HEALTHSOURCE INTEGRATED SOLUTIONS INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- HEALTHSOURCE INTEGRATED SOLUTIONS INC (EIN 20-8498601)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-15
- IRS object ID
- 201201369349307655
- Schema version
- 2010v3.4
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-15T17:08:14-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CBIZ MHM LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 990 SW FAIRLAWN ROAD | AddressLine1 |
| City | TOPEKA | City |
| State | KS | State |
| ZIP Code | 66606 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208498601 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KANSAS HEALTH SOLUTIONS LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | KANS | NameControl |
| Phone | 8665470222 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 534 S KANSAS AVE NO 510 | AddressLine1 |
| City | TOPEKA | City |
| State | KS | State |
| ZIP Code | 66603 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MYRON UNRUH | Name |
| Title | CEO | Title |
| Phone | 8665470222 | Phone |
| Date Signed | 2012-05-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LORI DOWNING | Name |
| Phone | 7852723176 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ANITA STEFANICH | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 534 S KANSAS AVE NO 510 | AddressLine1 |
| City | TOPEKA | City |
| State | KS | State |
| ZIP Code | 66603 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12567889 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.KANSASHEALTHSOLUTIONS.ORG | WebSite |
| Type Of Organization Other | X | TypeOfOrganizationOther |
| Type Of Org Other Description | SMLLC | TypeOfOrgOtherDescription |
| Year Formation | 2007 | YearFormation |
| State Legal Domicile | KS | StateLegalDomicile |
| Activity Or Mission Description | TO FUNCTION AS A PREPAID AMBULATORY HEALTH PLAN FOR PEOPLE WITH MEDICAID NEEDING MENTAL HEALTH SERVICES. WE ARE COMMITTED TO DELIVERING SERVICES THAT MEET OR EXCEED COMMUNITY STANDARDS OF ACCESSIBILITY, ACCEPTABILITY, VALUE, IMPACT, AND CULTURAL SENSITIVITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 121 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 296750 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -94636 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 12677881 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 12231899 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 59270 | InvestmentIncomePriorYear |
| Investment Income Current Year | 39240 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 296750 | OtherRevenuePriorYear |
| Other Revenue Current Year | 296750 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 13033901 | TotalRevenuePriorYear |
| Total Revenue Current Year | 12567889 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6377691 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6910768 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 6432319 | OtherExpensePriorYear |
| Other Expenses Current Year | 6945495 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 12810010 | TotalExpensesPriorYear |
| Total Expenses Current Year | 13856263 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 223891 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -1288374 | RevenuesLessExpensesCY |
| Total Assets BOY | 38394728 | TotalAssetsBOY |
| Total Assets EOY | 23700506 | TotalAssetsEOY |
| Total Liabilities BOY | 34760625 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 22349286 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3634103 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1351220 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO FUNCTION AS A PREPAID AMBULATORY HEALTH PLAN FOR PEOPLE WITH MEDICAID NEEDING MENTAL HEALTH SERVICES. WE ARE COMMITTED TO DELIVERING SERVICES THAT MEET OR EXCEED COMMUNITY STANDARDS OF ACCESSIBILITY, ACCEPTABILITY, VALUE, IMPACT, AND CULTURAL SENSITIVITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 13599588 | Expense |
| Revenue | 12231899 | Revenue |
| Description | KANSAS HEALTH SOLUTIONS, LLC (KHS) IS A NOT-FOR-PROFIT ORGANIZATION FOR THE PURPOSE OF FULFILLING THE FUNCTIONS AND OBLIGATIONS OF A PREPAID HEALTH PLAN, MANAGING A STATEWIDE SYSTEM AS TO BEHAVIORAL HEALTH SERVICES AND OTHERWISE FUNCTIONING IN A MANNER COMPATIBLE WITH THE VALUES, MISSIONS, AND GOALS OF THE MEMBERS OF THE ASSOCIATION OF COMMUNITY MENTAL HEALTH CENTERS OF KANSAS, INC. | Description |
| Total Program Service Expense | 13599588 | TotalProgramServiceExpense |
