2017-09-29T09:50:55-05:00 2017-06-30 351178661 Blue & Co LLC 500 N Meridian St Suite 200 Indianapolis IN 46204 990 2016-07-01 351070041 OAKLAWN PSYCHIATRIC CENTER INC OAKL 5745331234 330 LAKEVIEW DR GOSHEN IN 46527 Laurie N Nafziger President and CEO 5745331234 2017-09-28 1 Amber Kocher CPA P01286298 3176334705 2017-09-28 50.90.4.15 2017-09-28 12:54:53 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B19D0506B86ED19F1A0FD2AFEEB91090E576B51F 2016 2021-01-29 14:40:06Z Laurie N Nafziger 330 LAKEVIEW DR GOSHEN IN 46527 53550768 0 X www.oaklawn.org X 1959 IN TREATING THE WHOLE PERSON - MIND, BODY AND SPIRIT - IN ELKHART AND ST. JOSEPH COUNTIES, INDIANA. 18 17 1159 90 0 0 12746222 11800350 42202847 40408658 209992 391106 706499 933271 55865560 53533385 100096 91270 0 0 40852082 38875380 0 0 110012 11603872 11596717 52556050 50563367 3309510 2970018 41138593 41536100 19536830 17129734 21601763 24406366 WITH UNCOMMON EXPERTISE IN MENTAL HEALTH AND ADDICTIONS SERVICES, OAKLAWN JOINS WITH INDIVIDUALS, FAMILIES, AND OUR COMMUNITY ON THE JOURNEY TOWARD HEALTH AND WHOLENESS. 0 0 27119298 0 27323314 OUTPATIENT Services - PROVIDED OVER 111,360 CLIENT SERVICE ENCOUNTERS OF GROUP THERAPY, MEDICATION MANAGEMENT, AND INDIVIDUAL THERAPY; PROVIDED 80,048 CLIENT SERVICE ENCOUNTERS OF CARE COORDINATION; PROVIDED 76,834 CLIENT SERVICE ENCOUNTERS OF SKILLS BUILDING IN PERSONAL CARE AND COMMUNITY LIVING; AND PROVIDED AN ADDITIONAL 35,571 ENCOUNTERS OF OTHER COMMUNITY-BASED SERVICES. IN SUMMARY, A TOTAL OF 15,596 CONSUMERS WERE SERVED IN THE FISCAL YEAR. 12738527 91270 10786272 RESIDENTIAL SERVICES - IN ADDITION TO THE BEHAVIORAL HEALTH SERVICES FOR THIS POPULATION, THE ORGANIZATION PROVIDED 29,530 DAYS OF CHILD & ADOLESCENT RESIDENTIAL CARE AND 9,016 DAYS OF THERAPEUTIC FOSTER CARE. ADDITIONALLY, ADULTS LIVING IN SUPERVISED GROUP LIVING ARRANGEMENTS ARE PROVIDED RESIDENTIAL SUPPORT SERVICES ALONG WITH THE NECESSARY PSYCHIATRIC AND SUBSTANCE ABUSE SERVICES. A TOTAL OF 31,730 DAYS WERE PROVIDED TO THIS SEGMENT OF THE ADULT POPULATION. 3141115 0 3232239 INPATIENT SERVICES - PROVIDED 4,520 INPATIENT DAYS OF PSYCHIATRIC AND SUBSTANCE ABUSE STABILIZATION. 42998940 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 64 0 1 1159 1 0 0 0 0 0 0 0 0 0 0 X 18 17 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X Joseph Barkman 5745331234 330 Lakeview Dr Goshen IN 46528 Randall Cammenga MD Board Chair 0.50 0.00 X X 0 0 0 Audra Mark Vice Chair-term began Jan'17 0.30 0.00 X X 0 0 0 Kay Evans Ball Board Secretary 0.30 0.00 X X 0 0 0 Robert Shreiner Board Treasurer 0.30 0.00 X X 0 0 0 Marion Fulce Board Assistant Secretary 0.30 0.00 X X 0 0 0 Terri Burks board member 0.30 0.00 X 0 0 0 Jay Caponigro Board Member 0.30 0.00 X 0 0 0 Janilyn Daub Board Member 0.30 0.00 X 0 0 0 Jim Dubois board member 0.30 0.00 X 0 0 0 Carol Ebersole board member 0.30 0.00 X 0 0 0 Esleen Fultz board member-term began Jan'17 0.30 0.00 X 0 0 0 Trish Hankila board member-term began Jan'17 0.30 0.00 X 0 0 0 Ken Hochstetler board member-term began Jan'17 0.30 0.00 X 0 0 0 Chris Karam Board member 0.30 0.00 X 0 0 0 Darryl Riegsecker board member 0.30 0.00 X 0 0 0 Bradley Rogers board member 0.30 0.00 X 0 0 0 Beverly Teegarden board member 0.30 0.00 X 0 0 0 Phil Wiens board member 0.30 0.00 