2025-03-20T14:14:03-05:00 2024-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2023-07-01 351362298 FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER INC FOUR 5747225151 401 E 8TH STREET ROCHESTER IN 46975 CARRIE CADWELL CEO 5747225151 2025-03-20 1 1 TYLER K GREENE CPA P00057872 3176334705 2025-03-20 2023 2025-03-06 01:10:19Z 4C HEALTH CARRIE CADWELL 401 E 8TH STREET ROCHESTER IN 46975 35517456 0 X WWW.4CHEALTHIN.ORG X 1975 IN TO PROVIDE QUALITY MENTAL HEALTH CARE 8 8 645 8 0 0 4756500 5996234 30078366 27815411 194727 1225339 391382 267108 35420975 35304092 69453 83801 0 0 23149955 24209332 0 0 0 6295911 6071057 29515319 30364190 5905656 4939902 56624406 61060373 5225152 4334885 51399254 56725488 X DEDICATED TO HOLISTIC CARE GIVEN WITH COMPASSION, RESPECT, ACCEPTANCE AND HOPE. ACHIEVING EMOTIONAL WELL BEING AND INDEPENDENCE. 0 0 23837405 83801 28079814 THE CENTER PROVIDES COMPREHENSIVE MENTAL HEALTH SERVICES TO THE RESIDENTS OF CARROLL, CASS, CLINTON, FULTON, MIAMI, PULASKI, HOWARD, TIPTON, & WHITE COUNTIES ON BOTH AN INPATIENT AND OUTPATIENT BASIS. CARE IS PROVIDED TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS NET SERVICE REVENUE. THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THE CENTER'S CHARITY CARE POLICY IS $113,680 IN 2024. THE AMOUNT INCLUDES REDUCTIONS IN FEES BASED ON THE CLIENT'S ABILITY TO PAY AND CLIENT SERVICES PERFORMED FREE OF CHARGE. PLEASE CONTACT THE COMMUNITY RELATIONS DEPARTMENT FOR ADDITIONAL DETAILS RELATED TO THE CENTER'S EXEMPT PURPOSE.THE MED CLINIC ASSISTS IN MAINTAINING OUTPATIENT CLIENTS PSYCHIATRIC SYMPTOMS WITH THE LOWEST POSSIBLE DOSE OF MEDICATION AND THE LEAST AMOUNT OF SIDE EFFECTS WHILE OBTAINING AN OPTIMAL LEVEL OF FUNCTIONING. ALL OUTPATIENT CANDIDATES FOR MEDICATION INTERVENTION WILL BE EVALUATED PER STAFF PSYCHIATRIST/APN AND ENCOURAGED TO FOLLOW ALL TREATMENT RECOMMENDATIONS AS PRESCRIBED WITH THE ASSISTANCE OF THE MEDICATION CLINIC RN. 23837405 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 42 0 1 645 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 1 0 0 0 0 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 IN X DIANA ELLIOTT DIRECTOR OF ACCOUNTING AND HUMAN RESOURCES 5747322410 2355 S BUSINESS 31 PERU IN 46970 DEAN MCCURDY PRESIDENT 2.00 0.00 X X 0 0 0 KEITH KOLB PAST PRESIDENT 2.00 0.00 X X 0 0 0 JASON SEE SECRETARY/TREASURER 2.00 0.00 X X 0 0 0 LYNNE NESS PRESIDENT ELECT 2.00 0.00 X X 0 0 0 GLORIA CALHOUN BOARD MEMBER 2.00 0.00 X 0 0 0 MARY KAY BOARD MEMBER 2.00 0.00 X 0 0 0 TARA MCVAY BOARD MEMBER 2.00 0.00 X 0 0 0 LINDA WEBB BOARD MEMBER 2.00 0.00 X 0 0 0 CARRIE CADWELL CEO 40.00 0.00 X 457785 0 53022 JASON CADWELL CFO/CAO 40.00 0.00 X 389128 0 13531 KATHLEEN MILLER CHIEF MEDICAL OFFICER 40.00 0.00 X 457494 0 45785 NICOLE HIATT-DRANG CHIEF CLINICAL OFFICER 40.00 0.00 X 187356 0 9657 ANDREW HARTLEY CHIEF OPERATING OFFICER 40.00 0.00 X 221497 0 11071 LISA WILLIS-GIDLEY VP OF OPERATIONS 40.00 0.00 X 173984 0 