2016-12-21T10:49:43-06:00 2016-06-30 351178661 Blue & Co LLC 500 N Meridian St Suite 200 Indianapolis IN 46204 990 2015-07-01 351070041 OAKLAWN PSYCHIATRIC CENTER INC OAKL 5745331234 330 LAKEVIEW DR GOSHEN IN 46527 Laurie N Nafziger President and CEO 5745331234 2016-12-21 1 Amber Kocher CPA P01286298 3176334705 2016-12-21 2015 2017-02-10 21:41:12Z Laurie N Nafziger 330 LAKEVIEW DR GOSHEN IN 46527 55865756 0 X www.oaklawn.org X 1959 IN TREATING THE WHOLE PERSON - MIND, BODY AND SPIRIT - IN ELKHART AND ST. JOSEPH COUNTIES, INDIANA. 15 14 1168 72 0 0 11433699 12746222 41083110 42202847 154674 209992 538151 706499 53209634 55865560 97993 100096 0 0 38911578 40852082 0 0 86401 10166457 11603872 49176028 52556050 4033606 3309510 36504677 41138593 18157765 19536830 18346912 21601763 WITH UNCOMMON EXPERTISE IN MENTAL HEALTH AND ADDICTIONS SERVICES, OAKLAWN JOINS WITH INDIVIDUALS, FAMILIES, AND OUR COMMUNITY ON THE JOURNEY TOWARD HEALTH AND WHOLENESS. 0 0 28491652 0 27528621 OUTPATIENT Services - PROVIDED OVER 115,211 CLIENT SERVICE ENCOUNTERS OF GROUP THERAPY, MEDICATION MANAGEMENT, AND INDIVIDUAL THERAPY; PROVIDED 84,011 CLIENT SERVICE ENCOUNTERS OF CARE COORDINATION; PROVIDED 77,396 CLIENT SERVICE ENCOUNTERS OF SKILLS BUILDING IN PERSONAL CARE AND COMMUNITY LIVING; AND PROVIDED AN ADDITIONAL 35,831 ENCOUNTERS OF OTHER COMMUNITY-BASED SERVICES. IN SUMMARY, A TOTAL OF 16,853 CONSUMERS WERE SERVED IN THE FISCAL YEAR. 13076139 100096 11552816 RESIDENTIAL SERVICES - IN ADDITION TO THE BEHAVIORAL HEALTH SERVICES FOR THIS POPULATION, THE ORGANIZATION PROVIDED 33,835 DAYS OF CHILD & ADOLESCENT RESIDENTIAL CARE AND 8,371 DAYS OF THERAPEUTIC FOSTER CARE. ADDITIONALLY, ADULTS LIVING IN SUPERVISED GROUP LIVING ARRANGEMENTS ARE PROVIDED RESIDENTIAL SUPPORT SERVICES ALONG WITH THE NECESSARY PSYCHIATRIC AND SUBSTANCE ABUSE SERVICES. A TOTAL OF 33,226 DAYS WERE PROVIDED TO THIS SEGMENT OF THE ADULT POPULATION. 3589489 0 3826682 INPATIENT SERVICES - PROVIDED 5,046 INPATIENT DAYS OF PSYCHIATRIC AND SUBSTANCE ABUSE STABILIZATION. 45157280 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 50 0 1 1168 1 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X Joseph Barkman 5745331234 330 Lakeview Dr Goshen IN 46528 Randall Cammenga MD Board Chair 0.50 0.00 X X 0 0 0 Kay Evans Ball Board Secretary 0.50 0.00 X X 0 0 0 Robert Shreiner Board Treasurer 0.50 0.00 X X 0 0 0 Terri Burks board member 0.30 0.00 X 0 0 0 Jay Caponigro Board Member 0.30 0.00 X 0 0 0 Janilyn Daub Board Member 0.30 0.00 X 0 0 0 Rod Diller Board member 0.30 0.00 X 0 0 0 Jim Dubois board member 0.30 0.00 X 0 0 0 Carol Ebersole board member 0.30 0.00 X 0 0 0 Marion Fulce board member 0.30 0.00 X 0 0 0 Chris Karam Board member 0.30 0.00 X 0 0 0 Darryl Riegsecker board member 0.30 0.00 X 0 0 0 Bradley Rogers board member 0.30 0.00 X 0 0 0 Beverly Teegarden board member 0.30 0.00 X 0 0 0 Phil Wiens board member 0.30 0.00 X 0 0 0 LAURIE NAFZIGER President/CEO 40.00 1.00 X 236706 0 