X 0 0 0 Rod Diller Board member-term ended Dec'16 0.30 0.00 X 0 0 0 LAURIE NAFZIGER President/CEO 40.00 1.00 X 238121 0 43735 Joseph Barkman CFO 40.00 1.00 X 110525 0 24004 Gregg Nussbaum Vice President 40.00 0.00 X 90821 0 22604 DANIEL KINSEY MD Medical Director 40.00 0.00 X 268397 0 51440 Michael Platt MD psychiatrist 40.00 0.00 X 241460 0 48431 David Taylor MD psychiatrist 40.00 0.00 X 238977 0 49778 Douglas Jarvis MD Psychiatrist 40.00 0.00 X 228201 0 39488 Timothy McFadden MD psychiatrist 40.00 0.00 X 225514 0 45986 1642016 0 325466 26 0 1 0 MapleTronics Computer Inc 2116 West Wilden Avenue PO Box 136 Goshen IN 46527 IT Services 726548 Qualifacts Systems Inc PO Box 4577 Caroil Stream IL 60197 EHR Services 509766 South Bend Community School Corp 3003 North Bendix Drive South Bend IN 46628 Council/Consulting Services 296234 Golden Technologies 2402 Beech Street Valparaiso IN 46383 IT Equip/Support 265165 Enterprise Fleet Management PO Box 800089 Kansas City MO 64180 Fleet Management Services 264952 19 440107 11154565 205678 11800350 Net Patient Service Revenue 900099 37070652 37070652 Government Funding 900099 2766461 2766461 Outpatient Clinic Services 900099 571545 571545 40408658 381598 381598 335763 0 335763 335763 335763 26891 17383 9508 9508 9508 Other Revenue 900099 350508 350404 104 Meaningful Use Revenue 900099 247000 247000 597508 53533385 41341825 0 391210 91270 91270 529808 529808 32671929 29975436 2642781 53712 373606 323983 49009 614 2978942 2583274 390771 4897 2321095 2012803 304476 3816 24185 24185 3373184 1969286 1356925 46973 88748 77234 11514 1400666 1218948 181718 1647305 568451 1078854 576193 501440 74753 428147 372601 55546 306937 306937 1037381 902794 134587 599108 521382 77726 Hospital Assessment Fee 754308 754308 Food Supplies 584760 483834 100926 Medication Supplies 296811 245584 51227 Dues and Fees 128042 105942 22100 350942 290370 60572 50563367 42998940 7454415 110012 5664 5732 11366391 7548950 3814616 4042678 3016804 3589983 404232 570410 32275446 20261213 12231135 12014233 8870688 12683343 1429063 1080771 41138593 41536100 5360306 3782398 11073 11075 970804 941613 9647500 9030594 2177450 1836088 1369697 1527966 19536830 17129734 X 21601763 24406366 21601763 24406366 41138593 41536100 X 2970018 -303847 138432 X X 0 1 X 1 1 1 X 7713575 7671940 7595571 9523049 8442239 40946374 32160600 38424568 41331074 42604909 41006062 195527213 3061768 3103403 3179772 3223173 3358111 15926227 42935943 49199911 52106417 55351131 52806412 252399814 0 460812 1516167 1670852 1613525 1211039 6472395 460812 1516167 1670852 1613525 1211039 6472395 245927419 304740 336957 438063 511473 717361 2308594 304740 336957 438063 511473 717361 2308594 32069 1061 1788 1227 104 36249 43272752 49537929 52546268 55863831 53523877 254744657 0.96540 0.97020 0.00910 0.00810 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2976 2976 0 Part II-B, Line 1: A PORTION OF MEMBERSHIP DUES PAID TO INDIANA COUNCIL OF COMMUNITY MENTAL HEALTH CENTERS (ICCMHC) AND INDIANA ASSOCIATION OF RESIDENTIAL CHILD CARE AGENCIES (IARCCA) WERE ATTRIBUTED TO LOBBYING EXPENSES. 