Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 23017437 |
| Software Version: | 2023v6.0 |
| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | C.J. DAVIS AND ADAM ANDREASSEN - Business relationship, MICHAEL SCHWEND AND ANDREW SCHWEND - Family relationship |
| Form 990, Part VI, Line 4 Significant changes to organizational documents | ADULT & CHILD HEALTH, INC WAS AQUIRED BY BRIGHTLI OF INDIANA DURING THE YEAR. THE GOVERNING DOCUMENTS OF THE ORGANIZATION WERE UDPATED DURING THE YEAR TO REFLECT THIS CHANGE. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | THE SOLE MEMBER OF THE CORPORATION SHALL BE BRIGHTLI OF INDIANA, LLC, AN INDIANA LIMITED LIABILITY COMPANY. THE MEMBER IS A DISREGARDED ENTITY OF BURRELL-PREFERRED, INC. A MISSOURI NONPROFIT CORPORATION (THE "MEMBER"). THE MEMBER IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | THE MEMBER, WHO WILL PROVIDE THE CORPORATION WITH FINANCIAL SUPPORT AND EXPERTISE, WILL CONTRIBUTE TO THEIR SHARED MISSION TO ENABLE CORPORATION TO PROVIDE LOW COST, HIGH QUALITY MEDICAL CARE AND HEALTH EDUCATION AND OUTREACH FOR THOSE WHO ARE UNINSURED AND UNDERSERVED IN THE COMMUNITY SERVED BY CORPORATION. THE MEMBER SHALL HAVE ONLY THOSE RESERVED POWERS DESCRIBED BELOW, WHICH, EXCEPT TO THE EXTENT EXPRESSLY STATED, ARE NOT INTENDED TO CONFLICT WITH THE RIGHTS, RESPONSIBILITIES AND GOVERNANCE AUTHORITY OF THE BOARD OF DIRECTORS: (A) TO CONSULT WITH THE CORPORATION'S BOARD OF DIRECTORS REGARDING SELECTION OF DIRECTORS (DEFINED BELOW) AND PARTICIPATE AS A MEMBER OF THE BOARD OF DIRECTORS IN THE ELECTION OF DIRECTORS, SUBJECT TO THE OVERALL BOARD OF DIRECTORS COMPOSITION REQUIREMENTS SET FORTH IN ARTICLE V AND AS MAY BE REQUIRED UNDER STATE OR FEDERAL LAW; (B) TO HAVE THE INDEPENDENT AUTHORITY TO REQUEST, BUT NOT REQUIRE, A DIRECTOR BE REMOVED BY THE CORPORATION'S BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE, WHENEVER SUCH ACTION MAY BE IN THE BEST INTERESTS OF THE CORPORATION; (C) TO CONSULT WITH THE CORPORATION, AS A MEMBER OF THE CORPORATION'S BOARD OF DIRECTORS, REGARDING ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION PRIOR TO SUCH AMENDMENTS BEING APPROVED BY THE CORPORATION'S BOARD OF DIRECTORS, AND TO APPROVE ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION AND THE BYLAWS THAT PURPORT TO AMEND THE IDENTITY, RESERVE POWERS, OR OBLIGATIONS OF THE MEMBER; (D) TO CONSULT WITH AND ASSIST THE CORPORATION WITH THE DEVELOPMENT OF THE ANNUAL BUDGET FOR THE CORPORATION, FINANCIAL MANAGEMENT POLICIES AND PROCEDURES, HEALTH CARE POLICIES AND PROCEDURES AND OTHER OPERATIONAL POLICIES FOR THE CORPORATION; (E) TO APPROVE ANY DETERMINATION BY THE BOARD OF DIRECTORS TO ALTER, MODIFY OR CEASE CORPORATION'S STATUS AS AN EXEMPT ENTITY UNDER SECTION 501(C)(3) OF THE CODE OR THAT OF AN FQHC; (F) TO APPROVE ANY ACTION OF THE CORPORATION THAT REQUIRES THE MEMBER TO PROVIDE A GUARANTEE OR LETTER OF CREDIT, OR THAT REQUIRES ANY FORM OF FINANCIAL COMMITMENT OR UNDERTAKING BY THE MEMBER; (G) TO CONSULT WITH THE CORPORATION REGARDING THE ESTABLISHMENT OR IMPLEMENTATION OF ANY NEW LINE OF BUSINESS OR THE PURSUIT OF A NEW LICENSE, AND APPROVE ANY NEW LINE OF BUSINESS OR NEW LICENSE OUTSIDE THE SCOPE OF THE MISSION AND PURPOSES STATED HEREIN; (H) TO APPROVE ANY SALE, EXCHANGE, LEASE, MORTGAGE, PLEDGE, CONVEYANCE, LICENSE OR OTHER TRANSFER OF SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS IN ONE TRANSACTION OR IN A SERIES OF RELATED TRANSACTIONS; (I) TO APPROVE ANY ACTIONS OR INACTION THAT COULD HAVE A MATERIAL AND DEMONSTRABLE ADVERSE EFFECT ON THE BRAND OR REPUTATION OF MEMBER OR ITS AFFILIATES; (J) TO APPROVE THE CREATION OR FORMATION OF A NEW SUBSIDIARY; OR (K) TO APPROVE THE LIQUIDATION, DISSOLUTION OR WINDING-UP OF THE BUSINESS AND AFFAIRS OF THE CORPORATION. