21
Fdlm 99Q Return of Organization Exempt From Income Tax OMB No 1545-0047 Under section 501(c ), 527, or 4947 ( a)(1) of the Internal Revenue Code (except black lung 2004 benefit trust or private foundation) Depa rtment of th e Treasu ry - ' Internal Revenue Se rv ice 1110. The organization may have to use a copy of this return to satisfy state reporting requirements. - Lei I A For the 2004 calendar year, or tax year beginning 7/1/2004 and ending 6/30/2005 B Check if applicable: please C Name of organization D Employer identification number X Address change use IRS Key Point Heal th Services, Inc. 52- 1310095 label or F-jName change print or Number and street (or P 0 box if mail is not delivered to street address) Room/suite E Telephone number Initial retu rn type F-1 see 135 N. Parke St. 1 443-625-1590 Final return Specific City or town State or country ZIP +4 F Accounti ng method : ElCash ElAccrual Instruc- OX Amended retu rn UOn'• Aberdeen MARYLAND 21001 ❑Other (specify) El Application pending Section 501 (c)(3) organizations and 4947 (a)(1) nonexempt charitable H and I are not applicable to section 527 organizations. trusts must attach a completed Schedule A (Form 990 or 990 -EZ). H(a ) Is this a g ro up retu rn for affiliates ? El Yes Q No G Website : jo, WWW KeyPoint.Org H(b) If "Yes,' enter number of affiliates H(c) Are all affiliates included? _ _ El Yes El No J Organization type (check only one) 10- ❑X 501(c) ( 3) 1 (insert no ) 4947 (a)(1) or 527 (If "No," attach a list See instructions.) K Check here ►[:]if the organization's g ross receipts are normally not more th an $ 25,000 The H(d) Is this a separate return filed by an o aniza tion organization need not file a retu rn with th e IRS ; but if the organization received a Form 990 Package in the covered by a group ruling? Yes No mail, it should file a return without fi nancial data Some states require a complete return. I Group Exemption Number M Check "[: if the organization is not required L Gross receipts: Add lines 6b, 8b, 9b, and 1 Ob to line 12 9,787,7081 to attach Sch. B (Form 990 , 990-EZ, or 990-PF). Revenue , Expenses, and Changes in Net Assets or Fund Balances (See page 18 of the instructions. F-5 I Contributions , gifts, grants , and similar amounts received: r- a Direct public support . . . . . . . . . . . . . . . . . 1a 0 V--4 b Indirect public suppo rt . . . . . . . . . . . . . . . . . I b Y c Gove rn ment contributions (grants ) . . . . . . . . . . . . Ic 238 768 d Total (add lines Ia through 1c) (cash $ noncash $ ) 1d 238,768 2 Program se rv ice revenue including government fees and contracts (from Pa rt VII, line 93) 2 9,470 972 3 Membership dues and assessments . . . . . . . . . . . . . . . . . . . . . . 3 - 0 4 Interest on savings and tempora ry cash investments . . . . . . . . . . . . . . . . 4 1,425 5 Dividends and interest from securities . . . . . . . . . . . . . . . . . 5 0 6 a Gross rents . . . . . . . . . . . . . . . . . . . . . 6a b Less : rental expenses . . . . . . . . . . . . . . . . . 6b c Net rental income or (loss ) ( subtract line 6b from line 6a) . . . . . . . . . . . . . . 6c 0 7 Other investment income ( describe t 7 0 8 a Gross amount from sales of assets other (A) Secu ri ties ( B) Other than invento ry 0 8a 28,465 b Less : cost or other basis and sales expenses 0 8b 35,334 c Gain or (loss) (a ttach schedule ) . . . . . 0 8c -6869 d Net gain or ( loss) (combine line 8c , columns (A) and ( B)) . . . . . . . . . . . . 8d -6,869 9 Special events and activities ( attach schedule ). If any amount is from gaming , check here El R Ca enue (not including $ 0 of o rted on line 1a) . . . . . . . . . . . . 9a 0 b Less : direct enses other than fundraising expenses . . . . 9b 0 ARC 241 i e loss) from special events ( subtract line 9b from line 9 a) . . . . . . . 9c 0 10 a Gross sales ivento ry, less returns and allowances . . . . 10a ds sold . . . . . . . . . . . . . . . 10b O t or (lo s ) from sales of invento ry (attach schedule) (subtract line 10b from line 10a) . . . . 10c 0 . . . . . . . . . . . . . . 11 Other revenue (from Pa rt VII, line 103) . . . . ' . . 11 48,078 , 9c , 0c, and 11) 1 12 Total revenue (add lines Id, 2, 3 , 4 5, 6c , 7, 8d 12 9,752,374 13 Program services (from line 44, column (B)) . . . . . . . . . . . . . . . . . . 13 8 , 847 156 IV 14 Management and general (from line 44 , column (C)) . . . . . . . . . . . . . . . 14 1 , 515 ,911 15 Fundraising (from line 44 , column (D)) . . . . . . . . . . . . . . . . . . . . 15 0 16 Payments to affiliates (attach schedule) . . . . . . . . . . . . . . . . . . . . . 16 0 . . . . . . . . . . . . . . 17 Total expenses (add lines 16 and 44 , column (A)) . . . 17 10 ,363,067 18 Excess or (deficit ) for the year ( subtract line 17 from line 12) . . . . . . . . . . . . . 18 -610,693 19 Net assets or fund balances at beginning of year (from line 73 , column (A)) . . . . . . . 19 2 , 924,294 20 Other changes in net assets or fund balances (a tt ach explanation) . . . . . . . . . . 20 0 z 21 Net assets or fund balances at end of year (combine lines 18, 19, and 20) 21 2,313,601 For Privacy Act and Paperwork Reduction Act Notice , see the separate instructions . (HTA) - Form 990 (2004 70 0 E a3 ) 0 0 o 0--2 gym I S-f (, L37 1 j

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Page 1: Fdlm 99Q Return of Organization Exempt From Income Tax 2004990s.foundationcenter.org/990_pdf_archive/521/521310095/521310095... · Fdlm 99Q Return of Organization Exempt From Income

Fdlm 99Q Return of Organization Exempt From Income Tax OMB No 1545-0047

Under section 501(c ), 527, or 4947 (a)(1) of the Internal Revenue Code (except black lung 2004benefit trust or private foundation)Department of the Treasu ry • - • ' •Internal Revenue Serv ice 1110. The organization may have to use a copy of this return to satisfy state reporting requirements. • - Lei I

A For the 2004 calendar year, or tax year beginning 7/1/2004 and ending 6/30/2005B Check if applicable: please C Name of organization D Employer identification number

X Address change use IRS Key Point Health Services, Inc. 52-1310095label orF-jName change print or Number and street (or P 0 box if mail is not delivered to street address) Room/suite E Telephone number

Initial retu rn typeF-1 see 135 N. Parke St. 1 443-625-1590

Final return Specific City or town State or country ZIP + 4 F Accounti ng method : ElCash ElAccrualInstruc-

OX Amended return UOn'• Aberdeen MARYLAND 21001 ❑Other (specify) ►

El Application pending • Section 501 (c)(3) organizations and 4947(a)(1) nonexempt charitable H and I are not applicable to section 527 organizations.trusts must attach a completed Schedule A (Form 990 or 990 -EZ). H(a) Is this a g roup retu rn for affiliates? El Yes Q No

G Website : jo, WWW KeyPoint.Org H(b) If "Yes,' enter number of affiliates ►

H(c) Are all affiliates included?

_ _

El Yes El NoJ Organization type (check only one) 10- ❑X501(c) ( 3) 1 (insert no ) ❑4947(a)(1) or 527 (If "No," attach a list See instructions.)

K Check here ►[:]if the organization's g ross receipts are normally not more than $25,000 The H(d) Is this a separate return filed by an o anizationorganization need not file a retu rn with the IRS ; but if the organization received a Form 990 Package in the covered by a group ruling? Yes ❑ Nomail, it should file a return without financial data Some states require a complete return.

I Group Exemption Number ►

M Check "[: if the organization is not requiredL Gross receipts: Add lines 6b, 8b, 9b, and 1 Ob to line 12 ► 9,787,7081 to attach Sch. B (Form 990 , 990-EZ, or 990-PF).

