ADULT AND CHILD MENTAL HEALTH INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ADULT AND CHILD MENTAL HEALTH INC (EIN 35-1534713)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-03-15
IRS object ID
201210799349300561
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

FieldValueIRS element (for citing)
Timestamp2012-03-15T09:15:55-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BLUE & CO LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE AMERICAN SQUARE 2200AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46282ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN351534713EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ADULT & CHILD MENTAL HEALTH CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlADULNameControl
Phone3178825122Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line18320 MADISON AVENUEAddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code462276090ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameARNOLD DUNBARName
TitleCEOTitle
Phone3178825122Phone
Date Signed2012-03-19DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameANGELA L ZIRKELBACH CPAName
Phone3176334705Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1ADULT AND CHILD CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonARNOLD DUNBARNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1222 E OHIO STREETAddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Gross Receipts27885262GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.ADULTANDCHILD.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionPROVIDE STATE-OF-THE-ART MENTAL HEALTH SERVICES TO RESIDENTS OF MARION AND JOHNSON COUNTY, INDIANA.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees421TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI-4620TotalGrossUBI
Net Unrelated Business Txbl Income-4620NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year6098784ContributionsGrantsPriorYear
Contributions Grants Current Year6779658ContributionsGrantsCurrentYear
Program Service Revenue Prior Year21889606ProgramServiceRevenuePriorYear
Program Service Revenue CY18323093ProgramServiceRevenueCY
Investment Income Prior Year439709InvestmentIncomePriorYear
Investment Income Current Year370246InvestmentIncomeCurrentYear
Other Revenue Prior Year834240OtherRevenuePriorYear
Other Revenue Current Year434380OtherRevenueCurrentYear
Total Revenue Prior Year29262339TotalRevenuePriorYear
Total Revenue Current Year25907377TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year18685135SalariesEtcPriorYear
Salaries Etc Current Year17651930SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9348062OtherExpensePriorYear
Other Expenses Current Year7676769OtherExpensesCurrentYear
Total Expenses Prior Year28033197TotalExpensesPriorYear
Total Expenses Current Year25328699TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1229142RevenuesLessExpensesPriorYear
Revenues Less Expenses CY578678RevenuesLessExpensesCY
Total Assets BOY24508596TotalAssetsBOY
Total Assets EOY25791547TotalAssetsEOY
Total Liabilities BOY5897754TotalLiabilitiesBOY
Total Liabilities EOY5930730TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY18610842NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19860817NetAssetsOrFundBalancesEOY
Mission DescriptionWE PROVIDE STATE-OF-THE-ART SERVICES THAT EMPOWER ADULTS AND CHILDREN TO REACH THEIR FULL POTENTIAL WHILE EFFECTIVELY AND EFFICIENTLY MANAGING COMMUNITY AND CENTER RESOURCES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense21909698Expense
Revenue18323093Revenue
DescriptionADULT & CHILD MENTAL HEALTH CENTER, INC. (THE CENTER) IS A COMMUNITY MENTAL HEALTH CENTER WITH THE PURPOSE OF PROVIDING A COMPREHENSIVE NETWORK OF PREVENTATIVE, DIAGNOSTIC, THERAPEUTIC AND REHABILITATIVE MENTAL HEALTH SERVICES TO RESIDENTS OF MARION COUNTY AND ALL OF JOHNSON COUNTY IN THE STATE OF INDIANA. THE CENTER PROVIDES CARE TO CERTAIN PATIENTS UNDER REIMBURSEMENT AGREEMENTS WITH MEDICARE, MEDICAID, AND OTHER THIRD-PARTY PAYORS. GROSS REVENUE FROM THE MEDICARE & MEDICAID PROGRAMS ACCOUNTED FOR APPROXIMATELY 71% FOR THE YEAR ENDED 6/30/11. ADDITIONALLY, THE CENTER ACCEPTS PATIENTS REGARDLESS OF THEIR INDIVIDUAL ABILITY TO PAY, THEIR RACE, AGE, SEX, CREED OR NATIONAL ORIGIN. FOR THE YEAR ENDED 6/30/11, THE CENTER PROVIDED UNCOMPENSATED CARE OF APPROXIMATELY $883,000.Description
Total Program Service Expense21909698TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109634NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees421NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ARNOLD DUNBAR CEOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3178825122TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1222 E OHIO STREETAddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
CAROLE MCKINNEY
PRESIDENT1.00X000
STEVE WOHLFORD
VICE PRESIDENT1.00X000
SUE COLLINS RN
SECRETARY1.00X000
NICK HOPKINS CPA CFP
TREASURER1.00X000
KEN ALMON
MEMBER1.00X000
JANE BLESSING
MEMBER1.00X000
REV JAMES CARTER
MEMBER1.00X000
JERRY FRENCH
MEMBER1.00X000
MARGARITA HART
MEMBER1.00X000
MIKE KOLENDA PHD
MEMBER1.00X000
HON MARK LLOYD
MEMBER1.00X000
JOSEPH MATTHEWS III
MEMBER1.00X000
DAWN SHIMP
MEMBER1.00X000
GREG TAYLOR
MEMBER1.00X000
KEVIN TYRA
MEMBER1.00X000
ARNOLD R DUNBAR
CEO40.0024863609502X
JOSEPH BREYER
CFO40.001374640102X
