2021-05-17T16:48:25-05:00 2020-06-30 450250958 EIDE BAILLY LLP 810 S CINCINNATI AVE STE 600 TULSA OK 741191623 990 2019-07-01 731039733 GRAND LAKE MENTAL HEALTH CENTER INC GRAN 9182731841 114 WEST DELAWARE NOWATA OK 74048 LARRY SMITH CEO 9182731841 2021-05-17 1 CHANDRA FOSTER CPA P00104736 9187485000 2021-05-17 2019 2022-09-23 18:48:47Z SEE SCHEDULE O GRAND LAKE MEDICAL HEALTH CENTER AND GRAND LAKE MENTAL HEALTH CENTER LARRY SMITH 114 WEST DELAWARE NOWATA OK 74048 86784525 0 X WWW.GLMHC.NET X 1977 OK PROVIDE MENTAL HEALTH SERVICES TO INDIVIDUALS REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY. 13 13 1041 11 -8758 -8758 10493377 15124899 53168337 71303046 160815 144898 181073 166242 64003602 86739085 0 0 0 0 42485285 57176820 0 0 0 13559330 20366784 56044615 77543604 7958987 9195481 38784165 49440708 12211963 13673026 26572202 35767682 TO CREATE A WELCOMING, SUPPORTIVE AND POSITIVE ENVIRONMENT, IN WHICH AN ARRAY OF EFFECTIVE AND EFFICIENT TRAUMA-INFORMED, INTEGRATED SERVICES WILL PROMOTE AN IMPROVED QUALITY OF LIFE FOR CONSUMERS, COMMUNITIES AND EACH OTHER IN NORTHEASTERN AND NORTHCENTRAL OKLAHOMA. 0 0 60984100 71622944 THE OUTPATIENT PROGRAM IS DESIGNED TO PROVIDE A COMBINATION OF SERVICES THAT INCLUDE, BUT ARE NOT LIMITED TO INDIVIDUAL, GROUP AND FAMILY COUNSELING AND CRISIS INTERVENTION TO PERSONS BIRTH THROUGH LIFESPAN. SERVICES PROVIDED ARE BASED ON CLIENT NEED IN ORDER TO OPTIMIZE THEIR ABILITY TO LIVE AND BE SUCCESSFUL IN THEIR COMMUNITY, HOME AND WORK ENVIRONMENTS. 156 INPATIENT BEDS. 60984256 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 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 1 146 0 1 1041 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 1 0 OK X GRAND LAKE MENTAL HEALTH CENTER IN 9182731841 114 WEST DELAWARE NOWATA OK 74048 TAD JONES PRESIDENT 3.00 X X 0 0 0 ELAINE CLUGSTON VICE PRESIDENT 3.00 X X 0 0 0 SHELLI WEBB SECRETARY 3.00 X X 0 0 0 CHARLES HAMIT BOARD MEMBER 2.00 X 0 0 0 JIM TANNER BOARD MEMBER 2.00 X 0 0 0 BILL STUTSMAN BOARD MEMBER 2.00 X 0 0 0 CHARLENE LINGO BOARD MEMBER 2.00 X 0 0 0 DAVID FOSTER BOARD MEMBER 2.00 X 0 0 0 RICK LITTLEFIELD BOARD MEMBER 2.00 X 0 0 0 NANCY BARTON BOARD MEMBER 2.00 X 0 0 0 PAT DARLINGTON BOARD MEMBER 2.00 X 0 0 0 SANDY HADLEY BOARD MEMBER 2.00 X 0 0 0 LOWELL BARTO BOARD MEMBER 2.00 X 0 0 0 CHARLES DANLEY CHIEF EXECUTIVE OFFICER 45.00 X 514883 0 9648 LARRY SMITH CHIEF OPERATING OFFICER 45.00 X 512891 0 8831 DONNA AULTZ CHIEF FINANCIAL OFFICER 45.00 X 224242 0 9672 JOSH CANTWELL CHIEF CLINICAL OFFICER 45.00 X 214266 0 1296 JEFF HARLIN CHIEF CLINICAL OFFICER 45.00 X 218581 0 609 DR WELDON J MALLGREN MEDICAL DIRECTOR 45.00 X 396388 0 12511 RUTH HERLAN DATA MIGRATION ANALYST 45.00 