2021-05-17T11:24:34-05:00 2020-06-30 010493997 One River CPAs 150 Capitol Street Suite 3 Augusta ME 04330 990 2019-07-01 611419905 Kennebec Mental Health Associates KENN 2078732136 67 Eustis Parkway Waterville ME 04901 Thomas Mcadam Chief Executive Officer 2078732136 2021-05-14 1 Stephen L LeClair CPA P01370336 2076238401 2019 2022-09-23 18:48:47Z Thomas McAdam 67 Eustis Parkway Waterville ME 04901 4319464 0 X N/A X 2002 ME To coordinate, manage and support all of the administrative and other related activities, services and functions with respect to the operation of Kennebec Valley Mental Health Center d/b/a Kennebec Behavioral Health in connection with its delivery of behavioral health and other related services. 7 7 50 0 0 0 0 0 3951148 4232727 16004 17606 61799 69131 4028951 4319464 0 0 0 0 2735621 2996784 0 0 79455 1134622 1162892 3870243 4159676 158708 159788 2312700 2657231 761911 946654 1550789 1710577 X To coordinate, manage and support all of the administrative and other related activities, services and functions with respect to the operation of Kennebec Valley Mental Health Center (dba Kennebec Behavioral Health) and its related organizations, KMHA Real Estate and KMHA Foundation. 0 0 4080221 4301858 The coordination, management and support of administrative and other related activities with respect to Kennebec Valley Mental Health Center d/b/a Kennebec Behavioral Health and its related corporations, KMHA Real Estate and KMHA Foundation, in connection with the delivery of behavioral health and related services. 4080221 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 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 1 0 0 0 1 12 0 1 50 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X Josee L Shelley CPA 2078732136 67 Eustis Parkway Waterville ME 04901 X Janine D Taylor MD Medical Director/Psychiatrist 40.00 X 0 260779 36122 Arlene C Almazan MD Psychiatrist 40.00 X 0 269820 20585 Thomas McAdam MBA Chief Executive Officer 40.00 X 194251 0 69226 Teresa Hermida MD Psychiatrist 40.00 X 0 243838 13422 Bukher Emil NP Nurse Practitioner 40.00 X 0 203740 23038 Paige McInerney DO Psychiatrist 34.00 X 0 194600 30514 Josee Shelley CPA Chief Financial Officer 40.00 X 167050 0 21309 Melinda Morissette NP Nurse Practitioner 40.00 X 0 159881 24358 Rosalie Curtis Williams President/Secretary 2.00 X 0 0 0 Leon A Duff Vice President/Treasurer 2.00 X 0 0 0 Walter Price Director 1.00 X 0 0 0 Carol Axtell Director 1.00 X 0 0 0 Lisa Gibson Landry Director 1.00 X 0 0 0 Harold Bickmore Director 1.00 X 0 0 0 Thomas Longstaff Director 1.00 X 0 0 0 361301 1332658 238574 2 0 1 0 The Hanover Insurance Group 440 Lincoln Street Worcester MA 01653 Insurance provider 109600 1 Management Fee Income 561000 4232727 4232727 4232727 17606 17606 Miscellaneous income 561000 69131 69131 69131 4319464 4301858 0 17606 372792 340897 31895 2010152 1990376 19776 81540 80405 1135 352886 347964 4922 179414 175787 3627 200 200 11618 11558 60 4954 2259 2695 68982 66209 2773 115951 109703 6248 66432 63596 2836 13818 13573 245 269846 269846 68017 66233 1784 Communications 313547 313547 Equipment expenses 118743 118743 Maintenance and repair 76615 76380 235 Dues and fees 12153 11049 1104 22016 21896 120 4159676 4080221 0 79455 881371 1166605 471155 482260 51570 26333 40136 50765 2403095 1887687 546071 515408 322397 415860 2312700 2657231 720510 929996 41401 16658 761911 946654 X 1550789 1710577 1550789 1710577 2312700 2657231 159788 0 X X 0 1 X 1 0 X X 3 Kennebec Behavioral Health 010265559 7 1 3701533 0 KMHA Real Estate Inc 611419906 7 1 616635 0 KMHA Foundation Inc 611419904 7 1 30509 0 3 4348677 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2403095 1887687 515408 515408 Due From Affiliates 415860 415860 Due to Affiliates 16658 16658 X 4319464 0 4319464 0 4319464 4159676 0 4159676 0 4159676 Part X, Line 2: Income Tax Status - All of the Organizations are exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code. However, income from certain activities not directly related to the Organizations' tax-exempt purpose is subject to taxation as unrelated business income. In addition, the Organizations qualify for the charitable contribution deduction under Section 170(b)(1)(A). KBH has been classified as an organization that is not a private foundation under Section 509(a)(1). KMHA, KMHA Foundation, and KMHA Real Estate, Inc. have non-private foundation status as a supporting organization under IRC 509(a)(3). Management believes it has no uncertain tax positions with the Internal Revenue