NORTH CENTRAL MENTAL HEALTH SERVICES: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
NORTH CENTRAL MENTAL HEALTH SERVICES (EIN 31-0847283)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-03-29
IRS object ID
201210899349300036
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)
Timestamp2012-03-29T13:49:00-00:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

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 220AddressLine1
CityColumbusCity
StateOHState
ZIP Code43215ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

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
TitleExec DirTitle
Date Signed2012-03-29DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTheodore W Johnson CPA CFFName
Phone6142243078Phone
Date Prepared2012-03-29DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

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 Receipts14676980GrossReceipts
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. To provide mental health services.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees228TotalNbrEmployees
Total Nbr Volunteers100TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year2561830ContributionsGrantsPriorYear
Contributions Grants Current Year2886856ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11609564ProgramServiceRevenuePriorYear
Program Service Revenue CY11347969ProgramServiceRevenueCY
Investment Income Prior Year156373InvestmentIncomePriorYear
Investment Income Current Year98699InvestmentIncomeCurrentYear
Other Revenue Prior Year382839OtherRevenuePriorYear
Other Revenue Current Year343456OtherRevenueCurrentYear
Total Revenue Prior Year14710606TotalRevenuePriorYear
Total Revenue Current Year14676980TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year10670125SalariesEtcPriorYear
Salaries Etc Current Year10479000SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3305464OtherExpensePriorYear
Other Expenses Current Year3094570OtherExpensesCurrentYear
Total Expenses Prior Year13975589TotalExpensesPriorYear
Total Expenses Current Year13573570TotalExpensesCurrentYear
Revenues Less Expenses Prior Year735017RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1103410RevenuesLessExpensesCY
Total Assets BOY12594717TotalAssetsBOY
Total Assets EOY13662609TotalAssetsEOY
Total Liabilities BOY4441043TotalLiabilitiesBOY
Total Liabilities EOY4399885TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8153674NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY9262724NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo provide mental health servicesMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense5593830Expense
DescriptionCounseling, medical and community supportDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2373991Expense
DescriptionResidential/transistional servicesDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense3463168Expense
DescriptionMedical servicesDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp661463TotalOfOtherProgramServiceExp
Total Program Service Expense12092452TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
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
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109680NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees228NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
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 NiedzwiedskiNamePerson
Telephone Number6142996600TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeIndividual Trustee Or DirectorIndividualTrusteeOrDirectorHighest Compensated EmployeeHighestCompensatedEmployee
Donald R Wood
Pres/CEO040.00X28046200
Joseph J Niedzwiedski
CFO040.00X18941500
Robert M Loar
Assoc Dir of Oper Supp040.0015540400X
Prasad K Potaraju
Med Dir040.0013506200X
Daniel P Bridgeo
Comm Serv Dir040.0011016000X
William R Silliman
Clinical Dir040.0017651200X
Melinda Blakie
Board Member001.00000X
Jeanne Clement
Board Member001.00000X
David Fais
Board Member001.00000X
Gilbert Greene
Board Member001.00000X
Melvin Harris
Board Member001.00000X
John Krimm
Board Member001.00000X
Marcee McCreary
Board Member001.00000X
Michael O'Grady
Board Member001.00000X
Aron Ross
Board Member001.00000X
Charles Schneider
Board Member001.00000X
Philip Tieman
Board Member001.00000X
Greta Winbush
Board Member001.00000X
Radhika Gollapudy
Employee040.0021465800X
Bela Agabalyan
Employee040.0021759800X
Shamsun Nahar
Employee040.0019171600X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1670987TotalReportableCompFromOrg
Number Individuals GT100 K9NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Sharda Bobba
4849 Aberdeen AvenueDublinOH43016Contract doctor149000
McCormick & Reimuth Ins
PO Box 660WorthingtonOH43085Insurance195762
Allied Barton Security
PO Box 828854PhiladelphiaPA19182Security Guard Svc167010
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
All Other Contributions2886856AllOtherContributions
Total Contributions2886856TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Client insurance fees145974145974
ADAMH16300401630040
Title XIX95719559571955
FieldValueIRS element (for citing)
Total Program Service Revenue11347969TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column98699TotalRevenueColumn
Exclusion$98,699ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real265569Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real265569Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column265569TotalRevenueColumn
Related Or Exempt Function Income265569RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOther IncomeDescription
Total Revenue Column77887TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue77887TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14676980TotalRevenueColumn
Related Or Exempt Function Income11613538RelatedOrExemptFunctionIncome
Exclusion$98,699ExclusionAmount

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)
Total1670987Total
Program Services1503387ProgramServices
Management And General167600ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8808013Total
Program Services7924291ProgramServices
Management And General883722ManagementAndGeneral

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)
Total925070Total
Program Services867487ProgramServices
Management And General57583ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total193392Total
Program Services164176ProgramServices
Management And General29216ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total304705Total
Program Services280313ProgramServices
Management And General24392ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total501507Total
Program Services475676ProgramServices
Management And General25831ManagementAndGeneral

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)
Total203360Total
Program Services119535ProgramServices
Management And General83825ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Operating Supplies1733241633669958
Operating Expenses601512455879145633
Equipment and Improvements18097913834242637
Other1072110721

