2011-10-05T14:16:09-05:00 2011-06-30 GILLIAM COBLE & MOSER LLP PO BOX 621 BURLINGTON NC 272160621 990 2010-07-01 383102731 PAVILLON INTERNATIONAL PAVI 8286258210 241 PAVILLON PLACE MILL SPRING NC 28756 ANNE VANCE 8286258210 2011-10-04 1 BERT DAVIS 3362276283 2010 2016-03-07 17:11:31Z ANNE VANCE 241 PAVILLON PLACE MILL SPRING NC 28756 10600266 0 X WWW.PAVILLON.ORG X 1993 MI TO PROVIDE TREATMENT EDUCATION AND RECOVERY SERVICES THAT ARE ACCESSIBLE, EFFECTIVE, AND PROMOTE HOPE IN RECOVERY FOR INDIVIDUALS, FAMILIES, AND COMMUNITIES AFFECTED BY SUBSTANCE-USE DISORDERS. 10 10 132 12 0 0 157477 427012 9193880 10071877 52900 35921 62493 24699 9466750 10559509 918974 828796 0 0 4825927 5870062 0 0 169273 3004819 2797495 8749720 9496353 717030 1063156 10494203 12101415 2717668 3261724 7776535 8839691 TO PROVIDE TREATMENT EDUCATION AND RECOVERY SERVICES THAT ARE ACCESSIBLE, EFFECTIVE, AND PROMOTE HOPE IN RECOVERY FOR INDIVIDUALS, FAMILIES, AND COMMUNITIES AFFECTED BY SUBSTANCE-USE DISORDERS. 0 0 4174159 8234947 PRIMARY RESIDENTIAL: PAVILLON IS EFFECTIVE IN THE FIELD OF TWELVE-STEP RESIDENTIAL TREATMENT, RESEARCH-BASED RECOVERY SERVICES AND EDUCATION FOR CHEMICAL DEPENDENCY AND RELATED DISORDERS. SOME KEY COMPONENTS OF THE PROGRAM CONSIST OF (1) THE TWELVE STEPS, (2) INDIVIDUAL BIO-PSYCHO-SOCIAL ASSESSMENTS, (3) MEDICAL CARE AND DETOXIFICATION, (4) SPECIALTY GROUPS & SERVICES, (5) INDIVIDUAL TREATMENT PLANNING, (6) A FAMILY PROGRAM, AND (7) CONTINUING CARE/CASE MANAGEMENT. BREAKING THE ADDICTION TO DRUGS AND ALCOHOL INVOLVES A DEEP COMMITMENT IN FOSTERING RECLAMATION TO A HEALTHY AND STABLE LIFE WHERE PATIENTS EMERGE WITH HOPE AND A DEEPER UNDERSTANDING OF THEMSELVES AND THE REQUIREMENTS FOR A SUSTAINED RECOVERY. 828652 1516773 EXTENDED CARE: THIS IS A PROFESSIONAL'S PROGRAM DESIGNED FOR ANY PROFESSIONAL CAUGHT UP IN ADDICTION'S COMPLEX WEB OF NEUROLOGICAL AND BEHAVORIAL SYMPTOMS. PAVILLON'S MULTI-DISCIPLINARY TEAM OF ADDICTION SPECIALISTS, PHYSICIANS, PSYCHIATRISTS, PSYCHOLOGISTS, AND THERAPISTS CONDUCTS DETAILED EVALUATIONS OF THE CLIENT'S PHYSICAL, PSYCHOLOGICAL AND SPIRITUAL HEALTH. KEY ELEMENTS OF THE PROGRAMS CONSIST OF (1) 12-STEP FACILITATION, (2) COGNITIVE AND RELAPSE PREVENTION THERAPIES, (3) RECOVERY FOCUSED EDUCATIONAL GROUPS, (4) SPIRITUAL GROWTH GROUPS, AND (5) FAMILY EDUCATION AND COUNSELING. 