31509 HOPE KERNS COMPLIANCE OFFICER/DIRECTOR OF QUALITY 40.00 0.00 X 146026 0 39768 DIANA ELLIOTT DIRECTOR OF ACCOUNTING & HUMAN RESOURCES 40.00 0.00 X 162194 0 25528 AMY HERRON-MILLER ADVANCED PRACTICE REGISTERED NURSE 32.00 0.00 X 157318 0 783 JANE ABBOTT-RIDER ADVANCED PRACTICE REGISTERED NURSE 32.00 0.00 X 192679 0 10236 CRYSTAL RIDENOUR ADVANCED PRACTICE REGISTERED NURSE 32.00 0.00 X 157123 0 7853 MATTHEW TANNER ADVANCED PRACTICE REGISTERED NURSE 40.00 0.00 X 180466 0 35395 2883050 0 284138 17 0 1 0 ENVELOP IQ 905 N CAPITOL AVE STE 200 INDIANAPOLIS IN 46204 TECHNOLOGY SERVICES 472433 WILLIAM ELLIOTT 2611 N MERIDIAN RD PERU IN 46970 CONTRACTOR SERVICES 148107 2 5601230 395004 5996234 NET PATIENT SERVICE RE 621300 25679844 25679844 MENTAL HEALTH FUNDS RE 621300 2004710 2004710 GROUP HOME RENTAL INCO 531390 130857 130857 27815411 1433703 1433703 5000 213364 -208364 -208364 -208364 267108 264403 2705 267108 35304092 28079814 0 1228044 83801 83801 2237615 1799889 437726 18190931 14632387 3558544 122636 102192 20444 2236554 1863702 372852 1421596 1184605 236991 33015 33015 92650 92650 2173854 1476385 697469 90008 61129 28879 210455 142931 67524 403817 274253 129564 393999 267585 126414 662860 628403 34457 46174 31359 14815 605836 490728 115108 348065 111894 236171 HOSPITAL ASSESMENT FEES 609240 413766 195474 DUES & SUBSCRIPTIONS 109512 74375 35137 RECRUITING EXPENSES 106832 72555 34277 RECOGNITION EXPENSES 76029 51635 24394 108711 73831 34880 30364190 23837405 6526785 0 267 1882517 40962045 39901248 3295 3303 1216082 1230536 1783217 2531860 286595 329206 17525989 2344286 12372905 15181703 56624406 61060373 2171932 2544712 1437727 0 1615493 1790173 5225152 4334885 X 51399254 56725488 51399254 56725488 56624406 61060373 4939902 386332 0 X X 0 1 X 1 1 1 X 3974176 7251515 7345874 4756500 5996234 29324299 24749999 27891503 29393485 30078366 27815411 139928764 28724175 35143018 36739359 34834866 33811645 169253063 0 1611977 1264952 1486978 1809947 1649585 7823439 1611977 1264952 1486978 1809947 1649585 7823439 161429624 528249 332678 350592 730775 1433703 3375997 528249 332678 350592 730775 1433703 3375997 488968 367317 489352 391382 267108 2004127 29741392 35843013 37579303 35957023 35512456 174633187 0.92440 0.92640 0.01930 0.01430 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2019 AMOUNT: $ 488,968. 2020 AMOUNT: $ 367,317. 2021 AMOUNT: $ 489,352. 2022 AMOUNT: $ 391,382. 2023 AMOUNT: $ 267,108. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4906 4906 0 SCHEDULE C, PART II-B, LINE 1I: 12.6% OF DUES PAID TO IN COUNCIL OF COMMUNITY MENTAL HEALTH CENTERS AND 11.78% OF DUES PAID TO INDIANA HOSPITAL ASSOCIATION WERE ATTRIBUTABLE TO LOBBYING DURING THE FISCAL YEAR. 0 0 650323 650323 14543818 2095410 12448408 2331848 248876 2082972 15181703 ESTIMATED THIRD PARTY SETTLEMENTS 1790173 1790173 X 35898788 386332 208364 594696 35304092 0 35304092 30572554 208364 208364 30364190 0 30364190 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY 4C HEALTH AND RECOGNIZE A TAX LIABILITY IF 4C HEALTH 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 4C HEALTH, AND HAS CONCLUDED THAT AS OF JUNE 30, 2024 AND 2023, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. 