| Described In501 C3 | 0 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 1 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 1 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 406 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 121 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 1 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | KS | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ANITA STEFANICH | NamePerson |
| Telephone Number | 8665470222 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 534 S KANSAS AVE STE 510 | AddressLine1 |
| City | TOPEKA | City |
| State | KS | State |
| ZIP Code | 66603 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee |
|---|---|---|---|---|---|---|---|
| SHERMAN COLE | |||||||
| MEMBER-AT-LARGE | 4.00 | X | 0 | 0 | 0 | ||
| MARILYN COOK | |||||||
| MEMBER-AT-LARGE | 4.00 | X | 0 | 0 | 0 | ||
| JULIE DEJEAN | |||||||
| MEMBER-AT-LARGE | 4.00 | X | 0 | 0 | 0 | ||
| DOLORES FURTADO | |||||||
| MEMBER-AT-LARGE | 4.00 | X | 0 | 0 | 0 | ||
| KERRY MILLER | |||||||
| CONSUMER REPRESENTATIVE | 4.00 | X | 0 | 0 | 0 | ||
| SHERRI LUTHE | |||||||
| PRESENTER/CONSULTANT | 4.00 | X | 0 | 0 | 0 | ||
| MICHAEL HAMMOND | |||||||
| OWNER REPRESENTATIVE | 4.00 | X | 0 | 162000 | 19584 | ||
| RICHARD DALKE | |||||||
| ACMHCK PRESIDENT-ELECT | 4.00 | X | 0 | 0 | 0 | ||
| DAVID JOHNSON | |||||||
| MEMBER-AT-LARGE | 4.00 | X | 0 | 0 | 0 | ||
| BILLY PERSINGER | |||||||
| MEMBER-AT-LARGE | 4.00 | X | 0 | 0 | 0 | ||
| ROBBIN COLE | |||||||
| VICE CHAIRMAN | 4.00 | X | 0 | 0 | 0 | X | |
| ROBERT JACKSON | |||||||
| CHAIRMAN | 4.00 | X | 0 | 0 | 0 | X | |
| KEITH RICKARD | |||||||
| SECRETARY/TREASURER | 4.00 | X | 0 | 0 | 0 | X | |
| MICHAEL GOLDBERG | |||||||
| CEO | 40.00 | 228358 | 0 | 31635 | X | ||
| JASON SELLERS | |||||||
| CFO | 40.00 | 94017 | 0 | 25607 | X | ||
| MICHAEL LEESON | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | 182351 | 0 | 13593 | X | ||
| NATALIE MEUGNIOT | |||||||
| DIRECTOR OF OPERATIONS | 40.00 | 98396 | 0 | 10153 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 504726 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 162000 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 90419 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| ADMINISTRATIVE SERVICE | 561000 | 11328649 | 11328649 |
| MISCELLANEOUS | 900099 | 903250 | 903250 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 12231899 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 39240 | TotalRevenueColumn |
| Exclusion | $39,240 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MANAGEMENT FEES | Description |
| Business Code | 541610 | BusinessCode |
| Total Revenue Column | 296750 | TotalRevenueColumn |
| Unrelated Business Revenue | 296750 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 296750 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12567889 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12231899 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 296750 | UnrelatedBusinessRevenue |
| Exclusion | $39,240 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 393987 | Total |
| Program Services | 393987 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5145039 | Total |
| Program Services | 5145039 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95191 | Total |
| Program Services | 95191 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 839200 | Total |
| Program Services | 839200 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 437351 | Total |
| Program Services | 437351 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 230000 | Total |
| Program Services | 138000 | ProgramServices |
| Management And General | 92000 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67477 | Total |
| Management And General | 67477 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46740 | Total |
| Management And General | 46740 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34917 | Total |
| Program Services | 34917 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1939127 | Total |
| Program Services | 1939127 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1744081 | Total |
| Program Services | 1744081 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 334283 | Total |
| Program Services | 334283 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102745 | Total |
| Program Services | 102745 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81497 | Total |
| Program Services | 81497 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 294600 | Total |
| Program Services | 294600 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50458 | Total |
| Management And General | 50458 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| CBST CODES | 1135850 | 1135850 |
