2024-05-10T14:02:48-05:00 2023-06-30 352123203 KSM BUSINESS SERVICES INC PO BOX 40857 INDIANAPOLIS IN 46240 990 2022-07-01 351499772 AMETHYST HOUSE INC AMET 8123363570 PO BOX 11 BLOOMINGTON IN 47402 MARK DELONG EXECUTIVE DIRECTOR 8123363570 2024-05-08 1 MARK DELONG 999009999 1 BEN LYON P01262298 3175802000 2024-05-08 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARK DELONG PO BOX 11 BLOOMINGTON IN 47402 1552460 0 X WWW.AMETHYSTHOUSE.ORG X 1980 IN AMETHYST HOUSE PROVIDES A FOUNDATION FOR RECOVERY FOR THOSE IMPACTED BY SUBSTANCE ABUSE DISORDERS BY PROVIDING RESIDENTIAL AND OUTPATIENT TREATMENT SERVICES. 8 8 47 8 0 0 1064279 932032 545692 528986 -3346 11821 25513 -2945 1632138 1469894 0 0 0 0 959331 1039512 0 0 67825 490109 541558 1449440 1581070 182698 -111176 1201088 1378601 92942 373364 1108146 1005237 AMETHYST HOUSE PROVIDES A FOUNDATION FOR RECOVERY BY PARTNERING WITH INDIVIDUALS, FAMILIES, AND COMMUNITIES IMPACTED BY SUBSTANCE-USE DISORDERS, OFFERING HIGH-QUALITY RESIDENTIAL AND OUTPATIENT TREATMENT SERVICES AND GUIDANCE FOR HEALTHY LIVING. 0 0 532377 230766 MEN'S HOUSE - RESIDENTIAL TREATMENT PROGRAM SERVING 65 PATIENTS IN 2023 RECOVERING FROM ADDICTION. 303045 131359 WOMEN'S HOUSE - RESIDENTIAL TREATMENT PROGRAM SERVING 37 PATIENTS IN 2023 RECOVERING FROM ADDICTION. 384949 166861 OUTPATIENT TREATMENT IN BLOOMINGTON AND EVANSVILLE SERVING 47 PATIENTS IN 2023. 1220371 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 4 0 1 47 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 IN X GINA LOVELL 8123363570 PO BOX 11 BLOOMINGTON IN 47402 PAT SCHREMS PRESIDENT 2.00 X X 0 0 0 CHRIS FREDERICKSON TREASURER 2.00 X X 0 0 0 BRIAN GARVEY VICE PRESIDENT 2.00 X X 0 0 0 DAVID ELLIES SECRETARY 2.00 X X 0 0 0 MIKE LONG BOARD MEMBER 1.00 X 0 0 0 JOHN BEATTY BOARD MEMBER 1.00 X 0 0 0 DANIEL MILLER BOARD MEMBER 1.00 X 0 0 0 JOSEPH C NOWLIN BOARD MEMBER 1.00 X 0 0 0 MARK DELONG EXECUTIVE DIRECTOR 40.00 X 79409 0 0 GINA LOVELL ADMINISTRATIVE DIRECTOR 40.00 X 74913 0 0 SCOTT BISCHOFF CLINICAL DIRECTOR (CURRENT) 40.00 X 47308 0 0 NANCY NERAD CLINICAL DIRECTOR (FORMER) 40.00 X 20813 0 0 222443 0 0 0 0 0 0 0 16080 32783 850916 32253 932032 CLIENT FEES 624100 481129 481129 TREATMENT FEES 624100 47857 47857 528986 12188 12188 70108 70475 -367 -367 -367 7755 32783 12091 -4336 -4336 OTHER INCOME 523000 1391 1391 1391 1469894 528986 0 8876 236718 86958 117614 32146 665496 621177 27938 16381 68470 51045 14920 2505 68828 55420 10944 2464 30475 30475 3983 3983 9187 1401 7786 17161 11103 4543 1515 88726 59657 21801 7268 7805 6290 1515 5810 4683 1127 1385 730 655 24682 14808 8768 1106 38509 32541 5968 PROGRAM COSTS AND SUPPL 120665 111557 9104 4 SUBCONTRACT 112857 111535 1322 DUES AND SUBSCRIPTIONS 25506 11581 11525 2400 REPAIRS AND MAINTENANCE 24151 22634 1517 30656 17251 11369 2036 1581070 1220371 292874 67825 45255 43897 114696 73448 168567 112856 945005 451876 491500 493129 381070 393103 0 262168 1201088 1378601 84672 161106 8270 0 0 212258 92942 373364 X 1108146 1005237 1108146 1005237 1201088 1378601 -111176 8267 0 X X 0 1 X 1 1 1 X 765030 781688 925272 1064279 932032 4468301 765030 781688 925272 1064279 932032 4468301 4468301 44 5746 9434 5237 12188 32649 4060 0 0 0 0 4060 1956 3321 2424 29032 1391 38124 4543134 2580794 0.98350 0.98570 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2018 AMOUNT: $ 1,956. 2019 AMOUNT: $ 3,321. 2020 AMOUNT: $ 2,424. 2021 AMOUNT: $ 4,032. 2022 AMOUNT: $ 1,391. INSURANCE CLAIM - 2021 AMOUNT: $ 25,000. 10000 10000 886377 410470 475907 48628 41406 7222 493129 OPERATING LEASE RIGHT OF USE ASSET 262168 262168 OPERATING LEASE LIABILITY 212258 212258 X 1486269 8267 12091 20358 1465911 3983 3983 1469894 1589178 12091 12091 1577087 3983 3983 1581070 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM TAXES UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. IN ADDITION, THE ORGANIZATION HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE NOT TO BE A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE. THERE WAS NO UNRELATED BUSINESS INCOME TAX FOR THE YEARS ENDED JUNE 30, 2023 AND 2022. THE ORGANIZATION FILES U.S. FEDERAL AND STATE OF INDIANA INFORMATION TAX RETURNS. GENERALLY, THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR FISCAL YEARS BEFORE 2020. MANAGEMENT BELIEVES THAT THE ORGANIZATION'S INCOME TAX FILING POSITIONS WILL BE SUSTAINED ON AUDIT AND DOES NOT ANTICIPATE ANY ADJUSTMENTS THAT WILL RESULT IN A MATERIAL CHANGE. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 12,091. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 12,091. ANNUAL CONCERT 40538 32783 7755 12091 40538 32783 7755 12091 12091 -4336 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AND THE EXECUTIVE DIRECTOR BEFORE FILING. A COPY OF THE RETURN WILL BE EMAILED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C NEW MEMBERS ARE REQUIRED TO SIGN AT THEIR ORIENTATION SESSION. AT THE ANNUAL BOARD RETREAT EACH JANUARY ALL BOARD MEMBERS COMPLETE AND SIGN A CONFLICT OF INTEREST STATEMENT. THE GOVERNANCE COMMITTEE REVIEWS ANY REPORTED CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE DETERMINES THE COMPENSATION FOR THE EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. PART XII LINE 2C NO CHANGES FROM PRIOR YEAR.