BESTSELF BEHAVIORAL HEALTH INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- BESTSELF BEHAVIORAL HEALTH INC (EIN 16-1004090)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-08-25
- IRS object ID
- 201112379349300501
- 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 | 2011-08-25T08:59:04-05:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOPKINS & COMPANY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 INTERNATIONAL DR | AddressLine1 |
| City | BUFFALO | City |
| State | NY | State |
| ZIP Code | 142215794 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161004090 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKE SHORE BEHAVIORAL HEALTH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LAKE | NameControl |
| Phone | 7168420440 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 DELAWARE AVENUE NO 300 | AddressLine1 |
| City | BUFFALO | City |
| State | NY | State |
| ZIP Code | 14202 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | HOWARD K HITZEL PSYD | Name |
| Title | PRESIDENT | Title |
| Phone | 7168420440 | Phone |
| Date Signed | 2011-08-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RICHARD J PFENTNER | Name |
| Phone | 7166348800 | 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 | HOWARD K HITZEL PSYD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 DELAWARE AVENUE NO 300 | AddressLine1 |
| City | BUFFALO | City |
| State | NY | State |
| ZIP Code | 14202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 15329071 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.LAKE-SHORE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1971 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | LAKE SHORE BEHAVIORAL HEALTH, INC. PROVIDES A COMPREHENSIVE ARRAY OF TREATMENT AND REHABILITATION SERVICES FOR INDIVIDUALS WITH MENTAL ILLNESSES AND/OR CHEMICAL DEPENDENCY DISORDERS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 353 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | -2893 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -2893 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 6884733 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 5799305 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 9011246 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 9266430 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 266 | InvestmentIncomePriorYear |
| Investment Income Current Year | 11647 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 34719 | OtherRevenuePriorYear |
| Other Revenue Current Year | 39908 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 15930964 | TotalRevenuePriorYear |
| Total Revenue Current Year | 15117290 | 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 | 8920654 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9785894 | 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 | 5439826 | OtherExpensePriorYear |
| Other Expenses Current Year | 5449465 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14360480 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15235359 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1570484 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -118069 | RevenuesLessExpensesCY |
| Total Assets BOY | 8617905 | TotalAssetsBOY |
| Total Assets EOY | 8096708 | TotalAssetsEOY |
| Total Liabilities BOY | 3829568 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3416747 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4788337 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4679961 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | LAKE SHORE BEHAVIORAL HEALTH, INC. PROMOTES SELF-SUFFICIENCY, WELLNESS AND RECOVERY, AND AN ENHANCED QUALITY OF LIFE FOR ALL INDIVIDUALS WITH MENTAL ILLNESSES AND ADDICTIVE DISORDERS BY PROVIDING EFFECTIVE, ACCESSIBLE, AND CULTURALLY-SENSITIVE SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 5360600 | Expense |
| Revenue | 5763618 | Revenue |
| Description | MENTAL HEALTH TREATMENT: LAKE SHORE BEHAVIORAL HEALTH, INC. PROVIDES A RANGE OF OUTPATIENT TREATMENT AND REHABILITATION SERVICES TO INDIVIDUALS DIAGNOSED WITH MENTAL ILLNESSES INCLUDING DEPRESSION, ANXIETY, SCHIZOPHRENIA, AND BIPOLAR DISORDER, AMONG OTHERS. SERVICES INCLUDE INDIVIDUAL, GROUP AND FAMILY COUNSELING; PSYCHIATRIC EVALUATION; MEDICATION THERAPY; INDIVIDUALIZED RECOVERY PLANNING; SYMPTOM MONITORING; CRISIS INTERVENTION; BASIC LIVING SKILLS TRAINING; HEALTH ASSESSMENT; AND RELAPSE PREVENTION, AMONG OTHERS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2305883 | Expense |
| Revenue | 2143110 | Revenue |
| Description | INTENSIVE MENTAL HEALTH SERVICES: INTENSIVE SERVICES ARE COMPRISED OF THE ASSERTIVE COMMUNITY TREATMENT TEAMS (ACT), THE HOMELESS SERVICES PROGRAM AND THE CASE MANAGEMENT PROGRAM. LSBH OFFERS ASSERTIVE COMMUNITY TREATMENT (ACT) TO INDIVIDUALS WITH SERIOUS MENTAL ILLNESSES WHO HAVE PREVIOUSLY NOT BENEFITTED FROM TRADITIONAL OUTPATIENT MENTAL HEALTH SERVICES. ACT CONSISTS OF A MOBILE MENTAL HEALTH TEAM THAT PROVIDES COMPREHENSIVE, INDIVIDUALIZED PSYCHIATRIC TREATMENT TO PEOPLE IN THE COMMUNITY. THE HOMELESS SERVICES PROGRAM PROVIDES HOUSING AND SUPPORT SERVICES FOR INDIVIDUALS WHO ARE HOMELESS AND WHO SUFFER FROM A MENTAL ILLNESS. THE CASE MANAGEMENT PROGRAM OFFERS PLANNING, LINKING, ADVOCACY, AND MONITORING SERVICES TO INDIVIDUALS WITH SERIOUS MENTAL ILLNESSES. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3532282 | Expense |
| Revenue | 1102705 | Revenue |