Revenue , Expenses, and Changes in Net Assets or Fund Balances (See page 18 of the instructions.F-5 I Contributions , gifts, grants , and similar amounts received:r- a Direct public support . . . . . . . . . . . . . . . . . 1a 0V--4 b Indirect public support . . . . . . . . . . . . . . . . . I bY c Government contributions (grants) . . . . . . . . . . . . Ic 238 768

d Total (add lines Ia through 1c) (cash $ noncash $ ) 1d 238,7682 Program service revenue including government fees and contracts (from Part VII, line 93) 2 9,470 9723 Membership dues and assessments . . . . . . . . . . . . . . . . . . . . . . 3 - 04 Interest on savings and temporary cash investments . . . . . . . . . . . . . . . . 4 1,4255 Dividends and interest from securities . . . . . . . . . . . . . . . . . 5 06 a Gross rents . . . . . . . . . . . . . . . . . . . . . 6ab Less : rental expenses . . . . . . . . . . . . . . . . . 6bc Net rental income or (loss) (subtract line 6b from line 6a) . . . . . . . . . . . . . . 6c 0

7 Other investment income (describe t 7 08 a Gross amount from sales of assets other (A) Secu ri ties (B) Other

than inventory 0 8a 28,465

b Less : cost or other basis and sales expenses 0 8b 35,334c Gain or (loss) (attach schedule) . . . . . 0 8c -6869d Net gain or (loss) (combine line 8c, columns (A) and (B)) . . . . . . . . . . . . 8d -6,869

9 Special events and activities (attach schedule). If any amount is from gaming , check here ► ElR Ca enue (not including $ 0 of

orted on line 1a) . . . . . . . . . . . . 9a 0b Less : direct enses other than fundraising expenses . . . . 9b 0

ARC 241 i e loss) from special events (subtract line 9b from line 9a) . . . . . . . 9c 010 a Gross sales ivento ry, less returns and allowances . . . . 10a

ds sold . . . . . . . . . . . . . . . 10bOt or (lo s) from sales of invento ry (attach schedule) (subtract line 10b from line 10a) . . . . 10c 0

. . . . . . . . . . . . ..11 Other revenue (from Part VII, line 103) . . . .'

. . 11 48,078, 9c , 0c, and 11)112 Total revenue (add lines Id, 2, 3 , 4 5, 6c , 7, 8d 12 9,752,374

13 Program services (from line 44, column (B)) . . . . . . . . . . . . . . . . . . 13 8 , 847 156IV 14 Management and general (from line 44 , column (C)) . . . . . . . . . . . . . . . 14 1 ,515 ,911

15 Fundraising (from line 44 , column (D)) . . . . . . . . . . . . . . . . . . . . 15 016 Payments to affiliates (attach schedule) . . . . . . . . . . . . . . . . . . . . . 16 0

. . . . . . . . . . . . . .17 Total expenses (add lines 16 and 44 , column (A)) . . . 17 10,363,06718 Excess or (deficit) for the year (subtract line 17 from line 12) . . . . . . . . . . . . . 18 -610,69319 Net assets or fund balances at beginning of year (from line 73 , column (A)) . . . . . . . 19 2 , 924,29420 Other changes in net assets or fund balances (attach explanation) . . . . . . . . . . 20 0

z 21 Net assets or fund balances at end of year (combine lines 18, 19, and 20) 21 2,313,601For Privacy Act and Paperwork Reduction Act Notice , see the separate instructions .(HTA)

-

Form 990 (2004

70 0 E a3 ) 0 0 o 0--2 gym I S-f (, L37 1 j

Page 2: Fdlm 99Q Return of Organization Exempt From Income Tax 2004990s.foundationcenter.org/990_pdf_archive/521/521310095/521310095... · Fdlm 99Q Return of Organization Exempt From Income

Form 990 ('1004 Key Point Health Services, Inc. 52-1310095 Page 2Statement of All organizations must complete column (A). Columns (B), (C), and (D) are required for section 501(c)(3) and (4) organizationsFunctional Expenses and section 4947(a)(1) nonexempt ch aritable trusts but optional for others. (See page 22 of the instructi ons )Do not include amounts reported on line

6b, 8b 9b 10b or 16 of Part I. (A) Total (B) Programservices

(C) Managementand general (D) Fundraising

22 Grants and allocations (attach schedule) . . . . . . . .(cash $ 0 noncash $ 0 ) 22 0 0

23 Specific assistance to individuals (attach schedule) . . . 23 024 Benefits paid to or for members (attach schedule) . . . . 24 025 Compensation of officers, directors, etc. . . . . . . . . 25 458,401 95,795 362,60626 Other salaries and wages . . . . . . . . . . . . . 26 5,249,903 4,762,141 487,76227 Pension plan contributions . . . . . . . . . . . . . 27 028 Other employee benefits . . . . . . . . . . . . . 28 812,301 690,195 122,10629 Payroll taxes . . . . . . . . . . . . . . . . . . . 29 463,611 408,418 55,19330 Professional fundraising fees . . . . . . . . . . . 30 031 Accounting fees . . . . . . . . . . . . . . . . . 31 55,296 26,936 28,36032 Legal fees . . . . . . . . . . . . . . . . . . . 32 033 Supplies . . . . . . . . . . . . . . . . . . . . 33 034 Telephone . . . . . . . . . . . . . . . . . . . 34 123,484 99,669 23,81535 Postage and shipping . . . . . . . . . . . . . . 35 5,984 2,053 3,93136 Occupancy . . . . . . . . . . . . . . . . . . . 36 686,560 666,434 20,12637 Equipment rental and maintenance . . . . . . . . . . 37 129,778 86,337 43,44138 Printing and publications . . . . . . . . . . . . . . 38 40,166 12,719 27,44739 Travel . . . . 39 133 40 9340 Conferences, conventions, and meetings . . . . . . . 40 135 13541 Interest . . . . . . . . . . . . . . . . . . . . . 41 94,224 83,164 11,06042 Depreciation, depletion, etc. (attach schedule) . . . . . 42 266,868 205,533 61,33543 Other expenses not covered above (itemize): a ....... ........ 43a 0.

b See Attached------ ------- -------- ------ ------- --------- 43b 1,976,223 1,707,722 268,501--- --- - - -- -- --c --------- -- ----------- ------------------------ ---- 43c 0

d ----- ------ - ----- - ---------------------- - - --- 43d 0----- ---- ------ ------- ------e - -- 43e 0---- - - --- - --

f 43f 044 Total functional expenses (add lines 22 through 43). Organizations

completing columns (B)-(D), car these totals to lines 13-15 . 44 10 363,067 8,847,156 1,515 911 0Joint Costs . Check ►Qif you are following SOP 98-2.Are any joint costs from a combined educational campaign and fundraising solicitation repo rted in (B) Program services? . . . . ►[]Yes F-I NoIf "Yes ," enter ( 1) the aggregate amount of these joint costs $ 0 (ii) the amount allocated to Program services $iii the amount allocated to Management and general $ and iv the amount allocated to Fundraising $

Statement of Program Service Accomplishments (See page 25 of the instructions.)

What is the organization 's primary exempt purpose? ► Treatment & Rehabilitation of Mentally III Consumers_ _ --- _ _ Service

Required for 501(c)(3) andAll organizations must describe their exempt purpose achievements in a clear and concise manner. State the number

-Program

of clients served , publications issued , etc. Discuss achievements that are not measurable (Section 501 (c)(3) and (4) (4) ores , and 4947(a)(1)trusts, but optional for

organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of grants and allocations to others ) othersa Residential rehabilitation and mental health clinicsproviding housing, general living _ ______ _ ____expenses, personal skills and the training and treatment of mentally it patients._ ---------------------------------Over 3,000 patients a year-have-services provided by this program_____________________________________________

Grants and allocations $ 8,847,156b ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Grants and allocations $C ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Grants and allocationsd -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -----------------------------------

Grants and allocationse Other program services attach schedule Grants and allocations $f Total of Program Service Expenses (should equal line 44 , column (B), Program services) ► 8,847,156

Form 990 (2004)

Page 3: Fdlm 99Q Return of Organization Exempt From Income Tax 2004990s.foundationcenter.org/990_pdf_archive/521/521310095/521310095... · Fdlm 99Q Return of Organization Exempt From Income

Form 990 (2004) Key Point Health Services, Inc. 52-1310095 Page 3

' Balance Sheets (See page 25 of the instructions.)

