 PROGRAM FEES 621400 90242 90242 8779280 2511 2511 458304 699235 -240931 -240931 -240931 2375341 2519516 -144175 -144175 -144175 OTHER INCOME 900099 201565 201565 201565 14955579 8980845 -240931 -141664 313439 22586 290853 6590712 6065260 525452 1170848 1000076 170772 542373 466371 76002 956647 600766 355881 18966 9131 9835 746447 482594 263853 186522 175943 10579 105664 105664 156549 127997 28552 209271 73077 136194 OPERATING EXPENSES 3366922 3094263 272659 DIRECT CLIENT ASSISTANC 1611574 1606273 5301 REPAYMENT DUE FUNDING S 487255 487255 MISCELLANEOUS 99144 35238 63906 16562333 14246830 2315503 0 1028805 1690047 1316672 596695 199999 139302 78442 73236 4524971 3149342 3736330 1375629 20557 22602 162001 0 6542806 3897511 1634627 1593185 851837 2147657 4916357 1999695 148456 772199 7551277 6512736 X -1029028 -2635782 20557 20557 -1008471 -2615225 6542806 3897511 -1606754 0 X X 0 1 X 1 1 1 X 9639164 6456781 5734864 6616346 6357329 34804484 9639164 6456781 5734864 6616346 6357329 34804484 34804484 479 455 471431 543 2511 475419 213689 173719 161371 162270 201565 912614 36192517 35057265 0.96160 0.96470 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 302810 302810 1747442 1303297 444145 31031 31031 0 2337605 1708931 628674 106083 106083 0 1375629 DUE TO OTHERS 67828 PAYABLE DUE FUNDING SOURCE 704371 772199 X 15654814 699235 699235 14955579 0 14955579 17261568 699235 699235 16562333 0 16562333 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, 2016 AND 2015, 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 2014, 2015 AND 2016 ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 699,235. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 699,235. X X 1 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 0 403 0 213163 0 0 0 PART I, LINE 4A DORIAN WINGARD, COO $7,768 JAMES C RAGLANDRAGLAND ENTERPRISES FORMER BOARD MEMBER 77420 CONSULTING SERVICES 0 BUILDING AT 899 E BROAD ST. 2016-06-01 2375341 CONTRACT SALES PRICE 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 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 XII, LINE 2C: THE PROCESS HAS NOT CHANGED.