4C HEALTH HAS FILED ITS FEDERAL AND STATE INCOME TAX RETURNS FOR PERIODS THROUGH JUNE 30, 2023 AND IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. AS OF THE DATE THE FINANCIAL STATEMENTS WERE AVAILABLE TO BE ISSUED, THERE WERE NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS). PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OF EQUIPMENT 208,364. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OF EQUIPMENT 208,364. 1 LIVING ALLOTMENT - SUPERVISED GROUP LIVING 16 35775 EDUCATION ASSISTANCE PROGRAM 32 48026 PART I, LINE 2: 4C HEALTH MAKES ASSISTANCE AVAILABLE TO ELIGIBLE PERSONS TO FURTHER THE HEALTHCARE IN THE COMMUNITY. X X 0 0 0 0 0 0 0 0 0 CARRIE CADWELL CEO 327590 0 122500 0 7695 0 12277 0 40745 0 510807 0 0 0 KATHLEEN MILLER CHIEF MEDICAL OFFICER 422772 0 33931 0 791 0 16184 0 29601 0 503279 0 0 0 JASON CADWELL CFO/CAO 299038 0 90000 0 90 0 13531 0 0 0 402659 0 0 0 ANDREW HARTLEY CHIEF OPERATING OFFICER 173928 0 47500 0 69 0 11071 0 0 0 232568 0 0 0 MATTHEW TANNER ADVANCED PRACTICE REGISTERED NURSE 104749 0 21027 0 54690 0 35395 0 0 0 215861 0 0 0 LISA WILLIS-GIDLEY VP OF OPERATIONS 136424 0 37500 0 60 0 8971 0 22538 0 205493 0 0 0 JANE ABBOTT-RIDER ADVANCED PRACTICE REGISTERED NURSE 111005 0 25297 0 56377 0 9644 0 592 0 202915 0 0 0 NICOLE HIATT-DRANG CHIEF CLINICAL OFFICER 149718 0 37500 0 138 0 9375 0 282 0 197013 0 0 0 DIANA ELLIOTT DIRECTOR OF ACCOUNTING & HUMAN RESOU 124591 0 37500 0 103 0 8492 0 17036 0 187722 0 0 0 HOPE KERNS COMPLIANCE OFFICER/DIRECTOR OF QUALI 114657 0 31250 0 119 0 7720 0 32048 0 185794 0 0 0 CRYSTAL RIDENOUR ADVANCED PRACTICE REGISTERED NURSE 128269 0 11300 0 17554 0 7853 0 0 0 164976 0 0 0 AMY HERRON-MILLER ADVANCED PRACTICE REGISTERED NURSE 114103 0 14027 0 29188 0 783 0 0 0 158101 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 TWO OFFICERS AT FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER, INC., JASON CADWELL, CFO AND CARRIE CADWELL, CEO HAVE A FAMILIAL RELATIONSHIP. CARRIE CADWELL REPORTS DIRECTLY TO THE PRESIDENT OF THE BOARD OF DIRECTORS AND JASON CADWELL REPORTS DIRECTLY TO THE TREASURER OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A THE COUNTY COMMISSIONERS OR COUNTY COUNCIL OF FULTON COUNTY SELECTS ONE MEMBER TO SERVE ON THE BOARD OF DIRECTORS WHILE THE OTHER MEMBERS ARE ELECTED BY THE EXISTING MEMBERS AT THE ANNUAL MEETING OF THE ORGANIZATION. VACANCIES CAN BE FILLED BY REMAINING DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW OF THE FORM 990 BY THE ORGANIZATION'S CEO, CFO AND ACCOUNTING PERSONNEL. THE FINAL FORM INCLUDING REQUESTED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, IS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C THE