855638 855638 19296530 10234192 9062338 12117164 10027021 2090143 6114 6114 12014233 Fixed Income Bonds 12683343 F 12683343 Client Held Funds 90823 Est. Third-Party Payor Settlement 1331562 Other Current Liabilities 19527 Bond Interest Swap 86054 1527966 X Part X, Line 2: FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 superseded by FASB codification ASC 740: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY OPC AND AFFILIATES AND RECOGNIZE A TAX LIABILITY IF OPC AND AFFILIATES 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 OPC AND AFFILIATES, 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 CONSOLIDATED FINANCIAL STATEMENTS. OPC AND AFFILIATES ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 1 Assistance to individuals and families for various needs through resident 278 91270 X X X X 0 0 0 0 0 0 0 0 0 LAURIE NAFZIGER President/CEO 238121 0 0 0 0 0 6906 0 36829 0 281856 0 0 0 DANIEL KINSEY MD Medical Director 219884 0 37390 0 11123 0 6770 0 44670 0 319837 0 0 0 Michael Platt MD psychiatrist 195912 0 45548 0 0 0 6018 0 42413 0 289891 0 0 0 David Taylor MD psychiatrist 194360 0 44617 0 0 0 6088 0 43690 0 288755 0 0 0 Douglas Jarvis MD Psychiatrist 204904 0 23297 0 0 0 4783 0 34705 0 267689 0 0 0 Timothy McFadden MD psychiatrist 206166 0 19130 0 218 0 5248 0 40738 0 271500 0 0 0 A HOSPITAL AUTHORITY OF ELKHART COUNTY INDIANA 351657690 2013-12-04 10805000 See Part VI 0 0 0 A 10805000 10805000 2013 1 0 1 1 A 0 1 1 1 0 0 0 1 A 0 1 0 0 1 1 Fifth Third Bank 5.000000000000 0 0 0 0 1 A 1 Part I, Bond Issue, Row A, Column F Description of Purpose: The issue was to refinance previously issued "Adjustable Rate Demand Revenue Refunding and Improvement Bonds, Series 2006". EVERENCE See Part V below 6280346 See Part V 0 Schedule L, Part IV, Business Transactions involving interested persons: (A) NAME OF INTERESTED PERSON: EVERENCE(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: THE PRESIDENT OF EVERENCE, KEN HOCHSTETLER, AND SENIOR VICE PRESIDENT OF EVERENCE, RODNEY DILLER, served as BOARD MEMBERS FOR OAKLAWN PSYCHIATRIC CENTER, INC. (C) AMOUNT OF TRANSACTION: $6,280,346(D) DESCRIPTION OF TRANSACTION: EVERENCE ADMINISTERS THE EMPLOYEE HEALTH INSURANCE PLAN FOR OAKLAWN PSYCHIATRIC CENTER, INC. AND IS THE INVESTMENT ADVISOR FOR ITS 403B RETIREMENT PLAN. TRANSACTION AMOUNT IS FOR INSURANCE PREMIUMS PAID. Form 990, Part I, Line 6, Volunteers: IN ADDITION TO ALL VOLUNTEER BOARD OF DIRECTORS, THE ORGANIZATION IS SUPPORTED BY MORE THAN 72 ACTIVE VOLUNTEERS WHO SERVE IN A VARIETY OF SUPPORT SERVICES. DURING THE FISCAL YEAR OVER 2,500 HOURS OF SERVICE WERE GIVEN BY THESE VOLUNTEERS. Form 990, Part VI, Section A, line 1 Delegated Authority: PER the BYLAWS, THE EXECUTIVE COMMITTEE OF THE BOARD IS AUTHORIZED TO ACT ON THE FULL BOARD'S BEHALF. THE FULL BOARD MEETS QUARTERLY AND THE EXECUTIVE COMMITTEE GENERALLY MEETS AN ADDITIONAL FOUR TIMES ON ALTERNATE MONTHS. Form 990, Part VI, Section A, line 7a ELECTION OF MEMBERS: VOTING MEMBERS ARE SELECTED BY THE SPONSORING ORGANIZATION, MENNONITE HEALTH SERVICES ALLIANCE, AS PROVIDED IN THE BY-LAWS AND ARTICLES OF INCORPORATION OF OAKLAWN PSYCHIATRIC CENTER, INC. BOARD MEMBERS APPOINTED BY MENNONITE HEALTH SERVICES ALLIANCE ARE THE SOLE MEMBERS OF THE BOARD OF DIRECTORS. Form 990, Part VI, Section B, line 11b FORM 990 REVIEW PROCESS: THE PROCESS OF REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW BY THE ORGANIZATION'S SENIOR MANAGEMENT AND CHIEF