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13573570Total
Program Services12092452ProgramServices
Management And General1481118ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5242166BOY
EOY7425953EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1277498BOY
EOY1067348EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1840422BOY
EOY1150760EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY274419BOY
EOY240923EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis8036450LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4258825LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3960212BOY
EOY3777625EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY12594717BOY
EOY13662609EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2203527BOY
EOY2264046EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY548880BOY
EOY481328EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1688636BOY
EOY1654511EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4441043BOY
EOY4399885EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY8153674BOY
EOY9262724EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8153674BOY
EOY9262724EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12594717BOY
EOY13662609EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1103410ReconcilationRevenueExpenses
Reconcilation Other Changes5640ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
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 Years11074521CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12314373CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13255967CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14171394CurrentTaxYearMinus1Year
Current Tax Year14234825CurrentTaxYear
Total65051080Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11074521CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years12314373CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13255967CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14171394CurrentTaxYearMinus1Year
Current Tax Year14234825CurrentTaxYear
Total65051080Total
FieldValueIRS element (for citing)
Public Support Total17065051080PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years152395CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years109657CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years49577CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year156373CurrentTaxYearMinus1Year
Current Tax Year98699CurrentTaxYear
Total566701Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years307356CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years341794CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years443890CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year382839CurrentTaxYearMinus1Year
Current Tax Year343456CurrentTaxYear
Total1819335Total
FieldValueIRS element (for citing)
Total Support67437116TotalSupport
Public Support Pertcentage1700.96460PublicSupportPertcentage170
Public Support Pertcent Prior Year0.96270PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtctrueAgentTrusteeEtc
Beginning Balance281184BeginningBalance
Additions During Year2092372AdditionsDuringYear
Distributions During Year2156632DistributionsDuringYear
Ending Balance216924EndingBalance
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 Basis6542951OtherCostOrOtherBasis
Depreciation3053874Depreciation
Book Value3489077BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis925403OtherCostOrOtherBasis
Depreciation916493Depreciation
Book Value8910BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis296223OtherCostOrOtherBasis
Depreciation288458Depreciation
Book Value7765BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3777625TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Advanced from State of Ohio-Current$83,706
Other Liabilities$73,831
Medicaid Payback$399,430
Advances-Non Current$1,097,544
FieldValueIRS element (for citing)
Total Of Amounts1654511TotalOfAmounts
Total Revenue14676980TotalRevenue
Total Expenses13573570TotalExpenses
Excess Or Deficit For Year1103410ExcessOrDeficitForYear
Excess Or Deficit Per FS1103410ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt14682620TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments5640NetUnrealizedGainsInvestments
Revenue Not Rptd F9905640RevenueNotRptdF990
Revenue Subtotal14676980RevenueSubtotal
Total Revenue Per Form99014676980TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13573570TotExpensesEtcAuditedFinclStmt
Expenses Subtotal13573570ExpensesSubtotal
Total Expenses Per Form99013573570TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierXIdentifier
Return Reference2ReturnReference
ExplanationNCMHS has adopted the 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. NCMHS does not believe its financial statements include any uncertain tax positions. NCMHSs open tax periods are 2008 through 2010 based on filed Forms 990.Explanation

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)

Base Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
Donald R Wood
231457333886150270995280166
Joseph J Niedzwiedski
160934656118831186326184735
Robert M Loar
130963487513617149455153837
William R Silliman
153792626513617173674172330
Radhika Gollapudy
193998182918831214658223390
Bela Agabalyan
198445553713617217599220008
Shamsun Nahar
169254677015693191717214185

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990 Part VI11bE-mail prior to filing and approved at subsequent board meeting.
Form 990 Part VI12Board members prepare an annual Conflict of Interest Form.
Form 990 Part VI15Reviewed by Board of Trustees. The CEO reviews other officers and key employees. Comparability data etc. obtained from information shown in recent Columbus, Ohio Dispatch.
Form 990 Part VI19Upon request and through filing of the report, i.e. internet service.
Form 990 Part X5Unrealized gains of 5,640.
Form 990 Part III Program Service AccomplishmentsLine 4d Other ActivitiesProgram Service Expenses 474,768, Grants and allocations 0, Revenue 0 IDDT Program
Form 990 Part III Program Service AccomplishmentsLine 4d Other ActivitiesProgram Service Expenses 186,695, Grants and allocations 0, Revenue 0 Suicide Prevention
Form 990, Part III, Line 4d Program Service Expenses 474,768, Grants and allocations 0, Revenue 0 IDDT Program Form 990, Part III, Line 4d Program Service Expenses 186,695, Grants and allocations 0, Revenue 0 Suicide Prevention Form 990 Part VI Section B Line 11b E-mail prior to filing and approved at subsequent board meeting. Form 990 Part VI Section B Line 12 Board members prepare an annual Conflict of Interest Form. Form 990 Part VI Section B Line 15 Reviewed by Board of Trustees. The CEO reviews other officers and key employees. Comparability data etc. obtained from information shown in recent Columbus, Ohio Dispatch. Form 990 Part VI Section C Line 19 Upon request and through filing of the report, i.e. internet service. Form 990 Part X Line 5 Unrealized gains of 5,640.

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