| STAFF TRAINING & RETENT | 286198 | 286198 |
| CONSULTING EXPENSE | 250202 | 250202 |
| ESSENTIAL LEARNING | 144443 | 144443 |
| PASRR ACTIVITY | 114412 | 114412 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88465 | Total |
| Program Services | 88465 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13856263 | Total |
| Program Services | 13599588 | ProgramServices |
| Management And General | 256675 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19768589 | BOY |
| EOY | 19783880 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15961541 | BOY |
| EOY | 1367562 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2699781 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1946115 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 881450 | BOY |
| EOY | 753666 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1783148 | BOY |
| EOY | 1795398 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38394728 | BOY |
| EOY | 23700506 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1093807 | BOY |
| EOY | 3556066 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33666818 | BOY |
| EOY | 18793220 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34760625 | BOY |
| EOY | 22349286 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3634103 | BOY |
| EOY | 141744 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 1209476 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3634103 | BOY |
| EOY | 1351220 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38394728 | BOY |
| EOY | 23700506 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -1288374 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -994509 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 212172 | OtherCostOrOtherBasis |
| Depreciation | 197502 | Depreciation |
| Book Value | 14670 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2487609 | OtherCostOrOtherBasis |
| Depreciation | 1748613 | Depreciation |
| Book Value | 738996 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 753666 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| A/R PROVIDER & OTHER | 61769 |
| INVESTMENT IN SUBSIDIARY | 390754 |
| OTHER ASSETS | 133399 |
| ASSETS LIMITED AS TO USE | 1209476 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1795398 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | LIABILITIES UNDER SRS CONTRACT | Description |
| Amount | $18,793,220 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 18793220 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE COMPANY EVALUATES UNCERTAIN TAX POSITIONS ON AN ONGOING BASIS AND RECORDS A LIABILITY WHEN, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES AND THE LIABILITY WOULD BE INCURRED. THE COMPANY HAS CONCLUDED THAT THERE ARE NO UNCERTAIN TAX POSITIONS THAT REQUIRE A LIABILITY TO BE RECORDED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL HAMMOND | |||||||||||||
| 0 | 137000 | 0 | 6850 | 0 | 18150 | 0 | 0 | 0 | 19584 | 0 | 181584 | 0 | 0 |
| MICHAEL GOLDBERG | |||||||||||||
| 218358 | 0 | 10000 | 0 | 0 | 0 | 6996 | 0 | 24639 | 0 | 259993 | 0 | 253082 | 0 |
| MICHAEL LEESON | |||||||||||||
| 182351 | 0 | 0 | 0 | 0 | 0 | 5410 | 0 | 8183 | 0 | 195944 | 0 | 180888 | 0 |
Schedule L IRS990ScheduleL
DQP Table DQPTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JASON SELLERS | NamePerson |
| Description Of Transaction | MISAPPROPRIATION OF THE ORGANIZATION'S ASSETS. | DescriptionOfTransaction |
| Transaction Corrected | 0 | TransactionCorrected |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | SEE EXPLANATION IN SCHEDULE O,990 PART VI, SECTION A, LINE 5 FOR ADDITIONAL INFORMATION | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 5 | KHS PREVIOUSLY RECORDED AND RECEIVED PAYMENT OF REVENUE FOR THE FISCAL YEARS 2008 THROUGH 2011 BASED ON SUBMITTED COST REPORTS THAT INCLUDED CERTAIN FRAUDULENT CHARGES FOR PRINTING EXPENSES. THE COMPANY PERFORMED AN INVESTIGATION AND DETERMINED THAT ITS BEST ESTIMATE OF THE FRAUDULENT CHARGES THAT WERE PREVIOUSLY SUBMITTED AND REIMBURSED IS APPROXIMATELY $2.1 MILLION. THESE AMOUNTS HAVE BEEN RECORDED AS REDUCTIONS TO REVENUE IN EACH OF THE PERIODS TO WHICH THE CHARGES, AND RELATED REVENUE, RELATE RESULTING IN AN APPROXIMATELY $2.1 MILLION LIABILITY RECORDED ON THE STATEMENT OF FINANCIAL POSITION AS OF JUNE 30, 2011. KHS BELIEVES THAT IT HAS SUBSTANTIAL INSURANCE RECOVERIES AVAILABLE UNDER ITS EXISTING ARRANGEMENTS RELATED TO ITS EXPOSURE FOR THE FRAUDULENT ACTIVITY NOTED ABOVE. THE COMPANY'S INSURANCE ARRANGEMENT PROVIDES FOR A $10,000 DEDUCTIBLE AS WELL AS MAXIMUM REIMBURSEMENT OF $1 MILLION, WHICH CAN BE INCREASED TO $2 MILLION IF THE INSURED LOSS IS DEEMED TO BE FRAUDULENT UNDER THE INSURANCE ARRANGEMENTS. DUE TO THE UNCERTAINTY RELATED TO COLLECTING ANY INSURANCE RECOVERIES, KHS HAS NOT RECORDED ANY RECEIVABLES AS OF JUNE 30, 2011 RELATED TO THESE ARRANGEMENTS. | |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ASSOCIATION OF COMMUNITY MENTAL HEALTH CENTERS OF KANSAS, INC (ACMHCKS), A KANSAS NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER OF KANSAS HEALTH SOLUTIONS, LLC. | |
