2011-12-05T08:31:19-06:00 2011-06-30 RINEY HANCOCK CPAS PSC 2900 VEACH ROAD SUITE 2 OWENSBORO KY 42303 990 2010-07-01 610668290 GREEN RIVER REGIONAL MENTAL HEALTH MENTAL RETARDATION BOARD INC GREE 2706896500 CIGAR FACTORY COMPLEX 1100 WALNUT ST OWENSBORO KY 42301 MIKE MOUNTAIN 2706896500 2011-11-17 1 SCOTT L CLAY CPA 2709264540 2010 2016-02-24 21:20:13Z GAYLE DICESARE 1100 WALNUT STREET OWENSBORO KY 42301 30972615 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. 17 17 291 2 0 0 12660031 10322972 19998723 20587228 16223 53615 125593 8800 32800570 30972615 0 0 0 0 9945641 8411935 0 0 0 19514613 18645487 29460254 27057422 3340316 3915193 17734106 21230503 6082153 5646948 11651953 15583555 TO PROVIDE PLANNING, COORDINATION AND DIRECT DELIVERY OF MENTAL HEALTH, SUBSTANCE ABUSE AND MENTAL RETARDATION SERVICES AT VARIOUS LOCATIONS. 0 0 25145131 20587228 PLANNING, COORDINATION, AND DIRECT DELIVERY OF MENTAL HEALTH, SUBSTANCE ABUSE, AND MENTAL RETARDATION SERVICES, PRIMARILY ON AN OUT-PATIENT BASIS. 25145131 1 1 0 0 0 0 0 0 0 1 0 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 0 1 69 0 1 291 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 17 17 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 0.50 X 0 0 0 KENNY RILEY 0.50 X 0 0 0 NOEL QUINN 0.50 X 0 0 0 PATTI ALLEN 0.50 X 0 0 0 RENONA BROWNING 0.50 X 0 0 0 DONNA BUMPUS 0.50 X 0 0 0 MYRA SPAULDING 0.50 X 0 0 0 KELLY EDMONDSON 0.50 X 0 0 0 GALENA FULKERSON 0.50 X 0 0 0 MARTHA HARDESTY 0.50 X 0 0 0 KRISTI HIGDON 0.50 X 0 0 0 LEANN HOWELL 0.50 X 0 0 0 PETRINA WEISS 0.50 X 0 0 0 CHRIS MCCLURE 0.50 X 0 0 0 BETH MITCHELL 0.50 X 0 0 0 LISA TAYLOR 0.50 X 0 0 0 JUDY WOOD 0.50 X 0 0 0 KEITH WELLS 0.50 X 0 0 0 REBECCA EDMONDSON 0.50 X 0 0 0 GAYLE DICESARE 40.00 X 0 264798 17420 MIKE MOUNTAIN 40.00 X 0 175260 10264 JAMES STEIN 40.00 X 0 102099 6105 0 542157 33789 0 0 1 0 ARAMARK SERVICES INC 1112 FLORENCE ST EVANSVILLE IN 47710 FOOD PREP/CLEANING SERVICES 1296075 MEDICAL STAFFING SOLUTIONS 1033 EAST MT PLEASANT ROAD STE A EVANSVILLE IN 47710 NURSING STAFF 383406 UNIVERSITY PSYCHIATRIC FOUNDATION INC PO BOX 3367 LOUISVILLE KY 40201 PSYCHIATRIC SERVICES 316338 JUNIUS H ROSE III MD PA 1309 HAWTHORNE ROAD WILMINGTON NC 28403 PSYCHIATRIC SERVICES 186825 7 BROADWAY PLACE LLC 2424 LOUISIANA BLVD NE SUITE 300 ALBUQUERQUE NM 87110 RENT 143941 12 10313603 9369 10322972 MEDICARE/MEDICAID PAYM 624100 16925487 16925487 PATIENT SERVICES 624100 2403429 2403429 MANAGEMENT SERVICES 624100 1233743 1233743 TENANT RENT 623000 24569 24569 20587228 6755 6755 8800 8800 8800 8800 46860 46860 46860 46860 30972615 20587228 0 62415 5662655 5096390 566265 745684 671116 74568 1652516 1487265 165251 351080 315972 35108 2458118 2212306 245812 208429 187586 20843 10261005 9997372 263633 119831 107847 11984 689191 620271 68920 223139 200825 22314 1077890 970100 107790 402599 362339 40260 63397 57058 6339 46290 41661 4629 380400 342360 38040 377333 339599 37734 SUPPLIES 1447063 1302357 144706 TAXES 280711 252640 28071 MEDICAID TAX ASSESSMENT 270220 270220 MISCELLANEOUS 117241 105517 11724 DUES AND SUBSCRIPTIONS 56491 50842 5649 166139 153488 12651 27057422 25145131 1912291 0 7107977 8351999 155936 156408 38733 69280 3590751 3614406 490204 595882 14330198 10281726 4290220 4048472 52502 93667 600 554 2007183 4299835 17734106 21230503 2979274 4432093 1454641 774499 1648238 440356 6082153 5646948 X 11651953 15583555 11651953 15583555 17734106 21230503 X 3915193 16409 X X 0 1 1 X 1 1 X 11184006 12375952 13036744 12660031 10322972 59579705 17448510 18917653 19861239 19998723 20587228 96813353 28632516 31293605 32897983 32658754 30910200 156393058 0 0 0 156393058 258211 218460 157126 141816 62415 838028 258211 218460 157126 141816 62415 838028 28890727 31512065 33055109 