43219 Joseph Barkman CFO 40.00 1.00 X 107553 0 23248 Gregg Nussbaum Vice President 40.00 0.00 X 89741 0 22623 DANIEL KINSEY MD Medical Director 40.00 0.00 X 277275 0 50774 Elisa Bell MD psychiatrist 40.00 0.00 X 240302 0 45637 Timothy McFadden MD psychiatrist 40.00 0.00 X 234358 0 47168 Michael Platt MD psychiatrist 40.00 0.00 X 234631 0 46048 Nicholas Kramer Psychiatrist 40.00 0.00 X 233664 0 38020 1654230 0 316737 25 0 1 0 Golden Technologies 2402 Beech Street Valparaiso IN 46383 IT Equip/Support 811178 Qualifacts Systems Inc 200 2nd Ave South Nashville TN 37201 EHR Services 434026 Herrman & Goetz 225 S Lafayette Blvd South Bend IN 46527 HVAC Services 363190 American Bergen Drug Corp 25199 Network Place Chicago IL 60673 Healthcare Consulting 329570 Enterprise Fleet Management PO Box 800089 Kansas City MO 64180 Auto Fleet Services 242961 11 576555 11890509 279158 12746222 Net Patient Service Revenue 900099 39205860 39205860 Government Funding 900099 2489004 2489004 Outpatient Clinic Services 900099 507983 507983 42202847 208263 208263 303210 0 303210 303210 303210 1925 196 1729 1729 1729 Other Revenue 900099 205289 204062 1227 Meaningful Use Revenue 900099 198000 198000 403289 55865560 42908119 0 211219 100096 100096 523088 523088 32703969 30127187 2523017 53765 347089 314284 32234 571 4987018 4515673 463146 8199 2290918 2074393 212759 3766 3948625 2423461 1505064 20100 50355 44488 5867 1052597 929960 122637 1574504 509431 1065073 636978 562765 74213 391443 345837 45606 295324 295324 1148184 1014411 133773 574728 507767 66961 Food Supplies 617398 508511 108887 Hospital Assessment Fee 549864 549864 Medication Supplies 382108 314718 67390 Patient Care Supplies 177017 145798 31219 204747 168636 36111 52556050 45157280 7312369 86401 5870 5664 9965893 11366391 3946714 3814616 3013637 3016804 352680 404232 31548461 19317326 11535993 12231135 6739466 8870688 944424 1429063 36504677 41138593 4093751 5360306 20563 11073 261539 970804 10122500 9647500 2518638 2177450 1140774 1369697 18157765 19536830 X 18346912 21601763 18346912 21601763 36504677 41138593 X 3309510 -80045 25386 X X 0 1 X 1 1 1 X 7846524 7713575 7671940 7595571 9523049 40350659 31433807 32160600 38424568 41331074 42604909 185954958 2928819 3061768 3103403 3179772 3223173 15496935 42209150 42935943 49199911 52106417 55351131 241802552 0 460744 1512581 1670802 1613505 5257632 460744 1512581 1670802 1613505 5257632 236544920 18632 311615 695517 443073 513398 1982235 18632 311615 695517 443073 513398 1982235 32069 1061 1788 1227 36145 42227782 43279627 49896489 52551278 55865756 243820932 0.97020 0.00810 X Part I, Line 3 OAKLAWN PSYCHIATRIC CENTER, INC. (THE "CENTER") HAS BEEN DETERMINED BY THE IRS TO BE A PUBLIC CHARITY UNDER IRS CODE SECTION 170(B)(1)(A)(III). PER SCHEDULE H INSTRUCTIONS, ONLY ORGANIZATIONS THAT OPERATE AT LEAST ONE FACILITY THAT IS, OR IS REQUIRED TO BE, LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED BY THE STATE AS A HOSPITAL IS REQUIRED