| FORM 990, PART VI, SECTION A, LINE 7A | ACMHCKS, THE SOLE MEMBER OF KANSAS HEALTH SOLUTIONS, LLC HAS THE RIGHT TO APPOINT THE BOARD MEMBERS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE OPERATING AGREEMENT OF KANSAS HEALTH SOLUTIONS, LLC REQUIRES APPROVAL BY ACMHCKS, THE SOLE MEMBER, FOR THE FOLLOWING: (1) A MERGER, DISSOLUTION, SALE, TRANSFER, EXCHANGE, OR OTHER CONVEYANCE OF A SUBSTANTIAL PORTION (MORE THAN 50%) OF THE ASSETS OF THE COMPANY; (2) ANY FINANCIAL DECISIONS INVOLVING A DOLLAR AMOUNT IN EXCESS OF THAT SPECIFIED BY THE MEMBER; AND (3) ANY OTHER DECISION OF THE TYPE SPECIFIED IN ADVANCE BY THE MEMBER IN WRITING TO THE COMPANY. | |
| FORM 990, PART VI, SECTION B, LINE 11 | AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S ACCOUNTING PERSONNEL. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S ACCOUNTING PERSONNEL HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE DONE. | |
| THE ORGANIZATION SENDS OUT QUESTIONNAIRES ON AN ANNUAL BASIS TO IDENTIFY CONFLICTS TO ALL BOARD OF DIRECTORS, MEMBERS, OFFICERS, AND EMPLOYEES. IF THE KANSAS HEALTH SOLUTIONS, LLC COMPLIANCE OFFICER DETERMINES A CONFLICT OF INTERES EXISTS, THE PARTY INVOLVED ABSTAINS FROM THE VOTE. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE COMPENSATION OF THE CEO IS DETERMINED BY THE BOARD OF DIRECTORS. AN AD HOC COMMITTEE REVIEWS THE CEO'S CONTRACT ANNUALLY AT ITS MAY MEETING AND THAT COMMITTEE NEGOTIATES WITH THE CEO. THE COMMITTEE USES COMPARABLE DATA TO EVALUATE THE COMPENSATION LEVEL. THIS PROCESS IS NOTED IN THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE MINUTES. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES IS NOT REVIEWED BY THE BOARD OF DIRECTORS. THE COMPANY'S HUMAN RESOURCES DEPARTMENT, IN CONJUNCTION WITH THE CEO, IS RESPONSIBLE FOR SETTING COMPENSATION RANGE, THIS IS DONE THROUGH YEARLY REVIEW AND USAGE OF SALARY ASSESSOR SOFTWARE. ANY SALARY INCREASES ARE DONE WITH SUPERVISOR INPUT BASED ON PERFORMANCE AND WITH FINAL APPROVAL BY THE CEO. | FORM 990, PART VI, SECTION B, LINE 15A | |
| THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | PRIOR PERIOD ADJUSTMENTS: -1,044,150. INCOME OF INVESTMENT 49,641. TOTAL TO FORM 990, PART XI, LINE 5: -994,509. | FORM 990, PART XI, LINE 5: |
| IN AUGUST 2011, THE COMPANY DETERMINED THAT IT HAD INAPPROPRIATELY RECORDED REVENUE UNDER THE CONTRACT FOR ITS FISCAL YEARS ENDED JUNE JUNE 30, 2010, 2009 AND 2008. THE COMPANY HAS RESTATED THE JUNE 30, 2010 CONSOLIDATED FINANCIAL STATEMENTS TO REFLECT THE CORRECTION OF ERRORS RELATED TO THE MATTER DESCRIBED ABOVE, AS WELL AS ACCRUAL OF ADDITIONAL LIABILITIES (93,883), ADJUST THE RECOGNITION OF RENT EXPENSE (41,375), CORRECT INVESTMENT IN SUBSIDIARY (-191,108) AND CORRECT THE CATEGORIZATION OF NET ASSETS BETWEEN TEMPORARILY RESTRICTED AND UNRESTRICTED. | FORM 990, PART XI, LINE 5, ADDITIONAL EXPLANATION: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ASSOCIATION OF COMMUNITY MENTAL HEALTH OF KS | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 720 SE JACKSON | AddressLine1 |
| City | TOPEKA | City |
| State | KS | State |
| ZIP Code | 66603 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 480876205 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivities |
| Legal Domicile State | KS | LegalDomicileState |
| Exempt Code Section | 501(C)(4) | ExemptCodeSection |
| Public Charity Status | N/A | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TMHC SERVICES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 S KANSAS AVE STE 301 | AddressLine1 |
| City | TOPEKA | City |
| State | KS | State |
| ZIP Code | 66603 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208115687 | EIN |
| Primary Activity | DRUG/ALCOHOL TESTING & EMPLOYEE ASSISTANCE | PrimaryActivity |
| Legal Domicile State | KS | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 68706 | ShareOfTotalIncome |
| Share Of EOY Assets | 515794 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| TMHC SERVICES | ||
| K | 296750 | FMV |
| ASSOC OF COMMUNITY MENTAL HEALTH OF KS | ||
| D | 77750 | FMV |
| ASSOC OF COMMUNITY MENTAL HEALTH OF KS | ||
| O | 152250 | FMV |
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