32800570 30972615 157231086 0.99470 0.99470 0.00530 0.00530 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 335913 335913 9315725 6359392 2956333 309173 217228 91945 3839612 3241743 597869 529775 463363 66412 4048472 RESERVE FOR REPLACEMENTS 158512 DUE FROM GREEN RIVER INDEPENDENT LIVING II, INC. 42879 DUE FROM GREEN RIVER INDEPENDENT LIVING III, INC. 47038 DUE FROM HENDERSON GROUP HOME, INC. 254505 DUE FROM ACUMEN COUNSELING SERVICES, INC. 956102 TENANT SECURITY DEPOSITS 2181 RESIDUAL RECEIPTS RESERVE 3584 TAX AND INSURANCE ESCROW 507 DUE FROM BEHAVIORAL HEALTH SERVICES, INC. 2834527 4299835 DUE TO CIGAR FACTORY COMPLEX, INCORPORATED 166965 DUE TO RIVERVALLEY CONSULTING SERVICES, INC. 271210 TENANT SECURITY DEPOSITS 2181 440356 30972615 27057422 3915193 16409 16409 3931602 41669992 16409 10680968 10697377 30972615 0 30972615 39795135 12737713 12737713 27057422 0 27057422 PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED ENTITIES' REVENUE PER CONSOLIDATED FINANCIAL STATEMENTS 22,943,572. ELIMINATIONS PER CONSOLIDATED FINANCIAL STATEMENTS -12,288,449. OTHER ADJUSTMENTS 25,845. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RELATED ENTITIES' EXPENSES PER CONSOLIDATED FINANCIAL STATEMENTS 25,000,317. ELIMINATIONS PER CONSOLIDATED FINANCIAL STATEMENTS -12,288,449. OTHER ADJUSTMENTS 25,845. 0 0 23212276 18814732 4397544 0.16280 23212276 18814732 4397544 0.16280 340011 0 340011 0.01260 55000 0 55000 0.00200 15000 0 15000 0.00060 410011 410011 0.01520 23622287 18814732 4807555 0.17800 0 39631 0 0 0 0 1 1 RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL

1000 INDUSTRIAL DRIVE OWENSBORO KY 42301

CHILDREN'S PSYCHIATRIC HOSPITAL RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL 1 0 0 0 0 0 0 0 1 X 1 X X X X 1 X 0 0 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 $ 39631. PART III, LINE 4: THE AGENCY DOES NOT DESCRIBE BAD DEBT EXPENSE IN THEIR FINANCIAL STATEMENTS. THE COSTING METHODOLOGY USED TO REPORT THE AMOUNTS ON LINES 2 AND 3 WAS THE RATIO DETERMINED FROM WORKSHEET 2. NO BAD DEBT EXPENSES WERE INCLUDED IN THE AMOUNTS LISTED AS COMMUNITY BENEFIT. RIVERVALLEY BEHAVIORAL HEALTH HOSPITAL PART V, SECTION B, LINE 19D: THE HOSPITAL USED THE MEDICAID RATE FOR INDIVIDUALS WHO DID NOT HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. PART VI, LINE 3: X 0 0 0 0 0 0 0 0 0 GAYLE DICESARE 0 264798 0 0 0 0 0 0 0 17420 0 282218 0 0 MIKE MOUNTAIN 0 175260 0 0 0 0 0 0 0 10264 0 185524 0 0 JAMES STEIN 0 102099 0 0 0 0 0 0 0 6105 0 108204 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 16,409. FORM 990, PART XI, LINE 2C: THE FINANCE COMMITTEE OF THE BOARD IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. ACUMEN COUNSELING SERVICES INC 1100 WALNUT STREET OWENSBORO KY 42301 611248638 COUNSELING SERVICES TO CHARITABLE ACTIVITIES OF RELATED ORGANIZATIONS KY 501(C)(3) 11C 0 BEHAVIORAL HEALTHCARE SERVICES INC 1100 WALNUT STREET OWENSBORO KY 42301 311563579 OFFERS RESIDENTIAL SERVICES TO MENTALLY RETARDED INDIVIDUALS KY 501(C)(3) 9 0 CIGAR FACTORY COMPLEX INCORPORATED 1100 WALNUT STREET OWENSBORO KY 42301 611303939 OWNS AND MANAGES PROPERTY FOR OTHER CHARITABLE ORGANIZATIONS KY 501(C)(2) 0 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 0 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 0 HENDERSON GROUP HOME INC 1100 WALNUT STREET OWENSBORO KY 42301 611171902 PROVIDE HOUSING & PERSONNAL CARE FOR PHYSICALLY AND/OR MENATLY HANDICAPPED KY 501(C)(3) 9 0 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 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 CIGAR FACTORY COMPLEX INCORPORATED J 522000 FMV - CASH TRANSACTIONS ACUMEN COUNSELING SERVICES INC L 7661514 FMV - CASH TRANSACTIONS RIVERVALLEY CONSULTING SERVICES INC L 1566043 FMV - CASH TRANSACTIONS