Note: Where required, attached schedules and amounts within the description (A) (B)column should be for end-of-year amounts only. Beginning of year End of year

45 Cash-non-interest-bearing . . . . . . . . . . . . . . . . . . 4546 Savings and temporary cash investments . . . . . . . . . . . . . 532,467 46 405,553

47 a Accounts receivable . . . . . . . . . . 47a 412,301b Less: allowance for doubtful accounts . . . 47b 0 900,065 47c 412,301

48 a Pledges receivable . . . . . . . . . . 48a 0b Less: allowance for doubtful accounts . . . 48b 0 0 48c 0

49 Grants receivable . . . . . . . . . . . . 4950 Receivables from officers, directors, trustees, and key employees

(attach schedule) . . . 0 50 051 a Other notes and loans receivable (attachU)

schedule) . . . . . . . . . . . . . . 51a 0b Less: allowance for doubtful accounts 51b 0 0 51c 0

52 Inventories for sale or use . . . . . . . . . . . . . . . . . . . 5253 Prepaid expenses and deferred charges . . . . . . . 34 639 53 52,87954 Investments-securities (attach schedule) . . . . lo-[:]Cost LIFMV 0 54 055 a Investments-land, buildings, and

equipment: basis . . . . . . . . . . . 55a 0b Less: accumulated depreciation (attach

schedule) . . . . . . . . . . . . . . 55b 0 0 55c 056 Investments-other (attach schedule) . . . . . . . . . . 0 56 057 a Land, buildings, and equipment: basis . . . 57a 5,560 479

b Less: accumulated depreciation (attachschedule) . . . 57b 1,335 821 3,041,691 57c 4,224 658

58 Other assets (describe ► See attached worksheet ) 146 366 58 41.231

59 Total assets (add lines 45 through 58) (must equal line 74) 4,655,228 59 5,136,62260 Accounts payable and accrued expenses . . . . . . . . . . . . . 626,336 60 1,089,83561 Grants payable . . . . . . . . . . . . . . . . . . . . . . . 6162 Deferred revenue . . . . . . . . . . . . . . . . . . . . . . 6263 Loans from officers, directors, trustees, and key employees (attach

schedule) . . . . . . . . . . . . . . . . . . . . . . . . . 0 63 0

cc 64 a Tax-exempt bond liabilities (attach schedule) . . . . . . . . . . . 0 64a 0b Mortgages and other notes payable (attach schedule) . . . . . . . . 1 104,598 64b 1 ,733 186

65 Other liabilities (describe ► ) 0 65 0

66 Total liabilities (add lines 60 through 65) 1,730 934 66 2,823,021Organizations that follow SFAS 117, check here ► [X]and complete lines

67 through 69 and lines 73 and 74.67 Unrestricted . . . . . . . . . . . . . . . . . . . . . . . . 2 071,413 67 1,386,59868 Temporarily restricted . . . . . . . . . . . . . . . . . . . . 852,881 68 927,003

m 69 Permanently restricted . . . . . . . . . . . . . . . . . . 69Organizations that do not follow SFAS 117, check here ►Qand

complete lines 70 through 74.LL 70 Capital stock, trust principal, or current funds . . . . . . . . . . . 70y 71 Paid-in or capital surplus, or land, building, and equipment fund . . . . 71V 72 Retained earnings, endowment, accumulated income, or other funds . . 72

73 Total net assets or fund balances (add lines 67 through 69 orlines 70 through 72;column (A) must equal line 19; column (B) must equal line 21) . . . . 2,924,294 73 2,313,601

74 Total liabilities and net assets / fund balances (add lines 66 and 73) 4,655,228 74 5,136,622Form 990 is available for public inspection and, for some people, serves as the primary or sole source of information about a

particular organization. How the public perceives an organization in such cases may be determined by the information presentedon its return. Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organization'sprograms and accomplishments.

Page 4: Fdlm 99Q Return of Organization Exempt From Income Tax 2004990s.foundationcenter.org/990_pdf_archive/521/521310095/521310095... · Fdlm 99Q Return of Organization Exempt From Income

Form 990(2004) Key Point Health Services, Inc. 52-1310095 Page 4Reconciliation of Revenue per Audited Reconciliation of Expenses per AuditedFinancial Statements with Revenue per Financial Statements with Expenses perReturn (See page 27 of the instructions. Return

a Total revenue, gains, and other support a Total expenses and losses perper audited financial statements . . ► a 9,741 746 audited financial statements . . . ► a 10,352,439

b Amounts included on line a but not b Amounts included on line a but noton line 12, Form 990: on line 17, Form 990:

(1) Net unrealized gains (1) Donated serviceson investments . . . . $ and use of facilities . . $

(2) Donated services and (2) Prior year adjustmentsuse of facilities . . . . $ reported on line 20,

(3) Recoveries of prior Form 990 . . . . . . $year grants . . . . . $ (3) Losses reported on

(4) Other (specify)- line 20, Form 990 . . $________________ $ (4) Other (specify):

$----- ---- ----- $--------------------lines (1) through (4) ► b 0aAdd amounts on ____________________• $

Add amounts on lines (1) through (4) ► b 0c Linea minus line b . . . . . . . ► c 9,741,746 c Linea minus line b . . . . . . . ► c 10,352,439d Amounts included on line 12, d Amounts included on line 17,

Form 990 but not on line a: Form 990 but not on line a:(1) Investment expenses (1) Investment expenses

not included on line not included on line6b, Form 990 . . . . $ 6b, Form 990 . . . . $

(2) Other (specify): (2) Other (specify):

------------------ $ -------------------- $$ $

Add amounts on lines (1) and (2) . . ► d 0 Add amounts on lines (1) and (2) . ► d 0e Total revenue per line 12, Form 990 e Total expenses per line 17, Form 990

line c plus lined ► e 9,741,746 line c plus lined ► e 10,352,439List of Officers, Directors, Trustees, and Key Employees (List each one even if not compensated; see page 27of the instructions.)

(B) Title and average hours (C) Compensation (D) Contributions to (E) Expense(A) Name and address per week devoted to position ( If not paid , employee benefit plans & account and other

enter -0-.) deferred compensation allowances

---Name Bernard Piet-CPA--str 135 N.- Parke St---- Title Treasurercity Aberdeen ST MD zip 21001 HrIWK As Needed 3,750 0 0

---Name Richard Norwood - -str 135 N.- Parke St ----------------------------------------- Title Presidentc i Aberdeen ST MD zip 21001 Hr/WK As Needed 2,250 0 0

---Name Maria Lobianco ----str 135 N.-Parke St --------------------------------------- Title Directorc. Aberdeen ST MD zip 21001 Hr/WK As Needed 3,750 0 0

---Name Michael Hebrank ---str 135 N.-Parke-St --------------------------------------- Title Vice-Presa Aberdeen ST MD zip 21001 HrAVK As Needed 3,750 0 0

__ Name John Burton _--___ Str 135 N.- Parke St___ Tale Secretarycity Aberdeen ST MD zip 21001 Hr/WK As Needed 3,750 0 0

Name Julie Stancllff str 135 N.- Parke St---------------------------------------------- Title Directorc i Aberdeen ST MD zip 21001 Hr/WK As Needed 3,750 0 0

- Name William-Kirkpatrick str 135 N._ Parke St__ Tale DirectorAberdeen ST zip 21001 Hr/WK As Needed 3,000 0 0

---Name Karl-Weber-Phd----str 135 N.- Parke St-_ _ _----------------------------- Title CEOc i Aberdeen ST MD zip 21001 Hr/WK 40 186,510 0 18,954

---Name Elizabeth Hymel _ _ str 135 N.- Parke St_ _ _ Tale CFOcity Aberdeen ST MD zip 21001 Hr/WK 40 117,382 0 0

---Name Mark-Pecevich-MC -str 135 N.-Parke St---------------------------------------- Title COOc. Aberdeen ST MD zip 21001 HNWK 40 154,5081 0 18,605

75 Did any officer , director , trustee , or key employee receive aggregate compensation of more than $100,000 from yourorganization and all related organizations , of which more than $10,000 was provided by the related organizations? ►QYes [KNoIf "Yes," attach schedule-see page 28 of the instructions.

