2017-01-24T14:15:58-06:00 2016-06-30 610920132 RINEY HANCOCK CPAS PSC 2900 VEACH ROAD SUITE 2 OWENSBORO KY 42303 990 2015-07-01 610668290 GREEN RIVER REGIONAL MENTAL HEALTH MENTAL RETARDATION BOARD INC GREE 2706896500 1100 WALNUT ST OWENSBORO KY 42301 MIKE MOUNTAIN CFO 2706896500 2017-01-24 1 SCOTT L CLAY CPA P00114132 2709264540 2015 2021-01-29 14:40:06Z GAYLE DICESARE 1100 WALNUT STREET OWENSBORO KY 42301 48392549 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. 10 10 189 0 0 0 10980257 10797663 33381554 32081014 400341 176943 9600 9600 44771752 43065220 0 0 0 0 20924518 22371327 0 0 0 16355754 17704259 37280272 40075586 7491480 2989634 36673355 40006967 6447910 6652831 30225445 33354136 TO PROVIDE PLANNING, COORDINATION AND DIRECT DELIVERY OF MENTAL HEALTH, SUBSTANCE ABUSE AND MENTAL RETARDATION SERVICES AT VARIOUS LOCATIONS. 0 0 36098494 32081014 PLANNING, COORDINATION, AND DIRECT DELIVERY OF MENTAL HEALTH, SUBSTANCE ABUSE, AND MENTAL RETARDATION SERVICES, PRIMARILY ON AN OUT-PATIENT BASIS. 36098494 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 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 46 0 1 189 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 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 RICK COX CHAIRMAN 0.50 X 0 0 0 REBECCA EDMONDSON SECRETARY/TREASURER 0.50 X 0 0 0 DR RANDALL CAPPS DIRECTOR 0.50 X 0 0 0 MARTHA HARDESTY DIRECTOR 0.50 X 0 0 0 JEFF JONES DIRECTOR 0.50 X 0 0 0 GALENA FULKERSON DIRECTOR 0.50 X 0 0 0 KENNY RILEY DIRECTOR 0.50 X 0 0 0 MYRA SPAULDING DIRECTOR 0.50 X 0 0 0 LINDA TONGATE DIRECTOR 0.50 X 0 0 0 KEITH WELLS DIRECTOR 0.50 X 0 0 0 GAYLE DICESARE CEO 40.00 X 0 243057 23360 MIKE MOUNTAIN CFO 40.00 X 0 145673 12606 WARREN MILTEER EMPLOYEE 40.00 X 209022 0 98724 VITALKUMAR SHAH EMPLOYEE 40.00 X 334634 0 130299 543656 388730 264989 2 0 1 0 ARAMARK SERVICES INC PO BOX 651009 CHARLOTTE NC 282651009 FOOD PREP/JANITORIAL SERVICES 1021281 STATE AUTO INSURANCE COMPANY PO BOX 182738 COLUMBUS OH 432182738 WORKMANS COMP INSURANCE 397178 UNIVERSITY OF LOUISVILLE 401 EAST CHESTNUT ST SUITE 600 LOUISVILLE KY 40202 PSYCH SERVICES 325500 DANHAUER DRUGS 330 FREDERICA ST OWENSBORO KY 42301 PHARMACY 228330 KENTUCKY HOPSITAL INSURANCE CO PO BOX 436629 LOUISVILLE KY 402536629 COMPANY LIABILITY INSURANCE 222808 13 10797663 10797663 PATIENT SERVICES 624100 26990444 26990444 MEDICARE/MEDICAID PAYMENTS 624100 3997271 3997271 MANAGEMENT SERVICES 624100 1062567 1062567 TENANT RENT 623000 30732 30732 32081014 309336 309336 9600 0 9600 9600 9600 5194936 5327329 -132393 -132393 -132393 43065220 32081014 0 186543 X 17213057 15491751 1721306 1971017 1773915 197102 2051652 1846487 205165 1135601 1022040 113561 2424670 2182203 242467 289987 260988 28999 57702 57702 9604046 8643640 960406 21992 19793 2199 598542 538688 59854 222417 200175 22242 1065729 959156 106573 390689 351620 39069 81596 73436 8160 16580 14922 1658 286339 257705 28634 350352 315316 35036 SUPPLIES 1096760 987084 109676 BAD DEBTS 542654 542654 0 MEDICAID TAX ASSESSMENT 281248 281248 0 DUES AND SUBSCRIPTIONS 121474 109327 12147 251482 226346 25136 40075586 36098494 3977092 0 2378994 6245803 157348 157506 10744245 5381437 338949 290268 14018146 11292205 2968925 2725941 7858292 11422231 369 323 12226233 13783458 36673355 40006967 5457228 5781287 635385 537027 355297 334517 6447910 6652831 X 30225445 33354136 30225445 33354136 36673355 40006967 2989634 139057 0 X X 0 1 X 1 1 1 X 12004499 12157984 11396400 10980257 10797663 57336803 25434344 23022853 24942031 33381554 32081014 138861796 37438843 35180837 36338431 44361811 42878677 196198599 0 0 0 196198599 15707 21260 133283 250930 318936 740116 15707 21260 133283 250930 318936 740116 37454550 35202097 36471714 44612741 43197613 196938715 0.99620 0.99740 0.00380 0.00260 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 335913 335913 9505911 7347505 2158406 264110 236092 28018 3472662 3284225 188437 439550 424383 15167 2725941 INVESTMENTS - MARKETABLE SECURITIES 11017324 F INVESTMENTS - 457B DEFERRED COMP CONTRIBUTION 404907 F 11422231 RESERVE FOR REPLACEMENTS 221948 DUE FROM GREEN RIVER INDEPENDENT LIVING II, INC. 167212 DUE FROM GREEN RIVER INDEPENDENT LIVING III, INC. 50701 DUE FROM ACUMEN COUNSELING SERVICES, INC. 778772 TENANT SECURITY DEPOSITS 2304 RESIDUAL RECEIPTS RESERVE 3014 TAX AND INSURANCE ESCROW 449 