| Description | CHEMICAL DEPENDENCY: LAKE SHORE BEHAVIORAL HEALTH, INC. OFFERS INDIVIDUAL, GROUP AND FAMILY COUNSELING TO ADULTS EXPERIENCING PROBLEMS RELATED TO THE USE OF ALCOHOL OR OTHER ADDICTIVE SUBSTANCES. A FAMILY/COMMUNITY BASED TREATMENT PROGRAM IS AVAILABLE TO TEENAGERS AGED 11 TO 17 YEARS OLD. LSBH ALSO OFFERS AN INTENSIVE RESIDENTIAL ADDICTIONS TREATMENT PROGRAM FOR PREGNANT OR PARENTING WOMEN. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2604113 | Expense |
| Revenue | 256997 | Revenue |
| Description | ALL OTHER PROGRAM SERVICES. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 2604113 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 256997 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 13802878 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| 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 | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | 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 | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | 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 | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 174 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 353 | 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 |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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 | 1 | 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 | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREDERICK GILL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7168420440 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 DELAWARE AVENUE SUITE 300 | AddressLine1 |
| City | BUFFALO | City |
| State | NY | State |
| ZIP Code | 14202 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| PETER C RUNFOLA | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| WILLIAM GAJEWSKI | ||||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | X | ||
| JEFFREY LOWRY | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| CHARLES SYMS MSW | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| MARILYN WILSON | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| ANGELA BENZEL CPA | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| MICHAEL A DE FREITAS ESQ | ||||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | X | ||
| KAREN E EDMUND LMSW | ||||||||
| VICE CHAIRPERSON | 1.00 | X | 0 | 0 | 0 | X | ||
| RICHARD J SCHECHTER EQP | ||||||||
| VICE CHAIRPERSON | 1.00 | X | 0 | 0 | 0 | X | ||
| PATRICK SILVER | ||||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X | ||
| CHRISTINE ELLINGTON-ROWE | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | ||
| PATRICIA CARRINGTON ESQ | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| HOWARD HITZEL | ||||||||
| PRESIDENT | 35.00 | 163505 | 0 | 8306 | X | X | ||
| FREDERICK GILL | ||||||||
| CHIEF FINANCIAL OFFICER | 35.00 | 109729 | 0 | 15300 | X | |||
| STEFANIA FLYNN AIKINS | ||||||||
| PSY NURSE PRACTIONER | 35.00 | 108898 | 0 | 5582 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 382132 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 29188 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SECURITAS SECURITY SERVICES USA INC | |||||
| 1195 SHERIDAN DRIVE | TONAWANDA | NY | 14150 | SECURITY SERVICES | 211235 |
| UNIVERSITY PSYCHIATRIC INC | |||||
| ECMC 462 GRIDER ST 11TH FLOOR | BUFFALO | NY | 14215 | PSYCHIATRIC SERVICES | 197400 |
| DR JEFFERY KASHIN | |||||
| 925 DELAWARE AVE | BUFFALO | NY | 14209 | PSYCHIATRIC SERVICES | 148400 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Government Grants | 5799305 | GovernmentGrants |
| Total Contributions | 5799305 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICAID | 623990 | 5835563 | 5835563 |
| MEDICAID COPS | 623990 | 1281605 | 1281605 |
| THIRD PARTY PAYMENTS | 623990 | 822877 | 822877 |
| MEDICAID CSP | 623990 | 504293 | 504293 |
| CLIENT SERVICES | 623990 | 340235 | 340235 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 481857 | TotalRevenueColumn |
| Related Or Exempt Function Income | 481857 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 9266430 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13253 | TotalRevenueColumn |
| Exclusion | $13,253 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 8999 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 11892 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -2893 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -2893 | TotalRevenueColumn |
| Unrelated Business Revenue | -2893 | UnrelatedBusinessRevenue |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 198283 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 199889 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -1606 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1606 | TotalRevenueColumn |
| Exclusion | -$1,606 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 42801 | TotalRevenueColumn |
| Exclusion | $42,801 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 42801 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15117290 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9266430 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | -2893 | UnrelatedBusinessRevenue |
| Exclusion | $54,448 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 411320 | Total |
| Program Services | 114480 | ProgramServices |
| Management And General | 296840 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7391528 | Total |
| Program Services | 6923338 | ProgramServices |
| Management And General | 468190 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 313806 | Total |
| Program Services | 283652 | ProgramServices |
