NORTH CENTRAL MENTAL HEALTH SERVICES: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NORTH CENTRAL MENTAL HEALTH SERVICES (EIN 31-0847283)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-15
IRS object ID
201401359349301245
Schema version
2012v2.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-15T09:41:16-00:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Parms and Company LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1585 S Front St Ste 220AddressLine1
CityColumbusCity
StateOHState
ZIP Code43215ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN310847283EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1North Central Mental Health ServicesBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone6142996600Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11301 N High StreetAddressLine1
CityColumbusCity
StateOHState
ZIP Code43201ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJoseph NiedzwiedskiName
TitleChief Financial OfficerTitle
Phone6142996600Phone
Date Signed2014-05-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTheodore W Johnson CPAName
Phone6142243078Phone
Date Prepared2014-05-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJoseph NiedzwiedskiNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11301 N High StAddressLine1
CityColumbusCity
StateOHState
ZIP Code43201ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14088552GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.ncmhs.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1973YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTo provide mental health services.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees236TotalNbrEmployees
Total Nbr Volunteers100TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year3442353ContributionsGrantsPriorYear
Contributions Grants Current Year3026325ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11053432ProgramServiceRevenuePriorYear
Program Service Revenue CY10707464ProgramServiceRevenueCY
Investment Income Prior Year45657InvestmentIncomePriorYear
Investment Income Current Year34387InvestmentIncomeCurrentYear
Other Revenue Prior Year462289OtherRevenuePriorYear
Other Revenue Current Year320376OtherRevenueCurrentYear
Total Revenue Prior Year15003731TotalRevenuePriorYear
Total Revenue Current Year14088552TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year10852743SalariesEtcPriorYear
Salaries Etc Current Year10615276SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3266859OtherExpensePriorYear
Other Expenses Current Year3279810OtherExpensesCurrentYear
Total Expenses Prior Year14119602TotalExpensesPriorYear
Total Expenses Current Year13895086TotalExpensesCurrentYear
Revenues Less Expenses Prior Year884129RevenuesLessExpensesPriorYear
Revenues Less Expenses CY193466RevenuesLessExpensesCY
Total Assets BOY13904941TotalAssetsBOY
Total Assets EOY13482810TotalAssetsEOY
Total Liabilities BOY3770105TotalLiabilitiesBOY
Total Liabilities EOY3140746TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY10134836NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY10342064NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo provide mental health services.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense6473400Expense
DescriptionCounseling, medical and community support.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2187599Expense
DescriptionResidential/transitional services.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense3366953Expense
DescriptionMedical services.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp401963TotalOfOtherProgramServiceExp
Total Program Service Expense12429915TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096114NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees236NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJoseph Niedzwiedski CFONamePerson
Telephone Number6142996600TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11301 N High StAddressLine1
CityColumbusCity
StateOHState
ZIP Code43201ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Melinda Blakie
Board Member001.00X000
Jeanne Clement
Board Member001.00X000
David Fais
Board Member001.00X000
Gilbert Greene
Board Member001.00X000
Melvin Harris
Board Member001.00X000
John Krimm
Board Member001.00X000
Marcee McCreary
Board Member001.00X000
Michael O'Grady
Board Member001.00X000
Aron Ross
Board Member001.00X000
Charles Schneider
Board Member001.00X000
Philip Tieman
Board Member001.00X000
Greta Winbush
Board Member001.00X000
Donald R Wood
Pres/CEO040.0027340600X
Joseph J Niedzwiedski
CFO040.0018298800X
Robert M Loar
Assoc Dir of Oper Supp040.0015229000X
Prasad K Potaraju
Med Dir040.0013233100X
Daniel P Bridgeo
Comm Serv Dir040.0010706700X
William R Silliman
Clinical Dir040.0017468300X
Radhika Gollapudy
Employee040.0021574800X
Bela Agabalyan
Employee040.0021236500X
Stephen Busch
Employee040.0010392100X
Ajay Bhatia
Employee040.0015614200X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1710941TotalReportableCompFromOrg
Number Individuals GT100 K9NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Sharda Bobba
4849 Aberdeen AvenueDublinOH43016Contract doctor179500
McCormick & Reinmuth Ins
PO Box 660WorthingtonOH43085Insurance164509
Allied Barton Security
PO Box 828854PhiladelphiaPA19182Security Guard Svc158493
Procomp Software Consultants
555 Cincinnati-Batavia PikeCincinnatiOH45224Software Consultants185580
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
All Other Contributions3026325AllOtherContributions
Total Contributions3026325TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumn
Client insurance fees151942
ADAMH1922867
Title XIX8632655
FieldValueIRS element (for citing)
Total Program Service Revenue10707464TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column34387TotalRevenueColumn
Related Or Exempt Function Income34387RelatedOrExemptFunctionIncome

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real228953Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real228953Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column228953TotalRevenueColumn
Related Or Exempt Function Income228953RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOther IncomeDescription
Total Revenue Column91423TotalRevenueColumn
Related Or Exempt Function Income91423RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue91423TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14088552TotalRevenueColumn
Related Or Exempt Function Income354763RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1710941Total
Program Services1553192ProgramServices
Management And General157749ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8904335Total
Program Services7974339ProgramServices
Management And General929996ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Fees For Services Prof FundraisingFeesForServicesProfFundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total800690Total
Program Services750840ProgramServices
Management And General49850ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total275207Total
Program Services242462ProgramServices
Management And General32745ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total390563Total
Program Services361143ProgramServices
Management And General29420ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total597565Total
Program Services563370ProgramServices
Management And General34195ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total249848Total
Program Services212286ProgramServices
Management And General37562ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Operating Supplies1383151341054210
Operating Expenses636917502650134267
Equipment and Improvements17889813552843370
Other Expenses1180711807