EXECUTIVE OFFICER. THE GOVERNING BODY RECEIVES A COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVAL PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Section B, line 12c Conflict of Interest Compliance: The organization regularly and consistently monitors and enforces compliance with its conflict of interest policy. Oaklawn staff, Board members, volunteers and agents shall exercise the utmost good faith in all transactions touching upon their duty to Oaklawn and its property, and shall fully disclose any conflict of interest. Annually, Board members sign that they will abide by the policy and declare any conflict of interest they may have with the organization or its related organizations, and abstain from any voting where a conflict could exist. Form 990, Part VI, Section B, line 15 PROCESS OF DETERMINING COMPENSATION: TOP OFFICIAL: THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION PACKAGE PROVIDED TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION. THE COMPENSATION REVIEW INCLUDES A MARKET ANALYSIS STUDY AND A PERFORMANCE REVIEW. THIS PROCESS IS DOCUMENTED IN THE BOARD MINUTES. OTHER OFFICERS: THE ORGANIZATION ANNUALLY PARTICIPATES IN SEVERAL MARKET SURVEYS. MANAGEMENT COMPARES COMPENSATION LEVELS OF LIKE POSITIONS AND STRIVES TO ADJUST THE ORGANIZATION'S COMPENSATION PACKAGES FOR LIKE POSITIONS TO FALL WITHIN THE RANGE OF THE MARKET WITH A GOAL TO BE COMPETITIVELY PLACED BETWEEN THE 50TH AND 75TH PERCENTILE OF THE MARKET RANGE. THIS PROCESS IS DOCUMENTED IN THE BOARD MINUTES. Form 990, Part VI, Section C, line 19 DOCUMENTS AVAILABLE TO THE PUBLIC: COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED FOR REVIEW UPON REQUEST. IN ADDITION, THE ORGANIZATION IS ACCREDITED BY THE JOINT COMMISSION; MEETING THE REQUIREMENTS FOR THE BEHAVIORAL HEALTH CARE ACCREDITATION PROCESS. ALSO, THE ORGANIZATION IS CERTIFIED BY THE STATE OF INDIANA FAMILY AND SOCIAL SERVICES ADMINISTRATION, DIVISION OF MENTAL HEALTH AND ADDICTIONS, AS AN INDIANA COMMUNITY MENTAL HEALTH CENTER (CMHC). ACCORDINGLY, GOVERNING DOCUMENTS ARE REVIEWED AND REGULARLY PROVIDED TO THESE AND OTHER PUBLIC BODIES. Form 990, Part XI, line 9: change in derivative 138,432. Form 990, Part XII, Line 2c, Oversight of Audit: THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. Mennonite Health Services 1112 N Main Street Goshen IN 46528 231421919 Health and Human Service Ministries IN 501(c)(3) Line 10 N/A 0 Oaklawn foundation for Mental Health po Box 809 goshen IN 46527 356060037 fundraising/Mental Health Promotion IN 501(c)(3) Line 7 OPC 1 OAKLAWN CMHC 330 Lakeview Dr PO Box 809 goshen IN 46527 237317957 healthcare IN 501(c)(3) Line 7 OPC 1 Simadon Corporation po Box 809 goshen IN 46527 208473080 huD Housing IN 501(c)(3) Line 7 oPC 1 MADISON RESIDENTIAL SERVICES INC Po Box 809 goshen IN 46527 311135587 huD Housing IN 501(c)(3) Line 7 oPC 1 Riverside Corporation PO Box 809 Goshen IN 46527 351875879 huD Housing IN 501(c)(3) Line 7 opC 1 Oaklawn Estates Apartments Inc PO Box 809 goshen IN 46527 383646840 huD Housing IN 501(c)(3) Line 7 opC 1 Oaklawn Apartments Inc PO Box 809 Goshen IN 46527 311009857 HuD Housing IN 501(c)(3) Line 7 opc 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 Oaklawn Foundation for Mental Health C 440107 Fair market value