Form 990 (2004)

Page 5: Fdlm 99Q Return of Organization Exempt From Income Tax 2004990s.foundationcenter.org/990_pdf_archive/521/521310095/521310095... · Fdlm 99Q Return of Organization Exempt From Income

Form 990 200a Key Point Health Services, Inc. 52-1310095 Page 5'Other Information (See page 28 of the instructions.) Yes No

76 Did the organization engage in any activity not previously reported to the IRS? If "Yes," attach a detailed description of each activity 76 X77 Were any changes made in the organizing or governing documents but not reported to the IRS? . . . . . 77 X

If "Yes," attach a conformed copy of the changes.78 a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? 78a X

b If "Yes," has it filed a tax return on Form 990-T for this year? . . . . . . . . . . . . . . . . . . . 78b N/A79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? If "Yes," attach a statement 79 X80 a Is the organization related (other than by association with a statewide or nationwide organization) through common

membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization? . . . . . . . 80a Xb If "Yes," enter the name of the organization ►_St. Anthony's Homes, Inc___________________________________

and check whether it is OXexempt or Ononexempt.----------------------------------------------81 a Enter direct and indirect political expenditures. See line 81 instructions . . . 81a I

b Did the organization file Form 1120-POL for this year? . . . . . . . . . . . . . . . . . . . . . 81b X82 a Did the organization receive donated services or the use of materials, equipment, or facilities at no charge

or at substantially less than fair rental value? . . . . . . . . . . . . . . . . . . . . . . . . . . 82ab If "Yes," you may indicate the value of these items here. Do not include this amount

as revenue in Part I or as an expense in Part II. (See instructions in Part III.) 82b 083 a Did the organization comply with the public inspection requirements for returns and exemption applications? 83a X

b Did the organization comply with the disclosure requirements relating to quid pro quo contributions? . . . . 83b X84 a Did the organization solicit any contributions or gifts that were not tax deductible? . . . . . . . . . . 84a X

b If "Yes," did the organization include with every solicitation an express statement that such contributionsor gifts were not tax deductible? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84b N/A

85 501(c)(4), (5), or (6) organizations. a Were substantially all dues nondeductible by members? . . . . . . 85ab Did the organization make only in-house lobbying expenditures of $2,000 or less? . . . . . . . . . 85b

If "Yes" was answered to either 85a or 85b, do not complete 85c through 85h below unless theorganization received a waiver for proxy tax owed for the prior year.

c Dues, assessments, and similar amounts from members . . . . . . . . 85cd Section 162(e) lobbying and political expenditures . . . . . . . . . . . 85de Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices . . 85ef Taxable amount of lobbying and political expenditures (line 85d less 85e) . 85f 0g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f? . . . . . . . . . . 85h If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount on line 85f to

its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for thefollowing tax year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85h

86 501(c)(7) orgs. Enter: a Initiation fees and capital contributions included on line 12 . . 86ab Gross receipts, included on line 12, for public use of club facilities . . . . . 86b

87 501(c)(12) orgs. Enter: a Gross income from members or shareholders . . 87ab Gross income from other sources. (Do not net amounts due or paid to other

sources against amounts due or received from them.) . . . . . . . . 87b88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or

partnership, or an entity disregarded as separate from the organization under Regulations sections301.7701-2 and 301.7701-3? If "Yes," complete Part IX . . . . . . . . . . . . . . . . . . . . . 88 X

89 a 501(c)(3) organizations. Enter: Amount of tax imposed on the organization during the year under:section 4911 ' ; section 4912 ' ; section 4955 ►

b 501(c)(3) and 501(c)(4) orgs. Did the organization engage in any section 4958 excess benefit transactionduring the year or did it become aware of an excess benefit transaction from a prior year? If "Yes," attacha statement explaining each transaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89b X

c Enter: Amount of tax imposed on the organization managers or disqualified persons during the year undersections 4912, 4955, and 4958 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► 0

d Enter: Amount of tax on line 89c, above, reimbursed by the organization . . . . . . . . . . . . . . ► 090 a List the states with which a copy of this return is filed ► MD

b Number of employees employed in the pay period that includes March 12, 2004 (See instructions.) 190b 1 20391 The books are in care of ► Name Elizabeth Thoreson Hymel_CFO-------------- Telephone no. ► 443-625-1590

Located at ► 135 -N.- Parke St---------------- Ci Aberdeen---------------ST_MD__ ZIP +4 "21001___-_ ____________- -92 Section 4947(a)(1) nonexempt charitable trusts filing Form 990 in lieu of Form 1041- Check here . . . . .

_____. . . . . ►LJ

and enter the amount of tax-exempt interest received or accrued during the tax year . ► 1 92 IN/AForm 990 (2004)

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52-1310095 Paae 6Analysis of Income-Producing Activities (See page 33 of the instructions.)

Note: Enter gross amounts unless otherwise Unrelated busin ess income Excluded by section 512, 513, or 514 (E)

indicated.

93 Program service revenue-

(A)Business code

(B)Amount

(C)Exclusion code

(D)

Amount

Related orexempt function

incomea Fees for Service 8,446,574b Member Cost of Care, SSDI,SSI 838,389c Member DSS 106,786d Other 79,223ef Medicare/Medicaid payments . . . . .g Fees and contracts from government agencies

94 Membership dues and assessments . . . . .95 Interest on savings and temporary cash investments 1,42596 Dividends and interest from securities . . . .97 Net rental income or (loss) from real estate:

a debt-financed property . . . . . . . . .b not debt-financed property . . . . . .

98 Net rental income or (loss) from personal property99 Other investment income . . . . . .

100 Gain or (loss) from sales of assets other than inventory101 Net income or (loss) from special events . .102 Gross profit or (loss) from sales of inventory103 Other revenue. a

b St. Anthony Managment Fee 5,407c St. Anthony Cost Reimbursements 33,826d Medical Records 878e Other 7,967

104 Subtotal (add columns (B), (D), and (E)) . . . . 0 0 9,520,475105 Total (add line 104, columns (B), (D), and (E)) . . . . . . . . . . . . . . . . . . . . . ► 9,520,475Note: Line 105 plus line Id, Part / should equal the amount on line 12 Part 1.

lei Relationshi of Activities to the Accomplishment of Exempt Purposes (See page 34 of the instructions.)Line No.V

Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishmentof the organization's exempt purposes (other than by providing funds for such purposes).

105 The organization is a not fo arofit coaoration formed to provide community rehabilitation. aroarams and supervised

- miormation Ke aram i axaoie 5uos il ataries ana utsre araea tntities ziee a e 54 OT the instructions.(A)

Name, address, and EIN of corporation,partnership, or disregarded entity

(B)Percentage of

ownership interest(C)

Nature of activities(D)

Total income(E)

End-of-yearassets

N/A - % 0 0% 0 0% 0 0% 0 0

Information Regarding Transfers Associated with Personal Benefit Contracts (See page 34 of the instructions.)(a) Did the organization , during the year, receive any funds , directly or indirectly, to pay premiums on a personal benefi t contract? Yes X No(b) Did the organization , during the year, pay premiums, directly or iNote : If " Yes " to (b), file Form 8870 and Form 4720 see instructio

Under penalties f perjury, I declare that I have examined this return, includeand belief, ue, r t, nd complete Declaration of preparer (other th

PleaseSignHere

Sig atu a of officer

Karl D . Weber, CEOType or print name and title

PreparersPaid signaturePreparer's Firm's name (or yoursUse Only ifself-employed),

address and ZIP + 4

�=�i -7o0So3R o' Dtd' gti(� (S

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SCHEDULE A Organization Exempt Under Section 501(c)(3) OMB No 1545-0047

(Form 990 or 990-EZ) (Except Private Foundation) and Section 501(e), 501(f), 501(k),501(n), or Section 4947(a)(1) Nonexempt Charitable Trust 2004Supplementary Information-(See separate instructions.)

