2017-11-06T12:50:46-06:00 2017-06-30 420946155 Honkamp Krueger & Co PC 951 13th Avenue North Clinton IA 52732 990 2016-07-01 204380936 Bridgeview Community Mental Health Center BRID 5632435633 638 S Bluff Clinton IA 52732 Jennifer Graf President 5632435633 2017-10-31 1 JON F THOMS CPA P00139911 5632426911 2017-10-30 104.201.82.178 2017-10-31 08:20:56 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 7918FE016189A6C4E88119FAB79D3DFB6DC76730 2016 2021-01-29 14:40:06Z Jennifer Graf 638 S Bluff Clinton IA 52732 3173000 0 X N/A X 2005 IA TO PROVIDE COMPREHENSIVE, CARING AND QUALITY MENTAL HEALTH SERVICES FOR INDIVIDUALS IN CLINTON COUNTY AND THE SURROUNDING AREAS 7 7 61 1 0 0 18200 18353 3212558 3124532 20705 18914 781 8026 3252244 3169825 0 0 0 0 2382988 2241117 0 0 0 697309 862296 3080297 3103413 171947 66412 2826521 2775614 252084 134765 2574437 2640849 TO PROVIDE COMPREHENSIVE, CARING AND QUALITY MENTAL HEALTH SERVICES FOR INDIVIDUALS IN CLINTON COUNTY AND THE SURROUNDING AREAS 0 0 2537671 3124539 PROVIDED MENTAL HEALTH SERVICES TO APPROXIMATELY 3,500 INDIVIDUALS IN THE CLINTON COMMUNITY AND SURROUNDING AREA. 2537671 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 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 10 0 1 61 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 0 1 0 1 0 X Paul Blair 5632435633 638 S Bluff CLINTON IA 52732 JACK WOLFE DIRECTOR 2.50 X 0 0 0 Dan Srp DireCTOR 2.50 X 0 0 0 Eileen Golby OSF DireCTOR 2.50 X 0 0 0 Julie Allesee DirECTOR 2.50 X 0 0 0 JENNIFER GRAF PRESIDENT 2.50 X 0 0 0 RICH KLAHN Vice President 2.50 X 0 0 0 BARB DEHAVEN Secretary 2.50 X 0 0 0 PAUL BLAIR EXECUTIVE DIRECTOR 40.00 X 84778 0 6376 Marcia Christiansen Business Manager 40.00 X 53843 0 6836 Thomas Earwood Medical Director 40.00 X 330477 0 0 469098 0 13212 1 0 1 0 0 18353 18353 MEDICARE/MEDICAID/INSU 623990 2410866 2410866 RESIDENT FEES 623990 428846 428846 CONTRACTS/FEES 623990 171240 171240 CLINTON COUNTY AID 623990 95770 95770 Self Pay 623990 17810 17810 3124532 18914 18914 11194 3175 8019 8019 Miscellaneous 623990 7 7 7 3169825 3124539 0 26933 X 150038 75019 75019 1610008 1312192 297816 57601 45063 12538 281225 220012 61213 142245 112840 29405 1528 1528 30158 20721 9437 509289 509289 23735 23710 25 28688 28688 135544 101443 34101 12666 12455 211 15078 15078 16320 14993 1327 SUPPLIES 56004 33681 22323 EQUIPMENT 14332 9068 5264 DUES, FEES, LICENSES 10331 9795 536 STAFF DEVELOPMENT 7015 6479 536 1608 695 913 3103413 2537671 565742 0 712179 560651 1720839 1942314 279550 211292 80343 0 258994 197637 33610 61357 2826521 2775614 252084 134765 252084 134765 X 2574437 2640849 2574437 2640849 2826521 2775614 66412 0 X 0 1 X 0 0 X 174476 28720 26200 18200 18353 265949 174476 28720 26200 18200 18353 265949 9150 256799 12017 12361 13311 20705 18914 77308 500 500 343757 15519025 0.74700 0.91280 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 258994 197637 61357 61357 X 3169825 0 3169825 0 3169825 3103413 0 3103413 0 3103413 Part X, Line 2: The Center is exempt from income taxes as a non-profit organization under Section 501(c)(3) of the Internal Revenue Code and under state income tax code. The Organization's federal income tax returns for 2015, 2016 and 2017 are subject to examination by the IRS, generally for three years after they were filed. X 0 0 0 0 0 0 0 0 0 Thomas Earwood Medical Director 330477 0 0 0 0 0 0 0 0 0 330477 0 0 0 Part I, Line 3 COMPENSATION AMOUNTS ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. Form 990, Part VI, Section B, line 11b FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS. Form 990, Part VI, Section B, line 12c The organization monitors this policy by knowing who the directors are and investigating if there are any possible conflicts of interest. Form 990, Part VI, Section B, line 15b COMPENSATION AMOUNTS ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part IX, line 11g Psych services: Program service expenses 443,145. Management and general expenses 0. Fundraising expenses 0. Total expenses 443,145. contracted sevices: Program service expenses 2,963. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,963. personnel investigation: Program service expenses 155. Management and general expenses 0. Fundraising expenses 0. Total expenses 155. outsourced billing fees: Program service expenses 63,026. Management and general expenses 0. Fundraising expenses 0. Total expenses 63,026.