334413 341073 OUTPATIENT SERVICES: ALL PROGRAMS ARE DESIGNED TO ADDRESS PROBLEMS ASSOCIATED WITH CHEMICAL DEPENDENCIES AND, IF APPLICABLE, RELATED MENTAL HEALTH DISORDERS. THE GOAL IS TO HELP CLIENTS INTEGRATE A WORKABLE RECOVERY PROGRAM INTO DAILY LIFE BY COMBINING THE CONVENIENCE OF WEEKLY OUTPATIENT SERVICES WITH THE DEDICATED APPROACH NECESSARY TO ONGOING RECOVERY EFFORTS. FAMILIES ARE ALSO ENCOURAGED TO PARTICIPATE IN OUR OUTPATIENT PROGRAMS BY UTILIZING INDIVIDUAL AND FAMILY COUNSELING SESSIONS. 5337224 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 48 0 132 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 NC X X DAVID TRUSCOTT 8286942300 241 PAVILLON PLACE MILL SPRINGS NC 28756 ROBERT HAYES JR 2.00 X X 0 0 0 WILLIAM AUSTIN 2.00 X X 0 0 0 PETER BUDKO 2.00 X X 0 0 0 TOM COVINGTON 1.00 X 0 0 0 ROBERT GOODALE 1.00 X 0 0 0 OLSON HUFF 1.00 X 0 0 0 SCOTT MANSFIELD 1.00 X 0 0 0 PAT MARRIOTT 1.00 X 0 0 0 CHERYL KAYNARD 1.00 X 0 0 0 ROBERT TOOMEY 1.00 X 0 0 0 ANNE VANCE 40.00 X X 241890 0 53175 DAVID TRUSCOTT 40.00 X 90272 0 18665 SUSAN HOLMAN 40.00 X 187470 0 26998 JOHN ROBERTS 40.00 X 269858 0 14227 STEVE MILLETTE 40.00 X 120252 0 13208 LILIANE DESJARDINS X 50000 0 0 GILLES DESJARDINS X 50000 0 0 1009742 0 126273 4 1 1 0 COOPER CONSTRUCTION COMPANY PO BOX 806 HENDERSONVILLE NC 287930806 CONTRACTING 691531 BCBS OF NC PO BOX 30071 DURHAM NC 27702 INSURANCE 645759 SODEXO INC & AFFILIATES PO BOX 536922 ATLANTA GA 30353 FOOD SERVICE 232361 SYSCO FOOD SERVICE PO BOX 96 CONCORD NC NC 28026 FOOD SERVICE 182590 AMERICAN EXPRESS PO BOX 36001 FT LAUDERDALE FL 33336 CREDIT CARD 122069 7 427012 427012 PATIENT FEES 623990 10071877 10071877 10071877 35921 35921 61673 40757 20916 20916 FOOD, ALUMNI & RETREAT 900099 32817 32817 MISCELLANEOUS INCOME 900099 1743 1743 INSURANCE ADJUSTMENT 900099 -30777 -30777 3783 10559509 10092793 0 39704 828796 828796 902554 862154 40400 3828103 2089229 1628492 110382 127116 59660 62838 4618 610269 286419 301679 22171 402020 254714 138411 8895 15900 15900 41616 41616 485551 194701 279990 10860 41361 41361 169078 25088 138064 5926 245937 82003 163934 194263 40613 149120 4530 48699 1669 47030 133497 17980 115517 464448 71550 392898 66452 66452 FOOD SUPPLIES & SERVICE 355720 229704 125988 28 REPAIRS & MAINTENANCE 220259 55065 165194 SUPPLIES 219554 175402 42964 1188 PATIENT CARE 58418 58418 MISCELLANEOUS 20409 20409 16333 4059 11599 675 9496353 5337224 3989856 169273 2891779 3144006 283019 355672 101281 107338 165386 16319 13375 76871 113680 12389853 4189934 7105034 8199919 13843 8096 10494203 12101415 593983 596282 352079 516936 439255 414207 804358 1273016 527993 461283 2717668 3261724 X 7754442 8740844 22093 98847 7776535 8839691 10494203 12101415 1063156 0 X 0 1 1 X 0 X 