Department of the Treasuryinternal Revenue Serv ice ► MUST be completed by the above organizations and attached to their Form 990 or 990-EZName of the organization FEmployer identification number

Key Point Health Services, Inc. 52-1310095Compensation of the Five Highest Paid Employees Other Than Officers, Directors , and Trustees(see nano 1 of the inctrl tctinnc I ict each nne If there are nnne enter "None "l

(a) Name and address of each employee paid more (b) Title and average hours(c) Compensation

(d) Contributions toemployee benefit plans &

(e) Expenseaccount and other

than $50,000 per week devoted to position deferred compensati on allowances

Name Dr. Ralph Scoville, MDStr 135 N= Parke St------ --- ------- -------------------------

City Aberdeen ST MD Title Medical Directorzip 21001 Country USA Avg hr/wk 40 162,312 12,842

Name Dr. Shawn CassadyStr 135 N.- Parke St--------------------------

City Aberdeen ST MD Title PsychiatristZip 21001 Country USA Av hr/wk 40 141,760 7,760

Name Dr. Michael FulopStr 135 N.- Parke St--------------------------

City Aberdeen ST MD Title PsychiatristZip 21001 Country Avg hr/wk 32 112,610 11,782

Name Dr. Joseph Acra--- Str 135 N Parke -St ------------------------

City Aberdeen ST MD Title Medical DirectorZip 21001 Country USA Av hr/wk 40 159,124 10,916

Name Dr. Neil Carr--- Str 135 N Parke St ------------------------

City Aberdeen ST MD Title PsychiatristZip 21001 Country USA Avg hr/wk 30 107,4371

Total number of other employees paid over$50,000 ► 13

• .. Compensation of the Five Highest Paid Independent Contractors for Professional Servicesindividuals or firms). If there are n

(a) Name and address of each independent contractor paid more than $50,000 1 (b) Type of service I (c) Compensation

Name University of Maryland Check here if a business

IMedical

Str 737 W' Lombard St 3rd Floor---- ----- ------ ---------------------------------------Clty BaltimoreST MD ZIP 21202 Country USA Contractor 74,295

Name Check here if a businessLStr-----------------------------------------------------------------------

City

Name Check here if a businessStr-----------------------------------------------------------------------

CityST ZIP Country

Name Check here if a businessStr

city

Name Check here if a businessLStr-----------------------------------------------------------------------

City

Total number of others receiving over $50,000 forprofessional services . . . . . . . ► 0For Paperwork Reduction Act Notice, see the Instructions for Form 990 and Form 990-EZ. Schedule A (Form 990 or 990-EZ) 2004

(HTA)

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Schedule A (Form 990 or 990-EZ) 2004 Key Point Health Services, Inc. 52-1310095 Page 2

Statements About Activities (See page 2 of the instructions.) Yes No

1 During the year, has the organization attempted to influence national, state, or local legislation, including anyattempt to influence public opinion on a legislative matter or referendum? If "Yes," enter the total expenses paidor incurred in connection with the lobbying activities ► $ 0 (Must equal amounts on line 38,Part VI-A, or line i of Part VI-B). . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . 1 XOrganizations that made an election under section 501(h) by filing Form 5768 must complete Part VI-A Otherorganizations checking "Yes" must complete Part VI-B AND attach a statement giving a detailed description ofthe lobbying activities.

2 During the year, has the organization, either directly or indirectly, engaged in any of the following acts with anysubstantial contributors, trustees, directors, officers, creators, key employees, or members of their families, orwith any taxable organization with which any such person is affiliated as an officer, director, trustee, majorityowner, or principal beneficiary? (If the answer to any question is "Yes,"attach a deta iled statement explaining thetransactions.)

a Sale, exchange, or leasing of property? . . . . . . . . . . . . . . . . . . . . . . 2a Xb Lending of money or other extension of credit? . . . . . . . . . . . . . . . . . . . . . 2b Xc Furnishing of goods, services, or facilities? . . . . . . . . . . . . . . . . . . . . . . . 2c Xd Payment of compensation (or payment or reimbursement of expenses if more than $1,000)? . 2d X

e Transfer of any part of its income or assets? . . . . . . . . . . . . . . . 2e X

3 a Do you make grants for scholarships, fellowships, student loans, etc.? (If "Yes," attach an explanation of howyou determine that recipients qualify to receive payments.) . . . . . . . . . . . . . . 3a X

b Do you have a section 403(b) annuity plan for your employees? 3b X4 a Did you maintain any separate account for participating donors where donors have the right to provide advice

on the use or distribution of funds?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a Xb Do you provide credit counseling, debt management, credit repair, or debt negotiation services? . 4b X

Reason for Non-Private Foundation Status (See pages 3 through 6 of the instructions.)

The organization is not a private foundation because it is: (Please check only ONE applicable box.)5 ❑ A church, convention of churches, or association of churches. Section 170(b)(1)(A)(i).

6 ❑ A school. Section 170(b)(1)(A)(ii). (Also complete Part V.)

7 ❑ A hospital or a cooperative hospital service organization. Section 170(b)(1)(A)(iii).

8 ❑ A Federal, state, or local government or governmental unit. Section 170(b)(1)(A)(v)

9 ❑ A medical research organization operated in conjunction with a hospital. Section 170(b)(1)(A)(iii). Enter the hospital'sname, city, and state ►------------------------------ City -----------------------ST--------Country---------------------

10 ❑ An organization operated for the benefit of a college or university owned or operated by a governmental unit. Section170(b)(1)(A)(iv). (Also complete the Support Schedule in Part IV-A.)

11 a ❑X An organization that normally receives a substantial part of its support from a governmental unit or from the generalpublic Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A.)

11 b ❑ A community trust. Section 170(b)(1)(A)(vi). (Also complete the Support Schedule in Part IV-A )

12 ❑ An organization that normally receives, (1) more than 33 113% of its support from contributions, membership fees, and grossreceipts from activities related to its charitable, etc, functions-subject to certain exceptions, and (2) no more than 33 1/3%of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businessesacquired by the organization after June 30, 1975. See section 509(a)(2). (Also complete the Support Schedule in Part IV-A)

13 ❑ An organization that is not controlled by any disqualified persons (other than foundation managers) and supportsorganizations described in, (1) lines 5 through 12 above; or (2) section 501 (c)(4), (5), or (6), if they meet the test of section509(a)(2). (See section 509(a)(3) )

Provide the following information about the suppo rted organizations. (See page 5 of the instructions.)

(a) Name(s) of supported organization(s) (b) Line numberfrom above

14 ❑ An organization organized and operated to test for public safety Section 509(a)(4) (See page 5 of the instructions )

Schedule A (Form 990 or 990-EZ) 2004

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Schedule A (Form 990 or 990-EZ) 2004 Key Point Health Services, Inc. 52-1310095 Page 3ORM Support Schedule (Complete only if you checked a box on line 10, 11, or 12.) Use cash method of accounting.Note :, You may use the worksheet in the instructions for converting from the accnial to the rash method of arro,intinnCalendar year (or fiscal year beginning in) ► (a) 2003 (b) 2002 (c) 2001 (d 2000 (e) Total15 Gifts , grants , and contributions received. (Do

not include unusual grants. See line 28 104,951 651,468 245,740 172 292 1 174 45116 Membership fees received 017 Gross receipts from admissions , merchandise

sold or services performed , or furnishing offac il ities in any activity that is related to theorganization's charitable , etc , purpose 10,708,820 10,406,922 10,760,988 10,762,641 42,639,371

18 Gross income from interest , dividends,amounts received from payments on securitiesloans (section 512 (a)(5)), rents , royalties, andunrelated business taxable income (lesssection 511 taxes) from businesses acquiredby the organization after June 30, 1975 2,289 13,312 8.732 9,193 33,526

19 Net income from unrelated businessactivities not included in line 18 0

20 Tax revenues levied for the organization'sbenefit and either paid to it or expended onits behalf . . . . . . . . . . . . . . . . . . . 0

21 The value of services or facilities furnished tothe organization by a governmental unitwithout charge . Do not include the value ofservices or facilities generally furnished to thepublic without charge 53,136 53,136

22 Other income Attach a schedule Do notinclude gain or (loss) from sale of capital assets 15,679 12,521 50,407 0 78,607

23 Total of lines 15 through 22 10,831,739 11,084,223 11,065,867 10,997,262 43,979,09124 Line 23 minus line 17 122,919 677 301 304,879 234,621 1 339 72025 Enter 1 % of line 23 . 108 317 110:8421 110 659 109 97326 Organizations described on lines 10 or 11: a Enter 2% of amount in column (e), line 24 . . . .

b Prepare a list for your records to show the name of and amount contributed by each person (other than agovernmental unit or publicly supported organization) whose total gifts for 2000 through 2003 exceeded theamount shown in line 26a. Do not file this list with your return . Enter the total of all these excess amounts

c Total support for section 509(a)(1) test: Enter line 24, column (e) . . . . . . . . . . . . .d Add, Amounts from column (e) for lines- 18 33,526 19 0

22 78,607 26b 0

► 26a 26,794

► 26b► 26c 1 .339.720

e Public support (line 26c minus line 26d total) . . . . . . . . .f Public support percentage ( line 26e (numerator) divided by line 26c (denominator)) .