WRITTEN CONFLICT OF INTEREST POLICY IS REGULARLY AND CONSISTENTLY MONITORED AND COMPLIANCE IS ENFORCED BY THE BOARD PRESIDENT. THE SCOPE OF THIS POLICY INCLUDES ALL DIRECTORS, OFFICERS, AND ASSOCIATES. THE POLICY IS IN PLACE TO ASSIST FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER DIRECTORS, OFFICERS, ASSOCIATES, AND AGENTS WHO GOVERN AND ADMINISTER FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER AFFAIRS TO RESOLVE SITUATIONS THAT INVOLVE A DUAL INTEREST OR THAT MAY BE INTERPRETED AS A CONFLICT OF INTEREST AND TO DEFINE CONFLICT OF INTEREST SITUATIONS AND PROCEDURES TO FOLLOW ONCE THEY ARE DISCLOSED. THE COVERED PERSONS ARE HELD TO A STRICT RULE OF HONEST AND FAIR DEALING BETWEEN THEMSELVES AND THE ORGANIZATION. THEY SHALL NOT USE THEIR POSITIONS, OR KNOWLEDGE GAINED THEREFROM, IN SUCH A WAY THAT A CONFLICT MIGHT ARISE BETWEEN THE INTEREST IN THE ORGANIZATION AND THAT OF THE INDIVIDUAL. A SELF DISCLOSURE FROM COVERED PERSONS TO OTHER BOARD MEMBERS IS REQUIRED ON ANY POTENTIAL CONFLICTS OF INTEREST. ANY DIRECTOR HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHOULD REFLECT: A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THAT A QUORUM WAS PRESENT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION DETERMINATIONS OF FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER, INC.'S CEO ARE MADE BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. IN DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS INCLUDED ANALYZING THE INDIANA COUNCIL SALARY SURVEY, LOCAL RECRUITING INFORMATION, AND MARKET RATES RELEVANT TO FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER'S RURAL AREA TO HELP ASSIST IN THE DECISION MAKING PROCESS. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED THE FINAL COMPENSATION AMOUNTS, AND DOCUMENTATION OF THIS WAS PRESENTED TO THE FULL BOARD FOR APPROVAL AND RECORDED IN THE BOARD MINUTES. THE CEO IS NOT PRESENT DURING THESE MEETINGS DISCUSSIONS AND APPROVALS. COMPENSATION DETERMINATIONS OF FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER, INC.'S CFO ARE MADE BY THE INTERNAL AFFAIRS COMMITTEE. THE CFO IS NOT PRESENT DURING DISCUSSIONS OR APPROVALS OF THEIR COMPENSATION. COMPENSATION DETERMINATIONS OF FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER, INC.'S OTHER OFFICERS OR KEY EMPLOYEES WERE MADE BY THE CEO. OTHER OFFICERS AND KEY EMPLOYEES ARE NOT PRESENT DURING DISCUSSIONS OR APPROVALS OF THEIR COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C: OVERSIGHT OF AUDIT WE WORK DIRECTLY WITH THE AUDIT FIRM AND PROVIDE THE REQUESTED INFORMATION FOR THE AUDIT. ONCE THE AUDIT IS COMPLETED, THE AUDIT FIRM PROVIDES THE AUDIT DRAFT TO THE CEO, CFO AND DIRECTOR OF ACCOUNTING AND HUMAN RESOURCES. ONCE REVIEWED, THE AUDIT FIRM WILL PRESENT TO THE BOARD OF DIRECTORS AND GIVE THEM TIME FOR QUESTIONS WITHOUT FOUR COUNTY COMPREHENSIVE MENTAL HEALTH CENTER STAFF IN ATTENDANCE. THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.