101939 374408 109403 157477 427012 1170239 6120648 6113733 8060216 9243344 10133550 39671491 6222587 6488141 8169619 9400821 10560562 40841730 53900 60000 57650 91975 263525 0 53900 60000 57650 91975 263525 40578205 120638 34630 53965 52900 35921 298054 120638 34630 53965 52900 35921 298054 27057 46521 35182 45283 3783 157826 6370282 6569292 8258766 9499004 10600266 41297610 0.98260 0.98030 0.00720 0.00820 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 680399 680399 8979252 3158546 5820706 702879 494985 207894 2027323 536403 1490920 8199919 DEFERRED COMPENSATION OBLIGATION 461283 461283 10559509 9496353 1063156 0 1063156 10559509 0 10559509 0 10559509 9496353 0 9496353 0 9496353 1 FINANCIAL AID 143097 REDUCTION IN TOTAL FEE FUNDED FROM SCHOLARSHIP FUND. FULL SCHOLARSHIP 365002 FREE SERVICE PROVIDES & NOT FUNDED. TREATMENT DISCOUNTS 320697 REDUCE FEES CHARGED AND NOT FUNDED. X X X X 0 0 0 0 0 0 0 0 0 ANNE VANCE 241890 0 0 0 0 0 38500 0 14675 0 295065 0 246366 0 SUSAN HOLMAN 187470 0 0 0 0 0 20190 0 6808 0 214468 0 189653 0 JOHN ROBERTS 269858 0 0 0 0 0 9829 0 4398 0 284085 0 0 0 LILIANE DESJARDINS 50000 0 0 0 0 0 0 0 0 0 50000 0 50000 0 GILLES DESJARDINS 50000 0 0 0 0 0 0 0 0 0 50000 0 50000 0 DALE PATRICIA HOLL TO FINANCE THE EXTENDED CARE HOME X 475000 414207 0 1 1 414207 FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 WILL BE REVIEWED BY THE GOVERNING BOARD AT THEIR OCTOBER BOARD MEETING. ALL OUTSTANDING QUESTIONS WILL BE DISCUSSED AND RESOLVED BEFORE FILING THE FINAL FORM 990 TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C AS A RESULT OF CARF ACCREDITATION, A CORPORATE COMPLIANCE PROGRAM HAS BEEN ESTABLISHED PROVIDING TRAINING TO ALL EMPLOYEES REGARDING COMPLIANCE ISSUES, REPORTING AND INVESTIGATIONS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CEO IS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. THE COMPENSATION OF KEY EMPLOYEES ARE DETERMINED BY THE CEO. NO OTHER OFFICERS ARE COMPENSATED. THE PROCESS CONSISTS OF REVIEWING THE SALARY AND BENEFITS PROVIDED AT SIMILAR TREATMENT CENTERS' POSITIONS COUPLED WITH THE EXPERIENCE AND CREDENTIALS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE ON THE INTRANET FOR ALL EMPLOYEES. THE FORM 990 IS AVAILABLE TO THE PUBLIC, AS REQUESTED. PRIOR YEAR COMPENSATION SCHEDULE J, PART II, LINE 3, COLUMN F NO PRIOR YEAR COMPENSATION IS REPORTED FOR JOHN ROBERTS. HE WAS A NEW EMPLOYEE FOR THIS ORGANIZATION, WITH A HIRE DATE OF 1/7/2010. SINCE HE WAS NOT EMPLOYED BY THE ORGANIZATION IN THE PRIOR YEAR, HIS SALARY IS NOT DISCLOSED.