X 221112 0 9278 LISSA JAMES CHIEF CLINICAL COMPLIANCE OFFICER 45.00 X 239715 0 9370 DAVID MCELWAIN PSYCHIATRIST 45.00 X 309761 0 8514 AMY HOGAN CHIEF CLINICAL OFFICER 45.00 X 216673 0 9265 JASON CAGLE CHIEF INFORMATION OFFICER 45.00 X 205604 0 18159 ANGELA RHOTEN NURSE PRACTIONER 45.00 X 135756 0 11056 JULIE FINNEY PHYSICIAN'S ASSISTANT 45.00 X 135461 0 13964 BRENT BREWER PHYSICIAN'S ASSISTANT 50.00 X 229701 0 16442 DON CURRY PHYSICIAN'S ASSISTANT 50.00 X 216783 0 477 EMILY SHEARER INTEGRATED HEALTH SERV DIR 45.00 X 140171 0 438 4131988 0 139530 24 0 1 0 HUNTER'S PRECISION RX LLC 9432 NORTH MAY AVENUE OKLAHOMA CITY OK 73120 MEDICATION 3893572 MYCARE INTEGRATED SOFTWARE SOLUTIONS LL 5401 N PORTLAND AVE OKLAHOMA CITY OK 73112 IPAD SERVICE 507913 CSTAR MANAGEMENT LLC 304 S DUCK ST STILLWATER OK 74074 BUILDING MAINENANCE 349762 COORDINATED CARE HEALTH SOLUTIONS 5401 N PORTLAND AVENUE 260 OKLAHOMA CITY OK 73112 CONSULTANT 276726 VIP TECH SOLUTIONS GRP LLC 12149 S STATE HWY 51 COWETA OK 74429 PHONE/REPAIR SERVICE 186352 9 15109478 15421 15124899 PROFESSIONAL SERVICE FEES 624100 71300947 71300947 2099 2099 71303046 128830 128830 16035 24793 -8758 -8758 -8758 36715 20647 16068 16068 16068 MISCELLANEOUS INCOME 900099 175000 175000 175000 86739085 71622944 -8758 0 3310696 3310696 43155802 34589160 8566642 1475609 1238444 237165 6012269 4493027 1519242 3222444 2408164 814280 33945 33945 36942 36942 3249584 2930119 319465 2361406 1617537 743869 902791 871393 31398 926442 830382 96060 58762 58762 1671917 1391005 280912 300828 269128 31700 PHARMACY 2230473 2230473 0 0 MAINTENANCE 2207670 2172156 35514 0 VEHICLES 776658 590052 186606 0 FOOD SERVICES 579729 579729 0 0 5029637 4714725 314912 77543604 60984256 16559348 0 10509659 11144179 3560686 3601959 10007348 15153814 404814 531390 29947305 10937939 14301658 19009366 38784165 49440708 4159914 6078903 8052049 7594123 12211963 13673026 X 26572202 35767682 26572202 35767682 38784165 49440708 9195481 0 X 0 1 X 0 1 1 X 6852336 8015951 9458178 10493377 15124899 49944741 6852336 8015951 9458178 10493377 15124899 49944741 49944741 921 5749 17967 136700 144865 306202 100314 102585 63600 181073 175000 622572 50873515 201319884 0.98170 0.97970 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1111852 1111852 26449938 9330963 17118975 607864 193423 414441 1777651 1413553 364098 19009366 X 86763878 24793 24793 86739085 0 86739085 77568398 24793 24793 77543605 0 77543605 PART X, LINE 2: THE CENTER IS ORGANIZED AS AN OKLAHOMA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, QUALIFY FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTIONS 170(B)(1)(A)(VI) AND (VIII), AND HAVE BEEN DETERMINED NOT TO BE PRIVATE FOUNDATIONS UNDER SECTIONS 