2020-07-06T16:38:30-05:00 2019-06-30 610920132 RINEY HANCOCK CPAS PSC 2900 VEACH ROAD SUITE 2 OWENSBORO KY 42303 990 2018-07-01 610668290 GREEN RIVER REGIONAL MENTAL HEALTH MENTAL RETARDATION BOARD INC GREE 2706896500 1100 WALNUT ST OWENSBORO KY 42301 MIKE MOUNTAIN CFO 2706896500 2020-06-29 1 SCOTT L CLAY CPA P00114132 2709264540 74.87.131.58 2020-06-29 14:06:33 CD P 8F3F159F5286DA5CD97BDFBADA10DBD00A811017 CE57507312F03E43F5A19A2BCE00F9006A1BC891 2018 2021-01-29 14:40:06Z WANDA FIGUEROA-PERALTA 1100 WALNUT STREET OWENSBORO KY 42301 46944007 0 X WWW.RVBH.COM X 1966 KY PLANNING, COORDINATION AND DIRECT DELIVERY OF MENTAL HEALTH, SUBSTANCE ABUSE AND MENTAL RETARDATION SERVICES AT VARIOUS LOCATIONS. 14 14 99 0 0 0 8946926 9022016 34924604 34517128 653198 595296 9600 9600 44534328 44144040 0 0 0 0 22023155 21028177 0 0 0 19379478 21009404 41402633 42037581 3131695 2106459 47274850 49999952 5180079 5439462 42094771 44560490 TO PROVIDE PLANNING, COORDINATION AND DIRECT DELIVERY OF MENTAL HEALTH, SUBSTANCE ABUSE AND MENTAL RETARDATION SERVICES AT VARIOUS LOCATIONS. 0 0 37824373 34516904 PLANNING, COORDINATION, AND DIRECT DELIVERY OF MENTAL HEALTH, SUBSTANCE ABUSE, AND MENTAL RETARDATION SERVICES, PRIMARILY ON AN OUT-PATIENT BASIS. 37824373 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 43 0 1 99 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X MIKE MOUNTAIN 2706896500 CIGAR FACTORY COMPLEX 1100 WALNUT OWENSBORO KY 42301 JEFF JONES CHAIRMAN 0.50 X 0 0 0 PAT THOMPSON VICE CHAIRMAN 0.50 X 0 0 0 JORDON JOHNSON SECRETARY/TREASURER 0.50 X 0 0 0 JOHN BOARMAN DIRECTOR 0.50 X 0 0 0 MICHAEL BOLING DIRECTOR 0.50 X 0 0 0 DONNA BUMPUS DIRECTOR 0.50 X 0 0 0 ART EALUM DIRECTOR 0.50 X 0 0 0 KEITH FRANEY DIRECTOR 0.50 X 0 0 0 TARA HOWARD DIRECTOR 0.50 X 0 0 0 KENNY LANHAM DIRECTOR 0.50 X 0 0 0 MICHAEL ROE DIRECTOR 0.50 X 0 0 0 BARRY SMITH DIRECTOR 0.50 X 0 0 0 CHIP STAUFFER DIRECTOR 0.50 X 0 0 0 LINDA TONGATE DIRECTOR 0.50 X 0 0 0 WANDA FIGUEROA-PERALTA CEO 40.00 X 0 203263 24656 MIKE MOUNTAIN CFO 40.00 X 0 158427 16466 VITALKUMAR SHAH EMPLOYEE 40.00 X 157848 0 94010 157848 361690 135132 1 0 1 0 ARAMARK SERVICES INC PO BOX 651009 CHARLOTTE NC 282651009 FOOD PREP/JANITORIAL SERVICES 1089269 MEDICAL STAFFING SOLUTIONS 8601 N KENTUCKY AVE EVANSVILLE IN 47725 TEMP EMPLOYEE SERVICE 885159 KENTUCKY HOSPITAL INSURANCE CO PO BOX 436629 LOUISVILLE KY 402536629 COMPANY LIABILITY INSURANCE 420549 BARTON ASSOCIATES PO BOX 417844 BOSTON MA 022417844 PSYCH SERVICES 409960 PSYCHIATRIC CONSULTATION SERVICE 4320 CALAIS PLACE LEXINGTON KY 40515 PSYCH SERVICES 329600 21 9019509 2507 9022016 MEDICARE/MEDICAID PAYMENTS 624100 31290427 31290427 MANAGEMENT SERVICES 624100 2158989 2158989 PATIENT SERVICES 624100 1036668 1036668 TENANT