TO COMPLETE SCHEDULE H. THE CENTER PROVIDES MENTAL HEALTH SERVICES FOR CHILDREN, ADULTS, AND SENIORS; IS ACCREDITED BY THE JOINT COMMISSION AS A BEHAVIORAL HEALTH CARE CENTER; AND IS CERTIFIED BY THE INDIANA FAMILY AND SOCIAL SERVICES ADMINISTRATION THROUGH THE DIVISION OF MENTAL HEALTH AND ADDICTION (DMHA). THE CENTER IS NOT LICENSED AS A HOSPITAL IN THE STATE OF INDIANA, BUT IS LICENSED AS A FREE-STANDING PSYCHIATRIC INPATIENT TREATMENT FACILITY UNDER INDIANA ADMINISTRATIVE CODE 440 ARTICLE 1.5 THROUGH THE DMHA. Part I, line 9; Part III, line 16 and 18 OAKLAWN PSYCHIATRIC CENTER, INC. (THE "CENTER") HAS changed its reason for public charity status from Line 3 Hospital to an organization that normally receives more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions with no more than 33 1/3% of its support from gross investment income and unrelated business taxable income. The Center is in the process of updating its official public charity status with the IRS for fiscal year 2017. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2130 2130 0 Part II-B, Line 1: A PORTION OF MEMBERSHIP DUES PAID TO INDIANA COUNCIL OF COMMUNITY MENTAL HEALTH CENTERS (ICCMHC) AND INDIANA ASSOCIATION OF RESIDENTIAL CHILD CARE AGENCIES (IARCCA) WERE ATTRIBUTED TO LOBBYING EXPENSES. 855638 855638 19066364 9724451 9341913 11626459 9592875 2033584 12231135 Fixed Income Bonds 8870688 F 8870688 Client Held Funds 47823 Est. Third-Party Payor Settlem 1073478 Other Current Liabilities 23910 Bond Interest Swap 224486 1369697 X Part X, Line 2: FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 superseded by FASB codification ASC 740: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY OPC AND AFFILIATES AND RECOGNIZE A TAX LIABILITY IF OPC AND AFFILIATES 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 OPC AND AFFILIATES, AND HAS CONCLUDED THAT AS OF JUNE 30, 2016 AND 2015, 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. OPC AND AFFILIATES ARE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 1 Assistance to individuals and families for various needs through resident 305 100096 X X X X 0 0 0 0 0 0 0 0 0 LAURIE NAFZIGER President/CEO 229975 0 0 0 6731 0 6831 0 36388 0 279925 0 0 0 DANIEL KINSEY MD Medical Director 236797 0 39856 0 622 0 7216 0 43558 0 328049 0 0 0 Elisa Bell MD psychiatrist 240302 0 0 0 0 0 7289 0 38348 0 285939 0 0 0 Timothy McFadden MD psychiatrist 204782 0 29576 0 0 0 6259 0 40909 0 281526 0 0 0 Michael Platt MD psychiatrist 199129 0 35502 0 0 0 6148 0 39900 0 280679 0 0 0 Nicholas Kramer Psychiatrist 199625 0 34039 0 0 0 4893 0 33127 0 271684 0 0 0 A HOSPITAL AUTHORITY OF ELKHART COUNTY INDIANA 351657690 2013-12-04 10805000 See Part VI 0 0 0 A 10805000 10805000 2013 1 0 1 1 A 0 1 1 1 0 0 0 1 A 0 1 0 0 1 1 Fifth Third Bank 5.000000000000 0 0 0 0 1 A 1 Part I, Bond Issue, Row A, Column F Description of Purpose: The issue was to refinance previously issued "Adjustable Rate Demand Revenue Refunding and Improvement Bonds, Series 2006". EVERENCE See Part V below 6188145 See Part V 0 Schedule L, Part IV, Business Transactions involving interested persons: (A) NAME OF INTERESTED PERSON: Everence(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: The SENIOR VICE PRESIDENT of Everence, Rodney Diller, is a current BOARD MEMBER FOR OAKLAWN PSYCHIATRIC CENTER, Inc.