2019-05-15T14:57:08-05:00 2018-06-30 450250958 EIDE BAILLY LLP 810 S CINCINNATI AVE STE 600 TULSA OK 741191623 990 2017-07-01 731039733 GRAND LAKE MENTAL HEALTH CENTER INC GRAN 9182731841 114 WEST DELAWARE NOWATA OK 74048 LARRY SMITH COO 9182731841 2019-05-14 1 CHANDRA FOSTER P00104736 9187485000 2019-05-14 98.158.242.5 2019-05-14 09:02:39 CD P E09ED26753A0152F137A3243D2780EB3FBE097F4 0831FA90BCA8AD1791C6C0EA96F6E0164279AE07 2017 2019-02-21 02:37:17Z SEE SCHEDULE O GRAND LAKE MEDICAL HEALTH CENTER AND GRAND LAKE MENTAL HEALTH CENTER LARRY SMITH 114 WEST DELAWARE NOWATA OK 74048 47748832 0 X WWW.GLMHC.NET X 1977 OK PROVIDE MENTAL HEALTH SERVICES TO INDIVIDUALS REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY. 11 11 548 3 0 0 8015951 9458178 22504671 38209087 2829 15904 102583 63600 30626034 47746769 0 0 0 0 19373140 31832649 0 0 0 7919206 13337104 27292346 45169753 3333688 2577016 23900456 31055771 7864257 12442556 16036199 18613215 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 OKLAHOMA. 0 0 37168743 38288591 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 AGES 3 THRU 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. 178688 0 0 INPATIENT BEDS. 37347431 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 1 170 0 1 548 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 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 CHARLES HAMIT BOARD MEMBER 2.00 X 0 0 0 JIM TANNER BOARD MEMBER 2.00 X 0 0 0 TAD JONES PRESIDENT 3.00 X X 0 0 0 ELAINE CLUGSTON VICE PRESIDENT 3.00 X 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 SHELLI WEBB SECRETARY 3.00 X X 0 0 0 SANDY HADLEY BOARD MEMBER 2.00 X 0 0 0 CHARLES DANLEY CHIEF EXECUTIVE OFFICER 40.00 X 392817 0 18000 LARRY SMITH CHIEF OPERATING OFFICER 40.00 X 375297 0 18000 LISSA JAMES CLINICAL DIRECTOR 40.00 X 165119 0 9907 DR JOHN MALLGREN MEDICAL DIRECTOR 40.00 X 297943 0 17877 DONNA AULTZ CFO 40.00 X 156573 0 9394 AMY HOGAN CLINICAL DIRECTOR 40.00 X 149162 0 8950 RUTH HERLAN DIR. SUPPORT SVS 40.00 X 150230 0 9014 1687141 0 91142 10 0 1 0 HUNTER'S PRECISION RX LLC 9432 NORTH MAY AVENUE OKLAHOMA CITY OK 73120 CONSULTANT 4367568 WAGONER COMMUNITY HOSPITAL 513 3RD ST SW WAGONER OK 57380 INPATIENT BEDS 240819 GRAND LAKE GLASS 6716 US-59 GROVE OK 74344 GLASS CONTRACTOR 237206 RENEWIT CONSTRUCTION 2356 W NEW ORLEANS ST BROKEN ARROW OK 74011 GENERAL CONTRACTOR 231793 STOUT CONSTRUCTION INC 13720 EAST 86TH ST N SUITE 170 OWASSO OK 74055 GENERAL CONTRACTOR 231172 8 9457178 1000 9458178 PROFESSIONAL SERVICE FEES 624100 37532562 37532562 GOVERNMENT AGENCY FEES 624100 632423 632423 44102 44102 38209087 17967 17967 2063 -2063 -2063 -2063 MISCELLANEOUS INCOME 900099 63600 63600 63600 47746769 38288591 0 0 838957 838957 24779852 20637375 4142477 898362 723681 174681 3499772 2819261 680511 1815706 1462652 353054 47986 47986 46642 46642 3685310 3303320 381990 942301 822356 119945 463613 428092 35521 842846 700900 141946 75415 75415 968888 854156 114732 290538 247071 43467 OTHER OPERATING EXPENSE 4239669 3539256 700413 PHARMACY 1096828 1096828 FOOD SERVICES 458380 458380 INPATIENT EXPENSE 178688 178688 45169753 37347431 7822322 0 3571285 3850877 77 3495907 9258251 10573395 213182 464258 21667686 8996352 9191212 12671334 1666449 0 23900456 31055771 2447603 3957190 5416654 8485366 7864257 12442556 X 15913534 18613215 122665 0 16036199 18613215 23900456 31055771 2577016 0 X 1 X 0 0 1 1 X 7531536 7864538 6852336 8015951 9458178 39722539 7531536 7864538 6852336 8015951 9458178 39722539 39722539 31743 11043 921 5749 17967 67423 81393 263205 100314 102585 63600 611097 40401059 98173562 0.98320 0.98200 X 463582 463582 19575880 7528736 12047144 1628224 1467616 160608 12671334 X 47746769 0 47746769 0 47746769 45169753 0 45169753 0 45169753 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 2018 AND 2017. 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. X X X 0 0 0 0 0 0 0 0 0 CHARLES DANLEY CHIEF EXECUTIVE OFFICER 392817 0 0 0 0 0 18000 0 0 0 410817 0 0 0 LARRY SMITH CHIEF OPERATING OFFICER 375297 0 0 0 0 0 18000 0 0 0 393297 0 0 0 LISSA JAMES CLINICAL DIRECTOR 165119 0 0 0 0 0 9907 0 0 0 175026 0 0 0 DR JOHN MALLGREN MEDICAL DIRECTOR 297943 0 0 0 0 0 17877 0 0 0 315820 0 0 0 DONNA AULTZ CFO 156573 0 0 0 0 0 9394 0 0 0 165967 0 0 0 AMY HOGAN CLINICAL DIRECTOR 149162 0 0 0 0 0 8950 0 0 0 158112 0 0 0 RUTH HERLAN DIR. SUPPORT SVS 150230 0 0 0 0 0 9014 0 0 0 159244 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.