RENT 623000 31044 31044 34517128 452188 452188 9600 0 9600 9600 9600 2943075 2799743 224 143332 -224 143108 -224 143332 44144040 34516904 0 605120 X 16893288 15203959 1689329 1478934 1331040 147894 1923488 1731139 192349 732467 659220 73247 4480670 4032603 448067 62141 55927 6214 63516 63516 11147784 10033005 1114779 91568 82411 9157 523516 471164 52352 580683 522615 58068 1812658 1631392 181266 400932 360838 40094 38796 34916 3880 6039 5435 604 211778 191557 20221 1063 1063 SUPPLIES 838747 754872 83875 BAD DEBTS 260000 260000 MEDICAID TAX ASSESSMENT 217202 217202 MISCELLANEOUS EXPENSE 99331 89397 9934 172980 155681 17299 42037581 37824373 4213208 0 7580805 8882795 157821 158254 2968082 5140936 346970 389832 15642432 12202066 3647487 3440366 12309724 13129947 231 185 20263730 18857637 47274850 49999952 4483199 4771653 329250 260651 367630 407158 5180079 5439462 X 42094771 44560490 42094771 44560490 47274850 49999952 2106459 359260 0 X X 0 1 X 1 1 1 X 10980257 10797663 9989990 8946926 9022016 49736852 33381554 32081014 35999199 34924604 34517128 170903499 44361811 42878677 45989189 43871530 43539144 220640351 0 0 0 220640351 250930 318936 348029 440416 461788 1820099 250930 318936 348029 440416 461788 1820099 44612741 43197613 46337218 44311946 44000932 222460450 0.99180 0.99310 0.00820 0.00690 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 335913 335913 9927800 8025740 1902060 260033 256622 3411 4643410 3553692 1089718 475276 366012 109264 3440366 INVESTMENTS - MARKETABLE SECURITIES 12621813 F INVESTMENTS - 457B DEFERRED COMP CONTRIBUTION 508134 F 13129947 RESERVE FOR REPLACEMENTS 209267 DUE FROM GREEN RIVER INDEPENDENT LIVING II, INC. 259269 DUE FROM GREEN RIVER INDEPENDENT LIVING III, INC. 78794 DUE FROM ACUMEN COUNSELING SERVICES, INC. 651342 TENANT SECURITY DEPOSITS 1985 RESIDUAL RECEIPTS RESERVE 3039 TAX AND INSURANCE ESCROW 1543 DUE FROM BEHAVIORAL HEALTH SERVICES, INC. 10891642 DUE FROM CIGAR FACTORY COMPLEX, INC. 181065 DUE FROM HENDERSON GROUP HOME, INC. 73665 DUE FROM MICHELLE P. WAIVER 6506026 18857637 DUE TO RIVERVALLEY CONSULTING SERVICES, INC. 405173 TENANT SECURITY DEPOSITS 1985 407158 X 38793807 359260 7990388 8349648 30444159 13699881 13699881 44144040 38339437 10863576 10863576 27475861 14561720 14561720 42037581 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE COMPANY AND RECOGNIZE A TAX LIABILITY IF THE COMPANY 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 COMPANY, AND HAS CONCLUDED THAT AS OF JUNE 30, 2019 AND 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED ENTITIES' OPERATING REVENUE PER CONSOLIDATED FINANCIAL STATEMENTS 23,761,551. RELATED ENTITIES' INVESTMENT RETURNS 62,509. RELATED ENTITIES' LOSS ON DISPOSAL OF PROPERTY AND EQUIPMENT -3,011. ELIMINATIONS PER CONSOLIDATED FINANCIAL STATEMENTS -15,619,367. OTHER INTERCOMPANY ADJUSTMENTS 48,706. BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDITED STATEMENTS -260,000. PART XI, LINE 4B - OTHER ADJUSTMENTS: MICHELLE P. WAIVER REVENUES REPORTED NET OF EXPENSES PER AUDITED STATEMENTS 13,699,881. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED ENTITIES' EXPENSES PER CONSOLIDATED FINANCIAL STATEMENTS 26,434,237. ELIMINATIONS PER CONSOLIDATED FINANCIAL STATEMENTS -15,619,367. OTHER INTERCOMPANY ADJUSTMENTS 48,706. PART XII, LINE 4B - OTHER ADJUSTMENTS: MICHELLE P. WAIVER REVENUES REPORTED NET OF EXPENSES PER AUDITED STATEMENTS 13,699,881. BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDITED STATEMENTS 260,000. OTHER INTERCOMPANY ADJUSTMENTS 601,839. 1 1 0 0 0 0 0 29964873 28762631 1202242 0.02860 29964873 28762631 1202242 0.02860 164781 164781 0.00390 80000 80000 0.00190 15000 15000 0.00040 259781 259781 0.00620 30224654 28762631 1462023 0.03480 1 260000 0 1 1 1 1 RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL 1000 INDUSTRIAL DRIVE OWENSBORO KY 42301 X CHILDREN'S PSYCHIATRIC HOSPITAL RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL 1 0 0 1 X X X X X X X X X 17 1 0 0 1 X WWW.RVBH.COM X 1 17 1 WWW.RVBH.COM 0 1 X X X 1 1 X X 1 X WWW.RVBH.COM X WWW.RVBH.COM X X X 1 X 0 X 1 X 0 0 RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL'S PLANS TO ADDRESS SIGNIFICANT NEEDS ARE IDENTIFIED IN THE CHNA DOCUMENT AND AVAILABLE ON THE ENTITY'S WEBSITE. RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL PART V, SECTION B, LINE 13B: THE HOSPITAL AUTOMATICALLY APPLIES A DISCOUNT TO ALL CLIENTS THAT DO NOT HAVE A THIRD PARTY PAYER (GROSS CHARGES FOR SERVICES ARE REDUCED TO THE CURRENT MEDICAID ACCEPTED RATE AT THE DATE OF SERVICE). ADDITIONAL DISCOUNTS ARE APPLIED BASED ON FAMILY INCOME AND FAMILY SIZE USING AN INTERNALLY DEVELOPED SLIDING FEE SCALE. CLIENTS MAY ALSO APPLY FOR ADDITIONAL FEE REDUCTIONS, WHICH ARE SUBJECT TO APPROVAL BY THE CFO. RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL PART V, SECTION B, LINE 13H: THE HOSPITAL AUTOMATICALLY APPLIES A DISCOUNT TO ALL CLIENTS THAT DO NOT HAVE A THIRD PARTY PAYER (GROSS CHARGES FOR SERVICES ARE REDUCED TO THE CURRENT MEDICAID ACCEPTED RATE AT THE DATE OF SERVICE). ADDITIONAL DISCOUNTS ARE APPLIED BASED ON FAMILY INCOME AND FAMILY SIZE USING AN INTERNALLY DEVELOPED SLIDING FEE SCALE. CLIENTS MAY ALSO APPLY FOR ADDITIONAL FEE REDUCTION, WHICH ARE SUBJECT TO APPROVAL BY THE CFO. PART I, LINE 3C: THE HOSPITAL AUTOMATICALLY APPLIES A DISCOUNT TO ALL CLIENTS THAT DO NOT HAVE A THIRD PARTY PAYER (GROSS CHARGES FOR SERVICES ARE REDUCED TO THE CURRENT MEDICAID ACCEPTED RATE AT THE DATE OF SERVICE). ADDITIONAL DISCOUNTS ARE APPLIED