► 26d► 26e► 26f

27 Organizations described on line 12: a For amounts included in lines 15, 16, and 17 that were received from a "disqualified person,"prepare a list for your records to show the name of, and total amounts received in each year from, each "disqualified person " Do notfile this list with your return. Enter the sum of such amounts for each year

91.63%

(2003) •-------------------- (2002) ...................... (2001) --------------------- (2000) ---------------------b For any amount included in line 17 that was received from each person (other than "disqualified persons"), prepare a list for your records to

show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) $5,000.(Include in the list organizations described in lines 5 through 11, as well as individuals) Do not file this list with your return . After computing thedifference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excessamounts) for each year:

(2003) •-------------------- (2002) ...................... (2001) --------------------- (2000) ---------------------

c Add: Amounts from column (e) for lines 15 0 16 017 0 20 0 21 0 . . . . . ► 27c 0

d Add, Line 27a total . . 0 and line 27b total . . 0 . . . . . . ► 27d 0e Public support (line 27c total minus line 27d total) . . . . . . . . . . . . . . . . . . ► 27e 0f Total support for section 509(a)(2) test Enter amount from line 23, column (e) . ► 27f 0g Public support percentage ( line 27e (numerator) divided by line 27f (denominator)) . . . . . . . . . ► 27 0.00%h Investment income percentage (line 18, column (e) (numerator) divided by line 27f (denominator)) . ► 27h 0.00%

28 Unusual Grants : For an organization described in line 10, 11, or 12 that received any unusual grants during 2000 through 2003, preparea list for your records to show, for each year, the name of the contributor, the date and amount of the grant, and a brief description ofthe nature of the grant Do not file this list with your return . Do not include these grants in line 15.

Schedule A (Form 990 or 990-EZ) 2004

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Schedule A (Form 990 or 990-EZ) 2004 Key Point Health Services, Inc. 52-1310095 Page 4'Private School Questionnaire (See page 7 of the instructions.)(To be completed ONLY by schools that checked the box on line 6 in Part IV)

29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, Yes Noother governing instrument, or in a resolution of its governing body? . . . . . . . . . . . . . . . . . . . 29

30 Does the organization include a statement of its racially nondiscriminatory policy toward students in all itsbrochures, catalogues, and other written communications with the public dealing with student admissions,programs, and scholarships? . . . . . . . . . . . . . . . . . . 30

31 Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media duringthe period of solicitation for students, or during the registration period if it has no solicitation program, in a way thatmakes the policy known to all parts of the general community it serves? . . . . . . . . . . . . . . . . . . . . . . 81

If "Yes," please describe, if "No," please explain. (If you need more space, attach a separate statement )

---------------------------------------------------------------------------------------------------------

32 Does the organization maintain the following:

a Records indicating the racial composition of the student body, faculty, and administrative staff? . . . . . . . . . . . .

b Records documenting that scholarships and other financial assistance are awarded on a raciallynondiscriminatory basis? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Copies of all catalogues, brochures, announcements, and other written communications to the publicdealing with student admissions, programs, and scholarships? . . . . . . . . . . . . . . . . . . . . . . . .

d Copies of all material used by the organization or on its behalf to solicit contributions? . . . . . .

If you answered "No" to any of the above, please explain. (If you need more space, attach a separate statement )

---------------------------------------------------------------------------------------------------------

33 Does the organization discriminate by race in any way with respect to:

a Students' rights or privileges? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

b Admissions policies? . . . . . . . . . . . . . . . . . . .

c Employment of faculty or administrative staff? . . . . . . . . . .

d Scholarships or other financial assistance? . . . . . . . . . . . . . . . . . . . . . . . .

e Educational policies? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Use of facilities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Athletic programs? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Other extracurricular activities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If you answered "Yes" to any of the above, please explain (If you need more space, attach a separate statement )

34 a Does the organization receive any financial aid or assistance from a governmental agency? . . . . . . .

b Has the organization's right to such aid ever been revoked or suspended? . . . . . . . .If you answered "Yes" to either 34a or b, please explain using an attached statement.

35 Does the organization certify that it has complied with the applicable requirements of sections 4.01 through4.05 of Rev Proc 75-50, 1975-2 C.B 587, covering racial nondiscriminat ion? If "No," attach an explanation

Schedule A (Form 990 or 990-EZ) 2004

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Schedule A' (Form 990 or 990-EZ) 2004 Key Point Health Services, Inc. 52-1310095 Page 5Lobbying Expenditures by Electing Public Charities (See page 9 of the instructions.)(To be completed ONLY by an eligible organization that filed Form 5768)

Check ►a if the organization belongs to an affiliated group. Check ► b LI if you checked "a" and "limited control" provisions apply.

Limits on Lobbying ExpendituresAffiliated

(b)

group To be completedALL electingtotals for

(The term "expenditures " means amounts paid or incurred.)

36 Total lobbying expenditures to influence public opinion (grassroots lobbying ) . . . . . . . . . . 3637 Total lobbying expenditures to influence a legislative body (direct lobbying ) . . . . . . . . . . 3738 Total lobbying expenditures (add lines 36 and 37) . . . . . . . . . . . . . . . . . . . . 3839 Other exempt purpose expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . 3940 Total exempt purpose expenditures (add lines 38 and 39) . . . . . . . . . . . . . . . . . . 4041 Lobbying nontaxable amount Enter the amount from the following table-

If the amount on line 40 is- The lobbying nontaxable amount is-Not over $500,000 . . . . . 20% of the amount on line 40 . . . . . . ..Over $500 , 000 but not over $ 1,000,000 . $ 100,000 plus 15% of the excess over $500,000Over $ 1,000,000 but not over $1,500,000 . . $ 175,000 plus 10% of the excess over $1 , 000,000 41Over $1, 500,000 but not over $17 , 000,000 . $225,000 plus 5% of the excess over $1 , 500,000Over $17, 000,000 . . . . $ 1,000,000 . . . . . . . . . . .

42 Grassroots nontaxable amount (enter 25% of line 41) . . . . . . . . . . . . . . . . . 4243 Subtract line 42 from line 36 Enter -0- if line 42 is more than line 36 . . . . . . . . . . . . . 4344 Subtract line 41 from line 38 . Enter -0- if line 41 is more than line 38 . . . . . . . . . . . . . . 44

0

Caution : if there is an amount on either line 43 or line 44, you must file Form 4720.

4-Year Averaging Period Under Section 501(h)(Some organizations that made a section 501(h) election do not have to complete all of the five columns below

See the instructions for lines 45 throuah 50 on Daae 11 of the instructions )

Lobbying Expenditures During 4-Year Averaging Period

Calendar year (or (a) (b) (c) (d) (e)fiscal year beginning in ) ► 2004 2003 2002 2001 Total

50 Grassroots lobbying expenditures 0Lobbying Activity by Nonelecting Public Charities(For reporting only by organizations that did not complete Part VI-A) (See page 11 of the instructions.)

During the year, did the organization attempt to influence national, state or local legislation, including any Yes No Amountattempt to influence public opinion on a legislative matter or referendum, through the use of,

a Volunteers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .b Paid staff or management (Include compensation in expenses reported on lines c through h.) . . . . .