509(A)(1) AND (3), RESPECTIVELY. THE CENTER IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE CENTER IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT IS UNRELATED TO ITS EXEMPT PURPOSES. MANAGEMENT HAS DETERMINED THAT THE CENTER IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS. THE CENTER BELIEVES THAT IT HAS NOT ENGAGED IN ANY UNRELATED BUSINESS ACTIVITIES AS DEFINED BY THE IRS REGULATIONS. ACCORDINGLY, THERE WERE NO INCOME TAX LIABILITIES RECORDED IN FISCAL YEARS 2020 AND 2019. MANAGEMENT BELIEVES THAT THE CENTER HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANICAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 24,793. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 24,793. X X X X 0 0 0 0 0 0 0 0 0 CHARLES DANLEY CHIEF EXECUTIVE OFFICER 497812 0 0 0 17071 0 0 0 9648 0 524531 0 0 0 LARRY SMITH CHIEF OPERATING OFFICER 497018 0 0 0 15873 0 0 0 8831 0 521722 0 0 0 DONNA AULTZ CHIEF FINANCIAL OFFICER 222054 0 2188 0 0 0 0 0 9672 0 233914 0 0 0 JOSH CANTWELL CHIEF CLINICAL OFFICER 212078 0 2188 0 0 0 0 0 1296 0 215562 0 0 0 JEFF HARLIN CHIEF CLINICAL OFFICER 216393 0 2188 0 0 0 0 0 609 0 219190 0 0 0 DR WELDON J MALLGREN MEDICAL DIRECTOR 392669 0 3719 0 0 0 0 0 12511 0 408899 0 0 0 RUTH HERLAN DATA MIGRATION ANALYST 218924 0 2188 0 0 0 0 0 9278 0 230390 0 0 0 LISSA JAMES CHIEF CLINICAL COMPLIANCE OFFICER 234027 0 5688 0 0 0 0 0 9370 0 249085 0 0 0 DAVID MCELWAIN PSYCHIATRIST 307136 0 2625 0 0 0 0 0 8514 0 318275 0 0 0 AMY HOGAN CHIEF CLINICAL OFFICER 214485 0 2188 0 0 0 0 0 9265 0 225938 0 0 0 JASON CAGLE CHIEF INFORMATION OFFICER 203416 0 2188 0 0 0 0 0 18159 0 223763 0 0 0 BRENT BREWER PHYSICIAN'S ASSISTANT 181780 0 1177 0 46744 0 0 0 16442 0 246143 0 0 0 DON CURRY PHYSICIAN'S ASSISTANT 175851 0 1177 0 39755 0 0 0 477 0 217260 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B NO COMMITTEES ARE ABLE TO ACT ON BEHALF OF THE BOARD FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE REVIEWED BY THE BOARD AT THE NEXT MEETING AFTER IT IS PREPARED AND FILED. FORM 990, PART VI, SECTION B, LINE 12C ANY ACTIVITY IN THE COURSE OF AGENCY BUSINESS, MARKETING, AND/OR SERVICE DELIVERY THAT WOULD CREATE A CONFLICT OF INTEREST BETWEEN AN EMPLOYEE AND CLIENT, RESULTING IN ACTUAL, APPARENT, OR PERCEIVED USE OF THE EMPLOYEE'S POSITION FOR PRIVATE GAIN OR COMPLETE LOSS OF IMPARTIALITY, IS PROHIBITED. THE CONFLICT OF INTEREST POLICY IF REVIEWED ANNUALLY AT BOARD MEETING. NO CONFLICTS OF INTEREST HAVE BEEN DISCOVERED SINCE THE INCEPTION OF THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 ANNUAL REVIEW OF COMPENSATION IN COMPLIANCE WITH THE IRS REBUTTABLE PRESUMPTION RULE. FORM 990, PART VI, SECTION C, LINE 19 UPON WRITTEN REQUEST.