DUE FROM BEHAVIORAL HEALTH SERVICES, INC. 11441929 DUE FROM CIGAR FACTORY COMPLEX, INC. 447517 LONG-TERM PREPAID EXPENSES 669612 13783458 DUE TO RIVERVALLEY CONSULTING SERVICES, INC. 326254 TENANT SECURITY DEPOSITS 2304 DUE TO HENDERSON GROUP HOME, INC. 5959 334517 42134763 139057 10948707 11087764 31046999 12018221 12018221 43065220 39655984 11883066 11883066 27772918 12302668 12302668 40075586 PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED ENTITIES' REVENUE PER CONSOLIDATED FINANCIAL STATEMENTS 23,273,911. ELIMINATIONS PER CONSOLIDATED FINANCIAL STATEMENTS -11,766,426. OTHER INTERCOMPANY ADJUSTMENTS 41,669. TAXES NETTED AGAINST REVENUE PER AUDITED STATEMENTS -57,793. BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDITED STATEMENTS -542,654. PART XI, LINE 4B - OTHER ADJUSTMENTS: MICHELLE P. WAIVER REVENUES REPORTED NET OF EXPENSES PER AUDITED STATEMENTS 11,702,221. INVESTMENT RETURNS 316,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED ENTITIES' EXPENSES PER CONSOLIDATED FINANCIAL STATEMENTS 23,607,823. ELIMINATIONS PER CONSOLIDATED FINANCIAL STATEMENTS -11,766,426. OTHER INTERCOMPANY ADJUSTMENTS 41,669. PART XII, LINE 4B - OTHER ADJUSTMENTS: MICHELLE P. WAIVER REVENUES REPORTED NET OF EXPENSES PER AUDITED STATEMENTS 11,702,221. TAXES NETTED AGAINST REVENUE PER AUDITED STATEMENTS 57,793. BAD DEBT EXPENSE NETTED AGAINST REVENUE PER AUDITED STATEMENTS 542,654. 0 0 29833166 26604392 3228774 0.08170 29833166 26604392 3228774 0.08170 355391 0 355391 0.00900 80000 0 80000 0.00200 15000 0 15000 0.00040 450391 450391 0.01140 30283557 26604392 3679165 0.09310 0 542654 0 1 1 RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL 1000 INDUSTRIAL DRIVE OWENSBORO KY 42301 X CHILDREN'S PSYCHIATRIC HOSPITAL RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL 1 1 0 0 0 0 0 0 0 1 X 1 X X 1 X 0 0 RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL PART V, SECTION B, LINE 20E: 1. PROVIDED A WRITTEN NOTICE ABOUT UPCOMING ECAS (EXTRAORDINARY COLLECTION ACTION) AND A PLAIN LANGUAGE SUMMARY OF THE FAP AT LEAST 30 DAYS BEFORE INITIATING THOSE ECAS.2. MADE A REASONABLE EFFORT TO ORALLY NOTIFY INDIVIDUALS ABOUT THE FAP AND FAP APPLICATION PROCESS.3. PROCESSED INCOMPLETE AND COMPLETE FAP APPLICATIONS. RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL PART V, SECTION B, LINE 22D: THE HOSPITAL USED THE MEDICAID RATE FOR INDIVIDUALS WHO DID NOT HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 542,654. PART III, LINE 4: THE FOOTNOTES TO THE ORGANIZATION'S MOST RECENTLY AUDITED FINANCIAL STATEMENTS INCLUDE ON PAGE 9 AN EXPLANATION OF THE ORGANIZATION'S SIGNIFICANT ACCOUNTING POLICIES FOR RECORDING BAD DEBTS.THE COSTING METHODOLOGY USED TO REPORT THE AMOUNTS IN PART III, LINES 2 AND 3, WAS THE RATIO DETERMINED FROM WORKSHEET 2. NO BAD DEBT EXPENSES WERE INCLUDED IN THE AMOUNTS LISTED AS COMMUNITY BENEFIT. X 0 0 0 0 0 0 0 0 0 GAYLE DICESARE CEO 0 243057 0 0 0 0 0 0 0 23360 0 266417 0 0 MIKE MOUNTAIN CFO 0 145673 0 0 0 0 0 0 0 12606 0 158279 0 0 WARREN MILTEER EMPLOYEE 209022 0 0 0 0 0 0 0 98724 0 307746 0 0 0 VITALKUMAR SHAH EMPLOYEE 334634 0 0 0 0 0 0 0 130299 0 464933 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 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 4,493. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,493. PSYCHIATRIC CONSULTING: PROGRAM SERVICE EXPENSES 636,622. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 636,622. OTHER FEES: PROGRAM SERVICE EXPENSES 8,002,525. MANAGEMENT AND GENERAL EXPENSES 960,406. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,962,931. 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) 11C 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) 9 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) 9 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) 9 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) 9 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) 11B GREEN RIVER REGIONAL MHMR BOARD 1 EFFEXAS INC 1100 WALNUT STREET OWENSBORO KY 42301 271506915 SOFTWARE DEVELOPMENT KY BEHAVIORAL HEALTHCARE SERVICES INC C 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 CIGAR FACTORY COMPLEX INCORPORATED K 522000 FMV - CASH TRANSACTIONS ACUMEN COUNSELING SERVICES INC M 7315557 FMV - CASH TRANSACTIONS RIVERVALLEY CONSULTING SERVICES INC M 1626043 FMV - CASH TRANSACTIONS