CHARLES COATS MD
ASSOCIATE MEDICAL DIRECTOR40.00216220030287X
TERRY PARRISH MD
MEDICAL DIRECTOR40.00225362026815X
ANDREW MORRISON MD
PSYCHIATRIST40.0017080502658X
RICHARD M MCKASSON
SERVICE LINE DIRECTOR40.00126446016786X
CATHERINE HEROD MD
PSYCHIATRIST40.0017571102670X
TINA M CLOER
SERVICE LINE DIRECTOR40.0011529801643X
DANIEL ARENS
DIRECTOR BUSINES DEVELOPME40.001036580492X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1519600TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation90955TotalOtherCompensation
Number Individuals GT100 K9NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1LOCUMTENENSCOMBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 405547AddressLine1
CityATLANTACity
StateGAState
ZIP Code30384ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesMD SERVICESDescriptionOfServices
Compensation123621Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Government Grants6778330GovernmentGrants
All Other Contributions1328AllOtherContributions
Total Contributions6779658TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE9000991675061216750612
MEDICARE/MEDICAID PMTS90009915724811572481
FieldValueIRS element (for citing)
Total Program Service Revenue18323093TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column169016TotalRevenueColumn
Exclusion$169,016ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real572951Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real492984Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real79967Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column79967TotalRevenueColumn
Unrelated Business Revenue-4620UnrelatedBusinessRevenue
Exclusion$84,587ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1686131Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1478280Securities
Other6621Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities207851Securities
Other-6621Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column201230TotalRevenueColumn
Exclusion$201,230ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column354413TotalRevenueColumn
Exclusion$354,413ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue354413TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column25907377TotalRevenueColumn
Related Or Exempt Function Income18323093RelatedOrExemptFunctionIncome
Unrelated Business Revenue-4620UnrelatedBusinessRevenue
Exclusion$809,246ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1610554Total
Management And General1610554ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total12869937Total
Program Services12147794ProgramServices
Management And General722143ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1973959Total
Program Services1697605ProgramServices
Management And General276354ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1197480Total
Program Services1029833ProgramServices
Management And General167647ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total532485Total
Program Services457937ProgramServices
Management And General74548ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total491684Total
Program Services422848ProgramServices
Management And General68836ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total884424Total
Program Services760605ProgramServices
Management And General123819ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total119113Total
Program Services102437ProgramServices
Management And General16676ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total702305Total
Program Services603982ProgramServices
Management And General98323ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total146306Total
Program Services125823ProgramServices
Management And General20483ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total942594Total
Program Services810631ProgramServices
Management And General131963ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total162929Total
Program Services140119ProgramServices
Management And General22810ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
RESIDENTIAL SERVICES28130682813068
BAD DEBT EXPENSE275826275826

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total606035Total
Program Services521190ProgramServices
Management And General84845ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total25328699Total
Program Services21909698ProgramServices
Management And General3419001ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1090BOY
EOY790EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4573735BOY
EOY4488635EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY3049115BOY
EOY4023898EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3018326BOY
EOY2387175EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY102272BOY
EOY113369EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis15436946LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec7157684LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY8393582BOY
EOY8279262EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4987781BOY
EOY6030805EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY382695BOY
EOY467613EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY24508596BOY
EOY25791547EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1980556BOY
EOY1954258EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3081638BOY