Eli=c Media advertisements . . . . . . . . . . . . . . . . . . . . . . . . . .d Mailings to members, legislators, or the public . . . . . . . . . . . . . .e Publications, or published or broadcast statements . . . . . . . . . . . . . . . .f Grants to other organizations for lobbying purposes . . . . . . . . . . . . . . . . . . .g Direct contact with legislators, their staffs, government officials, or a legislative body . . . . . .h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other meansi Total lobbying expenditures (Add lines c through h.) MEN" 0

If "Yes" to any of the above, also attach a statement giving a detailed description of the lobbying activities.Schedule A (Form 990 or 990-EZ) 2004

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Schedule A (Form 990 or 990-EZ) 2004 Key Point Health Services, Inc. 52-1310095 Page 6

Information Regarding Transfers To and Transactions and Relationships With NoncharitableExempt Organizations (See page 11 of the instructions.)

51 Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section501(c) of the Code (other than section 501 (c)(3) organizations) or in section 527, relating to political organizations?

a Transfers from the reporting organization to a noncharitable exempt organization of. Yes No

(i) Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 all) X

(ii) Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a(ii) X

b Other transactions,

(i) Sales or exchanges of assets with a noncharitable exempt organization . . . . . . . . . . . . . . . . b( i ) X

(ii) Purchases of assets from a noncharitable exempt organization . . . . . . . b(ii) X

(iii) Rental of facilities, equipment, or other assets . . . . . . . . . . . . . . . . . . . . . . b( I i i ) X

(iv) Reimbursement arrangements . . . . . . . . . . . . . . . . . . . . . b ( Iv ) X

(v) Loans or loan guarantees b(v) X

(vi) Performance of services or membership or fundraising solicitations . . . . . . . . . . . b(v i ) X

c Sharing of facilities, equipment, mailing lists, other assets, or paid employees . . . . . . . . . . . . . . c X

d If the answer to any of the above is "Yes," complete the following schedule Column (b) should always show the fair market valueof the goods, other assets, or services given by the reporting organization If the organization received less than fair market valuein any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received:

(a) (b) (c) (d)Line no Amount involved Name of nonchantable exempt organization Description of transfers. transactions. and shanna arrangements

Schedule A (Form 990 or 990-EZ) 2004

52 a Is the organization directly or indirectly affiliated with , or related to, one or more tax-exempt organizationsdescribed in section 501 (c) of the Code (other than section 501 (c)(3)) or in section 527? . . . . . . . . . . El Yes F No

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Key Point Health Services, Inc. 52-1310095

Line 8 (990) - Gain/loss from sale of assets other than inventory

Totals: Grossale

Cost, otherbasis and expenses

Public Securities 0 0Non-Public Securities 0 0

Other sales 28,465 35,334Check if

gain/loss isfrom sale

Check ifgain/loss isfrom sale of

Check ifpurchaser

Cost or other basis(Enter one field only)

Expenseof sale and

cost of

Index Descriptionof publicsecurities

non publicsecurities

is abusiness Purchaser

Dateacquired

Acquisitionmethod

Datesold

Gross salesrice Cost

Donatedvalue

improve-ments

1 2004 Dodge Truck Stolen 3/11/2004 Purchase 8/24/2004 28,465 25,2312 Leasehold Improvements Abandoned LHI 7/1/1998 Purchase 3/31/2005 0 38,2013 Leasehold Improvements Abandoned LHI 1/1/1998 Purchase 3/31/2005 0 5504 Leasehold Improvements Abandoned LHI 7/1/1998 Purchase 3/31/2005 0 6,7745 Leasehold Improvements Abandoned LHI 7/1/1998 Purchase 3/31/2005 0 2,4506 Leasehold Improvements Abandoned LHI 7/1/1998 Purchase 3/31/2005 0 12,793 17 Leasehold Improvements Abandoned LHI 9/21/2000 Purchase 3/31/2005 0 4,7008 Various F & F Junked Various Purchase Various 0 10,2139 Various Automobiles Fully Depreciated Various Purchase Various 0 335,60610 Various Equip Junked Various Purchase Various 0 1 44311 Various Equip Staff Junked Various Purchase Various 0 105,26512 Various LHI Abandoned LHI Various Purchase Various 0 15,22113 Ad Sale of 314 William St 6/30/04 Various Purchase Various 0 014151617181920

To add more lines to this schedule. Dress CTRL+Q.

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ney roint neaitn cervices , Inc. 52-1310095

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Key Point Health Services, Inc

Line 47 (990) - Accounts receivable

I Accounts Receivable 122 ------------------------------------------

3 3------------------------------------------4 4------------------------------------------5 5------------------------------------------6 6------------------------------------------7 7------------------------------------------8 8------------------------------------------9 9------------------------------------------110 11(----------------------------------------11 Total accounts receivable . . . . . . . 11

Line 57 (990) - Land . buildings, and equipment

52-1310095

Allowance for doubtful accounts

412.301

Land (net of any amortization) Land (net of anv amortization)Beginning End

I Land ----------- --------- ------------------- -------------- 1 512,733 677,848---------------------------

2 -------- --------- ------------------- -------------- 2----------------------------- -3 --------------------------- --------- ------------------- -------------- 3-----------4 ------------------------ --------- ------------------- -------------- 4--------------

- -----5 --------- ------------------- -------------- 5------ ---------------------- --6 Total land (net of any amortization) . . . . . . . . . . . . . . . . . . . . 6 512,7331 677 8481

Buildings and equipment Buildings and equipment Accumulated depreciationBeginning End Beginning End

7 Vehicles -- 7---- 929,465 596,967 682,555 437,481------------------------------------

8 Pro�ram Equipment & Furniture-------- ---- 8 181,468 180,024 166,552 177,805_9 Staff Furniture & Fixtures ------------ - 9---- 336,178 325,966 304 732 312,883

---------------------- - -10 Buildinqs________________ ___________ __ _ 10 2,218,700 2,484,532 133,329 178,04911 Leasehold Improvements 11 109,288 1,050,503 60,151 49,014------------- --12 Equipment ___ _____ _ ____ _ _____ ____ 12 345,923 244,639 244745 180,58913 --------------- -- ---- --- -- - - 13--14 -- -- ------ ---- ---- ------ -- 14--- --15 1516 ------------------ 16---------------------- --17 Total buildings and equipment . 17 4,121 022 4,882,631 1,592,064 1,335,82118 Buildings and equipment (less accumulated depreciation) . . . . . . . . . . . 18 2,528,958 3,546,81019 Total land, buildings and equipment . . . . . . . . . . . . . . . . 19 3,041,691 4,224,658

Category or Item1 1-------------------------------------------------------------2 2-------------------------------------------------------------3 3-------------------------------------------------------------4 4-------------------------------------------------------------5 5-------------------------------------------------------------6 6-------------------------------------------------------------7 7-------------------------------------------------------------8 8-------------------------------------------------------------9 9-------------------------------------------------------------10 10-------------------------------------------------------------11 Total . . . . . . . . . . . . . . . . . . . . . . . . 11

Cost/Other BasisAccumulatedDepreciation Book Value

01 1 01 1 0

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Key Point Health Services, Inc

Line 58,(990) - Other assets

1 Due from Harford Aberdeen-------------------------------------------------------2 Security Deposits ---------------------------------------------------------------3 St_ Anthony's Homes,-Inc. -------------------------------------------------------4 Due from Ernployees------------------------------------------------------------5 CDA Escrow------------ -------------------------------------------------------------------6 --------------------------------------------------------------------------------7 --------------------------------------------------------------------------------8 --------------------------------------------------------------------------------9 --------------------------------------------------------------------------------10 --------------------------------------------------------------------------------

Total of er asses . . . . . . . . . . . . . . . . . . . . . . . . . . .

52-1310095

Beginning End1 16,2752 109,553 12,5973 12,164 24,9324 664 8145 7,710 2,888678910

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Key Point Health Services, Inc

Check if lender Originalis a business amount

Line 64b (990) - Mortgages and other notes payable

I Mortgages2 Arthur Helton3 Branch Banking4 Branch Bankin5 Branch Banking6 Branch Bankini7 Branch Bankini8 Branch Bankin9 Branch Bankin!10 Branch Bankin11 Branch Banking12 Branch Bankin13 Branch Banking14 First Union19 Totals . . . .