BASED ON FAMILY INCOME AND FAMILY SIZE USING AN INTERNALLY DEVELOPED SLIDING FEE SCALE. CLIENTS MAY ALSO APPLY FOR ADDITIONAL FEE REDUCTIONS, WHICH ARE SUBJECT TO APPROVAL BY THE CFO. PART III, LINE 4: PAGE 10 OF THE COMPANY'S FINANCIAL STATEMENTS DESCRIBE THE POLICY RELATING TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. NO BAD DEBT EXPENSE WAS INCLUDED IN THE AMOUNTS LISTED AS COMMUNITY BENEFITS. THESE AMOUNTS ARE RECORDED AS A REDUCTION OF NET PATIENT SERVICE REVENUE. PART III, LINE 9B: MONTHLY STATEMENTS ARE SENT TO THE PATIENT'S RESPONSIBLE PARTY. PAST DUE NOTICES ARE INCLUDED WITH ALL STATEMENTS MAILED IN WHICH PAYMENTS HAVE NOT BEEN RECEIVED WITHIN THE LAST THIRTY DAYS. ACCOUNTS OVER NINETY (90) DAYS OLD WITH NO PAYMENTS WITHIN THE LAST TWO MONTHS ARE SENT A FINAL NOTICE STATEMENT. IF NO PAYMENT IS RECEIVED AFTER THE FINAL NOTICE IS SENT, THE ACCOUNT IS SENT TO THE CFO FOR FINAL APPROVAL AND THEN WRITTEN OFF AS BAD DEBT. ACCOUNTS APPROVED BY THE CFO ARE TURNED OVER TO THE ORGANIZATION'S COLLECTION AGENCY. X 0 0 0 0 0 0 0 0 0 WANDA FIGUEROA-PERALTA CEO 0 203263 0 0 0 0 0 0 0 24656 0 227919 0 0 MIKE MOUNTAIN CFO 0 158427 0 0 0 0 0 0 0 16466 0 174893 0 0 VITALKUMAR SHAH EMPLOYEE 157848 0 0 0 0 0 0 0 94010 0 251858 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE CEO AND CONTROLLER AND THEN BY THE BOARD OF DIRECTORS BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS MONITORED BY THE BOARD, CFO, PURCHASING MANAGER, AND HUMAN RESOURCES DEPARTMENT AND INCLUDES REVIEWS OF VENDOR CONTRACTS AND EMPLOYMENT APPLICATIONS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REVIEWS AND APPROVES THE CEO'S COMPENSATION. THE HUMAN RESOURCES DEPARTMENT FORWARDS PROPOSED COMPENSATION ARRANGEMENTS FOR OTHER KEY PERSONNEL TO THE CEO FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 18 FORM 1023 AND FORM 990 ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND FORM 990 IS ALSO AVAILABLE ON PUBLIC WEBSITES SUCH AS GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST, THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G COLLECTION AGENCY SERVICES: PROGRAM SERVICE EXPENSES 5,902. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,902. PSYCHIATRIC CONSULTING: PROGRAM SERVICE EXPENSES 289,356. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 289,356. OTHER FEES: PROGRAM SERVICE EXPENSES 9,737,747. MANAGEMENT AND GENERAL EXPENSES 1,114,779. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,852,526. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. ACUMEN COUNSELING SERVICES INC 1100 WALNUT STREET OWENSBORO KY 42301 611248638 COUNSELING SERVICES TO CHARITABLE ACTIVITIES OF RELATED ORGANIZATIONS KY 501(C)(3) 12C GREEN RIVER REGIONAL MHMR BOARD 1 BEHAVIORAL HEALTHCARE SERVICES INC 1100 WALNUT STREET OWENSBORO KY 42301 311563579 OFFERS RESIDENTIAL SERVICES TO MENTALLY RETARDED INDIVIDUALS KY 501(C)(3) 10 GREEN RIVER REGIONAL MHMR BOARD 1 CIGAR FACTORY COMPLEX INCORPORATED 1100 WALNUT STREET OWENSBORO KY 42301 611303939 OWNS AND MANAGES PROPERTY FOR OTHER CHARITABLE ORGANIZATIONS KY 501(C)(2) GREEN RIVER REGIONAL MHMR BOARD 1 GREEN RIVER INDEPENDENT LIVING - II INC 1100 WALNUT STREET OWENSBORO KY 42301 611027454 PROVIDE HOUSING FOR ELDERLY AND/OR HANDICAPPED PERSONS KY 501(C)(3) 10 GREEN RIVER REGIONAL MHMR BOARD 1 GREEN RIVER INDEPENDENT LIVING - III INC 1100 WALNUT STREET OWENSBORO KY 42301 611153453 PROVIDE HOUSING FOR ELDERLY AND/OR HANDICAPPED PERSONS KY 501(C)(3) 10 GREEN RIVER REGIONAL MHMR BOARD 1 HENDERSON GROUP HOME INC 1100 WALNUT STREET OWENSBORO KY 42301 611171902 PROVIDE HOUSING & PERSONAL CARE FOR PHYSICALLY AND/OR MENTALLY HANDICAPPED KY 501(C)(3) 10 GREEN RIVER REGIONAL MHMR BOARD 1 RIVERVALLEY CONSULTING SERVICES INC 1100 WALNUT STREET OWENSBORO KY 42301 611354311 TO OFFER CONSULTING SERVICES TO RELATED NON-PROFIT ENTITIES KY 501(C)(3) 12B GREEN RIVER REGIONAL MHMR BOARD 1 ACUMEN COUNSELING SERVICES INC 1100 WALNUT STREET OWENSBORO KY 42301 611248638 COUNSELING SERVICES TO CHARITABLE ACTIVITIES OF RELATED ORGANIZATIONS KY 501(C)(3) 10 RIVERVALLEY CONSULTING SERVICES INC 1 BEHAVIORAL HEALTHCARE SERVICES INC 1100 WALNUT STREET OWENSBORO KY 42301 311563579 OFFERS RESIDENTIAL SERVICES TO MENTALLY RETARDED INDIVIDUALS KY 501(C)(3) 10 RIVERVALLEY CONSULTING SERVICES INC 1 CIGAR FACTORY COMPLEX INCORPORATED 1100 WALNUT STREET OWENSBORO KY 42301 611303939 OWNS AND MANAGES PROPERTY FOR OTHER CHARITABLE ORGANIZATIONS KY 501(C)(2) RIVERVALLEY CONSULTING SERVICES INC 1 GREEN RIVER INDEPENDENT LIVING - II INC 1100 WALNUT STREET OWENSBORO KY 42301 611027454 PROVIDE HOUSING FOR ELDERLY AND/OR HANDICAPPED PERSONS KY 501(C)(3) 10 RIVERVALLEY CONSULTING SERVICES INC 1 GREEN RIVER INDEPENDENT LIVING - III INC 1100 WALNUT STREET OWENSBORO KY 42301 611153453 PROVIDE HOUSING FOR ELDERLY AND/OR HANDICAPPED PERSONS KY 501(C)(3) 10 RIVERVALLEY CONSULTING SERVICES INC 1 HENDERSON GROUP HOME INC 1100 WALNUT STREET OWENSBORO KY 42301 611171902 PROVIDE HOUSING & PERSONAL CARE FOR PHYSICALLY AND/OR MENTALLY HANDICAPPED KY 501(C)(3) 10 RIVERVALLEY CONSULTING SERVICES INC 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 1 1 0 0 ACUMEN COUNSELING SERVICES INC M 8430337 COST BEHAVIORAL HEALTHCARE SERVICES INC Q 2919865 COST CIGAR FACTORY COMPLEX INCORPORATED K 1319318 FMV - CASH TRANSACTIONS RIVERVALLEY CONSULTING SERVICES INC J 140987 COST RIVERVALLEY CONSULTING SERVICES INC M 3445414 COST RIVERVALLEY CONSULTING SERVICES INC Q 1627354 COST GREEN RIVER INDEPENDENT LIVING - III INC Q 86923 COST