EOY2933676EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY835560BOY
EOY1042796EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5897754BOY
EOY5930730EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY18610842BOY
EOY19860817EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY18610842BOY
EOY19860817EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY24508596BOY
EOY25791547EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses578678ReconcilationRevenueExpenses
Reconcilation Other Changes671297ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
General ExplanationSCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART I, LINE 3, HOSPITAL: ADULT & CHILD MENTAL HEALTH CENTER, INC. HAS BEEN DETERMINED BY THE IRS TO BE A PUBLIC CHARITY UNDER IRS CODE SECTION 170(B)(1)(A)(III). THE ORGANIZATION PROVIDES A COMPREHENSIVE NETWORK OF PREVENTATIVE, DIAGNOSTIC, THERAPEUTIC AND REHABILITATIVE MENTAL HEALTH SERVICES, BUT DOES NOT MAINTAIN AN INPATIENT UNIT, AND IS NOT REQUIRED TO BE LICENSED AS A HOSPITAL FOR THE STATE OF INDIANA. SCHEDULE H IS NOT REQUIRED AS ONLY ORGANIZATIONS THAT OPERATE AT LEAST ONE FACILITY THAT IS, OR IS REQUIRED TO BE, LICENSED, REGISTERED, OR SIMILARY RECOGNIZED BY THE STATE AS A HOSPITAL IS REQUIRED TO COMPLETE SCHEDULE H.GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc1AgentTrusteeEtc
Beginning Balance53570BeginningBalance
Additions During Year1191877AdditionsDuringYear
Distributions During Year1209994DistributionsDuringYear
Ending Balance35453EndingBalance
Included On FS0IncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis499553OtherCostOrOtherBasis
Book Value499553BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11277504OtherCostOrOtherBasis
Depreciation5531347Depreciation
Book Value5746157BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis307347OtherCostOrOtherBasis
Depreciation218910Depreciation
Book Value88437BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3352542OtherCostOrOtherBasis
Depreciation1407427Depreciation
Book Value1945115BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings8279262TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ESTIMATED THIRD PARTY SETTLEMENTS$874,531
DEFERRED COMPENSATION$168,265
FieldValueIRS element (for citing)
Total Of Amounts1042796TotalOfAmounts
Total Revenue25907377TotalRevenue
Total Expenses25328699TotalExpenses
Excess Or Deficit For Year578678ExcessOrDeficitForYear
Net Unrealized GL On Investments671297NetUnrealizedGLOnInvestments
Total Adjustments671297TotalAdjustments
Excess Or Deficit Per FS1249975ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt27071658TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments671297NetUnrealizedGainsInvestments
Revenue Not Rptd F990671297RevenueNotRptdF990
Revenue Subtotal26400361RevenueSubtotal
Other Revenues Not Included-492984OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-492984RevenueNotRptdOnFinStmt
Total Revenue Per Form99025907377TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt25821683TotExpensesEtcAuditedFinclStmt
Other Expenses Included492984OtherExpensesIncluded
Expenses Not Rptd F990492984ExpensesNotRptdF990
Expenses Subtotal25328699ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99025328699TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART IV, LINE 1B:THE ORGANIZATION IS AN AGENT FOR HELD FUNDS FOR PATIENTS - REPRESENTATIVE PAYEE ACCOUNTS.
PART X:ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE CENTER 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 THE CENTER, AND HAS CONCLUDED THAT AS OF JUNE 30, 2011 AND 2010, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:
RENTAL EXPENSES -492,984.PART XII, LINE 4B - OTHER ADJUSTMENTS:
RENTAL EXPENSES 492,984.PART XIII, LINE 2D - OTHER ADJUSTMENTS:

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ARNOLD R DUNBAR
1970930200000315430940001020258138000
CHARLES COATS MD
2075170620080830183520119350246507000
TERRY PARRISH MD
224640062001020148800119350252177000
ANDREW MORRISON MD
161109000969602658000173463000
CATHERINE HEROD MD
169698000601302670000178381000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW OF THE FORMS AND REQUESTED SCHEDULES BY THE CEO. THE GOVERNING BODY REVIEWS AND APPROVES THE FORM 990 AND THE FINAL FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, ARE PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING.
EACH BOARD MEMBER AND OFFICER ARE REQUIRED TO SUBMIT ANNUALLY INFORMATION REGARDING CONFLICTS OF INTEREST AND POSSIBLE CONFLICTS OF INTEREST.FORM 990, PART VI, SECTION B, LINE 12C
THE COMPENSATION PACKAGE FOR THE CEO IS SET BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND APPROVED BY THE ENTIRE BOARD. THE EXECUTIVE COMMITTEE USES THE ANNUAL SALARY SURVEY CONDUCTED BY THE INDIANA COUNCIL OF COMMUNITY MENTAL HEALTH CENTERS AND OTHER APPLICABLE SALARY SURVEYS. SALARIES OF OTHER OFFICERS AND KEY EMPLOYEES ARE SET IN A SIMILAR FASHION BY THE CEO.FORM 990, PART VI, SECTION B, LINE 15
THESE DOCUMENTS ARE AVAILABLE BY REQUEST AND ALSO VIA THE ORGANIZATION'S WEB PAGE.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 671,297.FORM 990, PART XI, LINE 5:
OVERSIGHT OF AUDITTHE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.FORM 990, PART XII, LINE 2C

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