2012-03-15T09:15:55-05:00 2011-06-30 BLUE & CO LLC ONE AMERICAN SQUARE 2200 INDIANAPOLIS IN 46282 990 2010-07-01 351534713 ADULT & CHILD MENTAL HEALTH CENTER INC ADUL 3178825122 8320 MADISON AVENUE INDIANAPOLIS IN 462276090 ARNOLD DUNBAR 3178825122 2012-03-19 1 ANGELA L ZIRKELBACH CPA 3176334705 2010 2016-02-24 21:20:13Z ADULT AND CHILD CENTER ARNOLD DUNBAR 222 E OHIO STREET INDIANAPOLIS IN 46204 27885262 0 X WWW.ADULTANDCHILD.ORG X 1982 IN PROVIDE STATE-OF-THE-ART MENTAL HEALTH SERVICES TO RESIDENTS OF MARION AND JOHNSON COUNTY, INDIANA. 15 15 421 0 -4620 -4620 6098784 6779658 21889606 18323093 439709 370246 834240 434380 29262339 25907377 0 0 0 0 18685135 17651930 0 0 0 9348062 7676769 28033197 25328699 1229142 578678 24508596 25791547 5897754 5930730 18610842 19860817 WE 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. 0 0 21909698 18323093 ADULT & 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. 21909698 1 1 0 0 0 0 0 1 0 1 0 0 0 1 1 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 0 1 34 0 1 421 1 1 1 0 0 0 0 1 1 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X ARNOLD DUNBAR CEO 3178825122 222 E OHIO STREET INDIANAPOLIS IN 46204 CAROLE MCKINNEY 1.00 X 0 0 0 STEVE WOHLFORD 1.00 X 0 0 0 SUE COLLINS RN 1.00 X 0 0 0 NICK HOPKINS CPA CFP 1.00 X 0 0 0 KEN ALMON 1.00 X 0 0 0 JANE BLESSING 1.00 X 0 0 0 REV JAMES CARTER 1.00 X 0 0 0 JERRY FRENCH 1.00 X 0 0 0 MARGARITA HART 1.00 X 0 0 0 MIKE KOLENDA PHD 1.00 X 0 0 0 HON MARK LLOYD 1.00 X 0 0 0 JOSEPH MATTHEWS III 1.00 X 0 0 0 DAWN SHIMP 1.00 X 0 0 0 GREG TAYLOR 1.00 X 0 0 0 KEVIN TYRA 1.00 X 0 0 0 ARNOLD R DUNBAR 40.00 X 248636 0 9502 JOSEPH BREYER 40.00 X 137464 0 102 CHARLES COATS MD 40.00 X 216220 0 30287 TERRY PARRISH MD 40.00 X 225362 0 26815 ANDREW MORRISON MD 40.00 X 170805 0 2658 RICHARD M MCKASSON 40.00 X 126446 0 16786 CATHERINE HEROD MD 40.00 X 175711 0 2670 TINA M CLOER 40.00 X 115298 0 1643 DANIEL ARENS 40.00 X 103658 0 492 1519600 0 90955 9 0 1 0 LOCUMTENENSCOM PO BOX 405547 ATLANTA GA 30384 MD SERVICES 123621 1 6778330 1328 6779658 NET PATIENT REVENUE 900099 16750612 16750612 MEDICARE/MEDICAID PMTS 900099 1572481 1572481 18323093 169016 169016 572951 492984 79967 79967 -4620 84587 1686131 1478280 6621 207851 -6621 201230 201230 354413 354413 354413 25907377 18323093 -4620 809246 1610554 1610554 12869937 12147794 722143 1973959 1697605 276354 1197480 1029833 167647 532485 457937 74548 491684 422848 68836 884424 760605 123819 119113 102437 16676 702305 603982 98323 146306 125823 20483 942594 810631 131963 162929 140119 22810 RESIDENTIAL SERVICES 2813068 2813068 BAD DEBT EXPENSE 275826 275826 606035 521190 84845 25328699 21909698 3419001 0 1090 790 4573735 4488635 3049115 4023898 3018326 2387175 102272 113369 15436946 7157684 8393582 8279262 4987781 6030805 382695 467613 24508596 25791547 1980556 1954258 3081638 2933676 835560 1042796 5897754 5930730 X 18610842 19860817 18610842 19860817 24508596 25791547 X 578678 671297 X X 0 1 1 X 1 1 X SCHEDULE 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. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 53570 1191877 1209994 35453 0 499553 499553 11277504 5531347 5746157 307347 218910 88437 3352542 1407427 1945115 8279262 ESTIMATED THIRD PARTY SETTLEMENTS 874531 DEFERRED COMPENSATION 168265 1042796 25907377 25328699 578678 671297 671297 1249975 27071658 671297 671297 26400361 -492984 -492984 25907377 25821683 492984 492984 25328699 0 25328699 PART IV, LINE 1B: THE ORGANIZATION IS AN AGENT FOR HELD FUNDS FOR PATIENTS - REPRESENTATIVE PAYEE ACCOUNTS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -492,984. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 492,984. X X X 0 0 0 0 0 0 0 0 0 ARNOLD R DUNBAR 197093 0 20000 0 31543 0 9400 0 102 0 258138 0 0 0 CHARLES COATS MD 207517 0 620 0 8083 0 18352 0 11935 0 246507 0 0 0 TERRY PARRISH MD 224640 0 620 0 102 0 14880 0 11935 0 252177 0 0 0 ANDREW MORRISON MD 161109 0 0 0 9696 0 2658 0 0 0 173463 0 0 0 CATHERINE HEROD MD 169698 0 0 0 6013 0 2670 0 0 0 178381 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE 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. FORM 990, PART VI, SECTION B, LINE 12C 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 15 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 C, LINE 19 THESE DOCUMENTS ARE AVAILABLE BY REQUEST AND ALSO VIA THE ORGANIZATION'S WEB PAGE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 671,297. OVERSIGHT OF AUDIT FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.