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13895086Total
Program Services12429915ProgramServices
Management And General1465171ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY7465447BOY
EOY6213989EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY921448BOY
EOY1882239EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1386973BOY
EOY1518319EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY269916BOY
EOY132658EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis8442559LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4706954LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3861157BOY
EOY3735605EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY13904941BOY
EOY13482810EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2120791BOY
EOY1769188EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY40669BOY
EOY1318EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1608645BOY
EOY1370240EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3770105BOY
EOY3140746EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY10134836BOY
EOY10342064EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10134836BOY
EOY10342064EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13904941BOY
EOY13482810EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses193466ReconcilationRevenueExpenses
Reconciliation Unrealized Invest13762ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13255967CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14171394CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14234825CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14495785CurrentTaxYearMinus1Year
Current Tax Year13733789CurrentTaxYear
Total69891760Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years13255967CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14171394CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14234825CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14495785CurrentTaxYearMinus1Year
Current Tax Year13733789CurrentTaxYear
Total69891760Total
FieldValueIRS element (for citing)
Public Support Total17069891760PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years49577CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years156373CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years98699CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year45657CurrentTaxYearMinus1Year
Current Tax Year34387CurrentTaxYear
Total384693Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years443890CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years382839CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years343456CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year462289CurrentTaxYearMinus1Year
Current Tax Year320376CurrentTaxYear
Total1952850Total
FieldValueIRS element (for citing)
Total Support72229303TotalSupport
Public Support Pertcentage1700.96760PublicSupportPertcentage170
Public Support Pertcent Prior Year0.96570PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtctrueAgentTrusteeEtc
Beginning Balance198920BeginningBalance
Additions During Year1896636AdditionsDuringYear
Distributions During Year1907236DistributionsDuringYear
Ending Balance188320EndingBalance
Included On FSfalseIncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis271873OtherCostOrOtherBasis
Book Value271873BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6724443OtherCostOrOtherBasis
Depreciation3446884Depreciation
Book Value3277559BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis958185OtherCostOrOtherBasis
Depreciation928918Depreciation
Book Value29267BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis488058OtherCostOrOtherBasis
Depreciation331152Depreciation
Book Value156906BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3735605TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescription
Financial derivatives and other financial products
Closely-held equity interests

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
Federal income taxes
Advanced from State of Ohio-Current$83,706
Other Liabilities$256,403
Medicaid Payback$100,000
Advances-Non Current$930,131
FieldValueIRS element (for citing)
Total Of Amounts1370240TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt14102314TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments13762NetUnrealizedGainsInvestments
Revenue Not Rptd F99013762RevenueNotRptdF990
Revenue Subtotal14088552RevenueSubtotal
Total Revenue Per Form99014088552TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13895086TotExpensesEtcAuditedFinclStmt
Expenses Subtotal13895086ExpensesSubtotal
Total Expenses Per Form99013895086TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
X1North Central Mental Health Services, Inc. has adopted provisions of FASB ASC 740-10-25, which requires that a tax position be recognized or derecognized based on a more likely than not threshold. This applies to positions taken or expected to be taken in a tax return. North Central Mental Health Services, Inc. does not believe its financial statements include any uncertain tax positions. North Central Mental Health Services, Inc.s open tax periods are 2010 through 2012 based on filed Forms 990.
IV1bNorth Central is an Organizational Representative Payee, appointed by the Social Security Administration to receive and manage the social security and/or social security disability funds for some beneficiaries who are patients of North Central. North Central maintains a custodial bank account on behalf of these patients as instructed by the Social Security Administrations guidelines.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
Donald R Wood
Pres/CEO2384423496416257289663
Joseph J Niedzwiedski
CFO179989299929901212889
Robert M Loar
Assoc Dir of Oper Supp146443584721435173725
William R Silliman
Clinical Dir171908277523328198011
Radhika Gollapudy
Employee21574824739240487
Bela Agabalyan
Employee21236524151236516
Ajay Bhatia
Employee1561429193165335

Schedule M IRS990ScheduleM

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

ExplanationExplanation
Form 990, Part III, Line 4d Program Service Expenses 165,069, Grants and allocations 0, Revenue 0 IDDT Program
Form 990, Part III, Line 4d Program Service Expenses 236,894, Grants and allocations 0, Revenue 0 Suicide Prevention
Form 990 Part VI Section B Line 11b E-mail prior to filing and approved at a subsequent board meeting.
Form 990 Part VI Section B Line 12c Board members prepare an annual conflict of interest form.
Form 990 Part VI Section B Line 15 Reviewed by the board of trustees. The CEO reviews other officers and key employees.
Form 990 Part VI Section C Line 19 The agency services plan and budget are filed with the Franklin County ADAMH board and with the Ohio Department of Mental Health and the Ohio Department of Alcohol and Drug Services.
Form 990 Part XI Line 5 Unrealized gain loss on investment of 13,762.

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