(C) AMOUNT OF TRANSACTION: $6,188,145(D) DESCRIPTION OF TRANSACTION: Everence administers the employee health insurance plan for Oaklawn Psychiatric Center, Inc. and is the investment advisor for its 403B retirement plan. Transaction amount is for insurance premiums paid. Form 990, Part I, Line 6, Volunteers: IN ADDITION TO ALL VOLUNTEER BOARD OF DIRECTORS, THE ORGANIZATION IS SUPPORTED BY MORE THAN 72 ACTIVE VOLUNTEERS WHO SERVE IN A VARIETY OF SUPPORT SERVICES. DURING THE FISCAL YEAR OVER 2,500 HOURS OF SERVICE WERE GIVEN BY THESE VOLUNTEERS. FOrm 990, Part IV, Line 20a, hospital facility: OAKLAWN PSYCHIATRIC CENTER, INC. (THE "CENTER") PROVIDES MENTAL HEALTH SERVICES FOR CHILDREN, ADULTS, AND SENIORS; AND, IS A FREE-STANDING PSYCHIATRIC INPATIENT TREATMENT FACILITY UNDER INDIANA ADMINISTRATIVE CODE 440 ARTICLE 1.5. THE CENTER IS LICENSED THROUGH THE INDIANA FAMILY AND SOCIAL SERVICES ADMINISTRATION THROUGH THE DIVISION OF MENTAL HEALTH AND ADDICTION (DMHA). THE IRS GRANTED THE CENTER PUBLIC CHARITY STATUS UNDER IRS CODE SECTION 170(B)(1)(A)(III). PER SCHEDULE H INSTRUCTIONS, ONLY ORGANIZATIONS THAT OPERATE AT LEAST ONE FACILITY THAT IS, OR IS REQUIRED TO BE, LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED BY THE STATE AS A HOSPITAL IS REQUIRED TO COMPLETE SCHEDULE H. THE CENTER IS NOT LICENSED AS A HOSPITAL IN THE STATE OF INDIANA, THEREFORE, THE CENTER IS NOT REQUIRED TO COMPLETE SCHEDULE H. Form 990, Part VI, Section A, line 1 Delegated Authority: PER the BYLAWS, THE EXECUTIVE COMMITTEE OF THE BOARD IS AUTHORIZED TO ACT ON THE FULL BOARD'S BEHALF. THE FULL BOARD MEETS QUARTERLY AND THE EXECUTIVE COMMITTEE GENERALLY MEETS AN ADDITIONAL FOUR TIMES ON ALTERNATE MONTHS. Form 990, Part VI, Section A, line 7a ELECTION OF MEMBERS: VOTING MEMBERS ARE SELECTED BY THE SPONSORING ORGANIZATION, MENNONITE HEALTH SERVICES ALLIANCE, AS PROVIDED IN THE BY-LAWS AND ARTICLES OF INCORPORATION OF OAKLAWN PSYCHIATRIC CENTER, INC. BOARD MEMBERS APPOINTED BY MENNONITE HEALTH SERVICES ALLIANCE ARE THE SOLE MEMBERS OF THE BOARD OF DIRECTORS. Form 990, Part VI, Section B, line 11 FORM 990 REVIEW PROCESS: THE PROCESS OF REVIEWING THE FORM 990 INCLUDES A DETAILED REVIEW BY THE ORGANIZATION'S SENIOR MANAGEMENT AND CHIEF EXECUTIVE OFFICER. THE GOVERNING BODY RECEIVES A COPY OF THE FORM 990 INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, FOR REVIEW AND APPROVAL PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Section B, line 12c Conflict of Interest Compliance: The organization regularly and consistently monitors and enforces compliance with its conflict of interest