| Management And General | 30154 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1617282 | Total |
| Program Services | 1548271 | ProgramServices |
| Management And General | 69011 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51958 | Total |
| Program Services | 2442 | ProgramServices |
| Management And General | 49516 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3869 | Total |
| Management And General | 3869 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107654 | Total |
| Program Services | 47704 | ProgramServices |
| Management And General | 59950 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1289556 | Total |
| Program Services | 1281911 | ProgramServices |
| Management And General | 7645 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 384975 | Total |
| Program Services | 268074 | ProgramServices |
| Management And General | 116901 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71354 | Total |
| Program Services | 55218 | ProgramServices |
| Management And General | 16136 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 901048 | Total |
| Program Services | 822294 | ProgramServices |
| Management And General | 78754 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89198 | Total |
| Program Services | 79240 | ProgramServices |
| Management And General | 9958 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 351393 | Total |
| Program Services | 318804 | ProgramServices |
| Management And General | 32589 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 160018 | Total |
| Program Services | 64973 | ProgramServices |
| Management And General | 95045 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CLIENT INCIDENTALS | 1007612 | 1007612 | |
| FOOD | 267953 | 267953 | |
| MISCELLANEOUS | 260192 | 220186 | 40006 |
| MINOR EQUIPMENT | 211991 | 176217 | 35774 |
| VEHICLES | 151124 | 143853 | 7271 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 191528 | Total |
| Program Services | 176656 | ProgramServices |
| Management And General | 14872 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15235359 | Total |
| Program Services | 13802878 | ProgramServices |
| Management And General | 1432481 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 211630 | BOY |
| EOY | 1487750 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2962705 | BOY |
| EOY | 262248 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2612149 | BOY |
| EOY | 3042368 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 343853 | BOY |
| EOY | 295116 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 4940253 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2451212 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2477937 | BOY |
| EOY | 2489041 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 509253 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9631 | BOY |
| EOY | 10932 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8617905 | BOY |
| EOY | 8096708 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1615978 | BOY |
| EOY | 1039219 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2213590 | BOY |
| EOY | 2377528 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3829568 | BOY |
| EOY | 3416747 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4788337 | BOY |
| EOY | 4679961 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4788337 | BOY |
| EOY | 4679961 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8617905 | BOY |
| EOY | 8096708 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -118069 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 9693 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| 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 | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4328199 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4891764 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5486563 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6884733 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5799305 | CurrentTaxYear |
| Total | 27390564 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4328199 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4891764 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5486563 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6884733 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5799305 | CurrentTaxYear |
| Total | 27390564 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 27390564 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 9836 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 76358 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5230 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10589 | CurrentTaxYearMinus1Year |
| Current Tax Year | 13253 | CurrentTaxYear |
| Total | 115266 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 79822 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 50113 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 26510 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 33338 | CurrentTaxYearMinus1Year |
| Current Tax Year | 52494 | CurrentTaxYear |
| Total | 242277 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 27748107 | TotalSupport |
| Gross Receipts From Admissions Etc | 41231988 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.98710 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.98540 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 110408 | OtherCostOrOtherBasis |
| Book Value | 110408 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1173283 | OtherCostOrOtherBasis |