Service that require disclosure in its financial statements. The Organization's federal Returns of Organization Exempt from Income Tax (Forms 990) and Exempt Organization Business Income Tax Return (Form 990-T) for 2019, 2018, and 2017 are subject to examination by the IRS, generally for three years after they were filed. X X X X 0 0 0 0 0 0 0 1 0 Janine D Taylor MD Medical Director/Psychiatrist 0 219211 0 26088 0 15480 0 10728 0 25394 0 296901 0 0 Arlene C Almazan MD Psychiatrist 0 224975 0 16938 0 27907 0 8008 0 12577 0 290405 0 0 Thomas McAdam MBA Chief Executive Officer 155756 0 10000 0 28495 0 49625 0 19601 0 263477 0 38910 0 Teresa Hermida MD Psychiatrist 0 218918 0 16488 0 8432 0 10313 0 3109 0 257260 0 0 Bukher Emil NP Nurse Practitioner 0 187238 0 9156 0 7346 0 8103 0 14935 0 226778 0 0 Paige McInerney DO Psychiatrist 0 180390 0 14019 0 191 0 8289 0 22225 0 225114 0 0 Josee Shelley CPA Chief Financial Officer 132881 0 19000 0 15169 0 5679 0 15630 0 188359 0 0 0 Melinda Morissette NP Nurse Practitioner 0 137371 0 22319 0 191 0 6688 0 17670 0 184239 0 0 Part I, Line 7 The key employees and some of the highest compensated employees received compensation based on personal productivity standards contained within their employment contracts. Form 990, Part VI, Section B, line 11b A copy of the 990 is provided to the Finance Committee prior to filing with the Internal Revenue Service. The Finance Committee meets bi-monthly and, at its discretion, can add discussion and review of the organization's 990 to its agenda. Form 990, Part VI, Section B, line 12c The conflict of interest policy requires that each Board member annually sign a statement that they will abide by the policy. Any potential conflict of interest is required to be disclosed by a Board member at a Board meeting with procedures for investigation and resolution being managed by the Board. On an annual basis the Board is reminded of the policy by senior staff. Form 990, Part VI, Section B, line 15 The compensation of the CEO is established by the Board of Directors based on industry-specific wage survey data. The CEO's performance is reviewed annually by the Board President and any increase in compensation is approved within the framework of salary adjustments approved by the Board for all staff. Compensation of senior managers of the organization is managed by the CEO using current wage survey data and within the framework of salary adjustments approved by the Board for all staff during the annual budget approval process. Form 990, Part VI, Section C, line 18 All governing documents, policies and audited financial statements are available to be viewed at the organization's administrative offices. An annual report reflecting a summary of its audited financial statements is available in printed format and on the website of Kennebec Behavioral Health (www.kbhmaine.org). Form 990, Part VI, Section C, line 19 The organization's annual form 990 return is available for viewing at the organization's administrative offices and also on www.guidestar.org. Form 1023 is available for public inspection at the administrative offices of the organization. Form 990, Part VII All employees of KMHA and KBH are eligible to participate in a Vacation Buy-out program, which is taxable income and increases reportable base compensation. Included in Mr. McAdam's, Ms. Shelley's, Dr. Almazan's, Dr. Taylor's, Dr. Hermida's, and Mr. Bukher's reportable compensation are $6,802, $14,978, $27,717, $15,290, $8,241 and $7,154 respectively in vacation buy-out. Form 990, Part XI, Line 2c The process of oversight of the audit has not changed from the previous year. Kennebec Behavioral Health 67 Eustis Parkway Waterville ME 04901 010265559 Promote the well-being of children, families and adults ME 501(c)(3) 170(b)(1)(A) 0 KMHA Real Estate Inc 67 Eustis Parkway Waterville ME 04901 611419906 Hold title to, manage and maintain properties for Kennebec Behavioral Health ME 501(c)(3) 509(a)(3) Type I Org 0 KMHA Foundation Inc 67 Eustis Parkway Waterville ME 04901 611419904 Hold, manage and invest funds and gifts for Kennebec Behavioral Health ME 501(c)(3) 509(a)(3) Type I Org 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 Kennebec Behavioral Health - management agreement L 3617727 Amount paid KMHA Foundation Inc - management agreement L 30509 amount paid KMHA Real Estate Inc - Rental agreement for office space K 115951 Amount paid KMHA Real Estate Inc - management agreement L 500684 Amount paid Kennebec Behavioral Health L 83806 Amount paid