policy. Oaklawn staff, Board members, volunteers and agents shall exercise the utmost good faith in all transactions touching upon their duty to Oaklawn and its property, and shall fully disclose any conflict of interest. Annually, Board members sign that they will abide by the policy and declare any conflict of interest they may have with the organization or its related organizations, and abstain from any voting where a conflict could exist. Form 990, Part VI, Section B, line 15 PROCESS OF DETERMINING COMPENSATION: TOP OFFICIAL: THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION PACKAGE PROVIDED TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION. THE COMPENSATION REVIEW INCLUDES A MARKET ANALYSIS STUDY AND A PERFORMANCE REVIEW. THIS PROCESS IS DOCUMENTED IN THE BOARD MINUTES. OTHER OFFICERS: THE ORGANIZATION ANNUALLY PARTICIPATES IN SEVERAL MARKET SURVEYS. MANAGEMENT COMPARES COMPENSATION LEVELS OF LIKE POSITIONS AND STRIVES TO ADJUST THE ORGANIZATION'S COMPENSATION PACKAGES FOR LIKE POSITIONS TO FALL WITHIN THE RANGE OF THE MARKET WITH A GOAL TO BE COMPETITIVELY PLACED BETWEEN THE 50TH AND 75TH PERCENTILE OF THE MARKET RANGE. THIS PROCESS IS DOCUMENTED IN THE BOARD MINUTES. Form 990, Part VI, Section C, line 19 DOCUMENTS AVAILABLE TO THE PUBLIC: COPIES OF THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED FOR REVIEW UPON REQUEST. IN ADDITION, THE ORGANIZATION IS ACCREDITED BY THE JOINT COMMISSION; MEETING THE REQUIREMENTS FOR THE BEHAVIORAL HEALTH CARE ACCREDITATION PROCESS. ALSO, THE ORGANIZATION IS CERTIFIED BY THE STATE OF INDIANA FAMILY AND SOCIAL SERVICES ADMINISTRATION, DIVISION OF MENTAL HEALTH AND ADDICTIONS, AS AN INDIANA COMMUNITY MENTAL HEALTH CENTER (CMHC). ACCORDINGLY, GOVERNING DOCUMENTS ARE REVIEWED AND REGULARLY PROVIDED TO THESE AND OTHER PUBLIC BODIES. Form 990, Part XI, line 9: change in derivative 25,386. Form 990, Part XII, Line 2c, Oversight of Audit: THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR. Mennonite Health Services 1112 N Main Street Goshen IN 46528 231421919 Health and Human Service Ministries IN 501(c)(3) Line 9 N/A 0 Oaklawn foundation for Mental Health po Box 809 goshen IN 46527 356060037 fundraising/Mental Health Promotion IN 501(c)(3) Line 7 OPC 1 OAKLAWN CMHC 330 Lakeview Dr PO Box 809 goshen IN 46527 237317957 healthcare IN 501(c)(3) Line 7 OPC 1 Simadon Corporation po Box 809 goshen IN 46527 208473080 huD Housing IN 501(c)(3) Line 7 oPC 1 MADISON RESIDENTIAL SERVICES INC Po Box 809 goshen IN 46527 311135587 huD Housing IN 501(c)(3) Line 7 oPC 1 Riverside Corporation PO Box 809 Goshen IN 46527 351875879 huD Housing IN 501(c)(3) Line 7 opC 1 Oaklawn Estates Apartments Inc PO Box 809 goshen IN 46527 383646840 huD Housing IN 501(c)(3) Line 7 opC 1 Oaklawn Apartments Inc PO Box 809 Goshen IN 46527 311009857 HuD Housing IN 501(c)(3) Line 7 opc 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 Oaklawn Foundation for Mental Health C 576555 Fair market value