| Depreciation | 87771 | Depreciation |
| Book Value | 1085512 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1985179 | OtherCostOrOtherBasis |
| Depreciation | 1397903 | Depreciation |
| Book Value | 587276 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1541472 | OtherCostOrOtherBasis |
| Depreciation | 948212 | Depreciation |
| Book Value | 593260 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 129911 | OtherCostOrOtherBasis |
| Depreciation | 17326 | Depreciation |
| Book Value | 112585 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2489041 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MUTUAL FUNDS | Description |
| Book Value | 509253 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 509253 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| REFUNDABLE ADVANCES | $461,728 |
| DUE TO MEDICAID | $1,915,800 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2377528 | TotalOfAmounts |
| Total Revenue | 15117290 | TotalRevenue |
| Total Expenses | 15235359 | TotalExpenses |
| Excess Or Deficit For Year | -118069 | ExcessOrDeficitForYear |
| Donated Services And Facilities | 9693 | DonatedServicesAndFacilities |
| Total Adjustments | 9693 | TotalAdjustments |
| Excess Or Deficit Per FS | -108376 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 15140481 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 9693 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | 13498 | OtherRevenues |
| Revenue Not Rptd F990 | 23191 | RevenueNotRptdF990 |
| Revenue Subtotal | 15117290 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 15117290 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 15248857 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 13498 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 13498 | ExpensesNotRptdF990 |
| Expenses Subtotal | 15235359 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 15235359 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | LOSS ON DISPOSAL OF ASSETS 13,498. |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | LOSS ON DISPOSAL OF ASSETS 13,498. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | HOWARD HITZEL | NamePerson |
| Base Compensation Filing Org | 163505 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 8216 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 90 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 171811 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS PRESENTED IN DRAFT FORM TO MEMBERS OF THE BOARD OF LAKE SHORE BEHAVIORAL HEALTH, INC. FOR THEIR REVIEW AND APPROVAL PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. | |
| IN ACCORDANCE WITH LAKE SHORE BEHAVIORAL HEALTH'S CONFLICT OF INTEREST POLICY, EACH OFFICER INCLUDES ANY NON-DIRECTOR SERVING ON ANY COMMITTEE OF THE BOARD OF DIRECTORS AND DIRECTORS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: A. HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, B. HAS READ AND UNDERSTANDS THE POLICY, C. HAS AGREED TO COMPLY WITH THE POLICY, D. UNDERSTANDS THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES, AND E. IS NOT AWARE THAT HE OR SHE HAS ANY FINANCIAL INTEREST OR, IF HE OR SHE IS AWARE OF ANY FINANCIAL INTEREST, A DESCRIPTION OF THE MATERIAL FACTS CONCERNING IT. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE BOARD SUBCOMMITTEE HAS THE RESPONSIBILITY TO DETERMINE THE COMPENSATION OF KEY EMPLOYEES. THE PURPOSE OF THE COMMITTEE IS TO APPROVE ANNUAL PERFORMANCE STANDARDS AND TO DETERMINE APPROPRIATE PERFORMANCE MEASURES AND ESTABLISH CRITERIA FOR ANY INCENTIVE BASED COMPENSATION. IT ALSO ANNUALLY REVIEWS AND APPROVES ANY CHANGES TO THE TOTAL COMPENSATION OF KEY EMPLOYEES. THE COMMITTEE DETERMINES IF THE COMPENSATION IS REASONABLE. TO ACCOMPLISH THIS, THE COMMITTEE WILL OBTAIN COMPARABLE COMPENSATION DATA FOR EXECUTIVES OF OTHER NON PROFIT ORGANIZATIONS OF SIMILAR SIZE IN THE WESTERN NEW YORK AREA. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON ITS OWN WEBSITE. COPIES CAN BE PROVIDED UPON REQUEST BY PHONE, IN WRITING, OR VIA E-MAIL. A COPY OF THE 990 CAN BE FOUND THROUGH THE WEBSITE WWW.GUIDESTAR.ORG. | FORM 990, PART VI, SECTION C, LINE 19 | |
| THE COMPANIES ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN FOR INCOME TAX PURPOSES WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS ONLY TO THE EXTENT THAT AN UNCERTAIN TAX POSITION (IF ANY) IS ATTRIBUTABLE TO THE COMPANIES. THE TAX RETURNS FOR THE TAX YEARS 2007 THROUGH 2010 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE FOR U.S. FEDERAL TAX PURPOSES AND ALSO BY NEW YORK STATE FOR STATE TAX PURPOSES. | FORM 990, PART X, LINE 1 | |
| THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. | FORM 990, PART XII, LINE 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKE SHORE COMMUNITY MENTAL HEALTH FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 DELAWARE | AddressLine1 |
| City | BUFFALO | City |
| State | NY | State |
| ZIP Code | 14202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161450067 | EIN |
| Primary Activities | PROVIDE FINANCIAL ASSISTANCE TO LAKE SHORE BEHAVIORAL INC. | PrimaryActivities |
| Legal Domicile State | NY | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | CHARITABLE | PublicCharityStatus |
| Controlled Org | 0 | ControlledOrg |
| 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 | 0 | 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 | 0 | 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 | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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