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A TENTATIVE DRAFT OF THE 990 IS REVIEWED BY THE SYSTEM DIRECTOR OF FINANCE, THE VICE PRESIDENT OF FINANCE, THE EXECUTIVE VICE PRESIDENT OF FINANCE, THE CHIEF FINANCIAL OFFICER, AND THE PRESIDENT/CEO BEFORE BEING PROVIDED TO THE BOARD OF DIRECTORS. THE 990 IS EMAILED TO THE BOARD OF DIRECTORS FOR REVIEW BEFORE FILING. |
| Form 990, Part VI, Line 12c Conflict of interest policy | THE ORGANIZATION INQUIRES ANNUALLY IF ANY OF THE BOARD MEMBERS HAVE A CONFLICT OF INTEREST. POTENTIAL CONFLICTS ARE REVIEWED BY THE BOARD OF DIRECTORS. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER ABSTAINS FROM VOTING ON THE MATTER AND THE RESOLUTION IS DOCUMENTED IN THE BOARD MINUTES. CORPORATE COMPLIANCE IS RESPONSIBLE FOR MONITORING AND COMPLIANCE OF THE CONFLICT-OF-INTEREST POLICY FOR ALL EMPLOYEES. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | THE COMPENSATION PACKAGE FOR THE CEO IS SET BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND APPROVED BY THE ENTIRE BOARD.BURRELL-PREFERRED, INC., A RELATED ORGANIZATION, HIRED GALLAGHER TO DO A COMPENSATION REVIEW FOR EXECUTIVES IN OCTOBER 2023 AND MAY 2024. THE MISSOURI BEHAVIORAL HEALTH COUNCIL (MBHC)SPONSORED A CUSTOM COMPENSATION AND BENEFITS SURVEY PERFORMED BY CBIZ IN 2024. THE CEO COMPENSATION WAS APPROVED BY BOTH THE FINANCE COMMITTEE AND THE BOARD. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | THE EXECUTIVE COMMITTEE USES THE ANNUAL SALARY SURVEY CONDUCTED BY THE INDIANA COUNCIL OF COMMUNITY MENTAL HEALTH CENTERS AND OTHER APPLICABLE SALARY SURVEYS. SALARIES OF OTHER OFFICERS AND KEY EMPLOYEES ARE SET IN A SIMILAR FASHION BY THE CEO. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. ADDITIONALLY, FINANCIALS ARE MADE AVAILABLE AT EACH BOARD MEETING. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | FAIR MARKET VALUE ADJUSTMENTS DURING ACQUISITION - 5467129; |
| Form 990, Part III, Line 1: Organization's Mission Continued | OUR VISION: WE STRIVE FOR CARING COMMUNITIES, WHERE EVERY CHILD, ADULT, AND FAMILY HAVE OPPORTUNITIES TO LIVE HEALTHY, HAPPY LIVES. OUR VALUES: THE FOLLOWING VALUE AND BELIEF STATEMENTS ARE THE FOUNDATION OF THE SERVICES WE PROVIDE: -WE BELIEVE IN PEOPLE AND THE STRENGTH OF DIVERSITY. WE DEEPLY RESPECT THE IDEAS, BACKGROUNDS, AND LIVED EXPERIENCES OF THOSE WE SERVE TO CREATE SAFE, INCLUSIVE ENVIRONMENTS WHERE EVERYONE IS WELCOME. -WE BELIEVE IN MEETING PEOPLE WHERE THEY ARE. EVERYONE'S ROAD TO RECOVERY AND WELLNESS HAS A DIFFERENT ROUTE, DESTINATION, AND ETA. AS PARTNERS IN HEALTH, WE ARE FLEXIBLE WHEN ADDRESSING EACH PERSON'S NEEDS. -WE LOVE WHAT WE DO AND A GENUINE DESIRE TO IMPROVE LIVES DRIVES US FORWARD. WORKING HARD AND PLAYING HARD BUILDS THE STRONG TEAMS NEEDED FOR OUR MISSION-DRIVEN CULTURE. -WHATEVER WE DO, WE DO WELL. WE ARE DEDICATED TO THE BEST QUALITY OF CARE AND QUALITY OF LIFE FOR THE PERSONS WE SERVE. WE USE DATA TO SET PERFORMANCE GOALS, MEASURE PROGRESS TOWARD THOSE GOALS, AND EMBRACE THE LEARNING OPPORTUNITIES THAT INFORM OUR WORK. -WE ARE CHAMPIONS FOR HEALTH EQUITY AND THE PROMISE OF HEALTHY COMMUNITIES. WE BELIEVE IN HIGH QUALITY, AFFORDABLE HEALTHCARE AND SOCIAL SERVICES FOR ALL. |
| Software ID: | 23017437 |
| Software Version: | 2023v6.0 |