Lender's name

& Trust& Trust& Trust& Trust& Trust& Trust& Trust& Trust& Trust& Trust& Trust

Security providedI Buildings2 None3 Dodge Maxi Van4 Dodge Maxi Van5 Dodge Maxi Van6 Dodge Maxi Van7 Jeep Cherokee8 Dodge Van9 Hyundai Elantra10 Ford Van11 Ford Van12 Dodge Ram13 Dodge Ram14 Chevy Van

IPurpose of loan

Purchase Assets2 Purchase Assets3 Purchase Assets4 Purchase Assets5 Purchase Assets6 Purchase Assets7 Purchase Assets8 Purchase Assets9 Purchase Assets10 Purchase Assets11 Purchase Assets12 Purchase Assets13 Purchase Assets

Lender's Title

Date of noteVarious2/11/2005

10/16/200110/16/200110/16/200110/16/20014/24/20021/7/20034/20/20046/11/20046/14/20048/18/20043/15/20045/25/2000

1,630,795200,00024,11821,11820,61819,61824,27220,9068,000

15,75515,75523,63825,23128,884

19 2,078,708

Maturity dateVarious1/31/201010/16/200510/16/200510/16/200510116/Z0054/24/200612/31/20083/15/20096/11/20086/14/20088/31/20093/15/20095/25/2005

Description of consideration

Balance dueend of year

1,466,939189,003

2,2791,9961,9481,8549,905

11,1873,443

12,21612,21620,200

1,733,186

Interest rateVarious

8.00%6.37%6.37%6.37%6.37%7.00%6.15%5.85%7.13%7.13%6.50%6.50%

Prime-.51 %

FMV of consideration

52-1310095

Balance duebeginningof year

975,475

8,7527,6637,4827,119

14,78915,6177,368

15,75515,755

24,1514,672

1,104,598

Repaymentterms

MonthlyMonthlyMonthlyMonthlyMonthlyMonthlyMonthlyMonthlyMonthlyMonthlyMonthlyMonthlyMonthlyMonthly

Relationship to InsiderNoneNoneNoneNoneNoneNoneNoneNoneNoneNoneNoneNoneNone

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KEY POINT HEALTH SERVICES, INC.

KEY POINT HEATH SERVICES, INC.FOR THE YEAR ENDED JUNE 30, 2005

FID# 52-1310095

FORM 990, PAGE 2 OTHER EXPENSES LINE 43b:

BAD DEBTBANK FEESCONSULTINGCONTRIBUTIONSDUES & SUBSCRIPTIONSEQUIPMENT MEMBERSWORKMANS COMPENSATION INSURANCEINSURANCE - OTHERGROCERIESLICENSESAUTO EXPENSEINSURANCE-AUTOBUILDING REPAIRSOFFICE CLEANINGLAWN MAINTENANCELOBBYISTOTHER PROFESSIONAL FEESMEDICAL EXPENSEMOVING & STORAGEOFFICE EXPENSEMISCELLANEOUSPERSONAL LIVING EXPENSEACTIVITIESDIRECTORS FEESPROPERTY TAXES & FEESENTERTAINMENTUTILITIES

TOTALS

2:25 PM 2/14/2006

Management Service Programs Totals382,770 382,770

3,416 3,41638,552 155,760 194,31227,323 27,32315,286 333 15,619

16,593 16,5932,721 35,463 38,184

27,677 132,614 160,291228,016 228,016

1,230 10,264 11,49410,361 120,870 131,23118,482 60,736 79,21819,883 90 ,370 110,253

3,212 3,212510 5,705 6,215

22,550 22,55031,478 31,478

280 13,397 13,6778,907 14,596 23,503

23,550 64,009 87,559

167,239 167,23951,342 51,342

29,250 29,25088 1,937 2,025

5,510 286 5,7963,997 129,660 133,657

268,501 1,707,722 1 , 976,223

SCHEDULE A, STATEMENTS ABOUT ACTIVITIES PART III LINE 2d:

Payment of compensation was made to the following individuals for services renderedAll fees were negotiated and were reasonable to comparable services for non related persons.

Chad Hymel - Lawn Services $ 1,005

H:\HumanResources \BethHymel\My Documents\TaxReturns\2004\H \HumanResources \BethHymel\MyPAGE1 Documents\TaxReturns\2004\TAX RETURN ATTACH MENT6-30-05

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QQ Application for Extension of Time To File anFormV �,/(Rev. December 2004) Exempt Organization Return OMB No. 1545-1709Department of the Treasury ► F ile a separate application for each return.Internal Revenue Service

• If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box . . . . . . . . ► ❑✓• If you are filing for an Additional (not automatic) 3-Month Extension , complete only Part II (on page 2 of this form).Do not complete Pa rt 9 unless you have already been granted an automatic 3-month extension on a previously filed Form 8868.

Automatic 3-Month Extension of Time-Only submit original (no copies needed)

Form 990-T corporations requesting an automatic 6-month extension-check this box and complete Part I only . . . ► ❑All other corporations (including Form 990-C filers) must use Form 7004 to request an extension of time to file income tax returns.Partnerships, REMICs, and trusts must use Form 8736 to request an extension of time to file Form 1065, 1066, or 1041.Electronic Filing (e-file). Form 8868 can be filed electronically if you want a 3-month automatic extension of time to file one of thereturns noted below (6 months for corporate Form 990-T filers). However, you cannot file it electronically if you want the additional(not automatic) 3-month extension, instead you must submit the fully completed signed page 2 (Part II) of Form 8868. For moredetails on the electronic filing of this form, visit www.irs.gov/efile.

Type orprintFile thedue date forfiling yourreturn. Seeinstructions.

Name of Exempt OrganizationKEY POINT HEALTH SERVICES, INC.Number, street, and room or suite no. If a P.O. box, see instructions.135 N. PARKE ST.

Employer identification number52 1310095

City, town or post office, state, and ZIP code. For a foreign address, see Instructions.ABERDEEN, MD 21001

Check type of return to be filed (file a separate application for each return):© Form 990 ❑ ' Form 990-T (corporation) ❑ Form 4720❑ Form 990-BL ❑ Form 990-T (sec. 401(a) or 408(a) trust) ❑ Form 5227❑. Form 990-EZ ❑ Form 990-T (trust other than above) El Form 6069El Form 990-PF ❑_Form 1041-A ❑ Form 8870

• The books are in the care of ►_ELIZABETH THORESON HYMEL, CPA

Telephone No. ► - 625.1590 FAX No. P- ...443 __)_ 625.1595--_-_• if the organization does not have an office or place of business in the United States, check this box . . . . . . ► ❑• If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) . If thisis for the whole group, check this box ►❑ . If it is for part of the group, check this box ► ❑ and attach a list with thenames'and EINs of all members the extension will cover.

1 I request an automatic 3-month (6-months for a Form 990-T corporation) extension of time until _FEBRUARY 15 2099,to file the exempt organization return for the organization named above. The extension is for the organization's return for:► ❑ calendar year 20 ___ or► l tax year beginning JULY 1 JUNE 30 05,Y ------------ -------------------- - 20---, and ending --------------- ------------ , 20

2 If this tax year is for less than 12 months, check reason: ❑ Initial return ❑ Final return ❑ Change in accounting period

3a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less anynonrefundable credits. See instructions . . . . . . . . . . . . . . . . . . . . . $ CD

b If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated tax paymentsmade. Include any prior year overpayment allowed as a credit . . . . . . . . . . . . . $

o Balance Due. Subtract line 3b from line 3a. Include your payment with this form, or, if required, depositwith FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). Seeinstructions . . . . . . . . . . . . . . . . . . $ NONE

Caution . If you are going to make an electronic fund withdrawal with this Form 8868, see Form 8453-EO and Form 8879-EOfor payment instructions.For Privacy Act and Paperwork Reduction Act Notice, see Instructions . Cat No. 27916D Form 8868 (Rev. 12-2004)

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Form 8868 (Rev. 12-2004) Page 2• If you are filing for an Additional (not automatic) 3-Month Extension, complete only Part Il and check this box . - ► ❑Note. Only complete Part II if you have already been granted an automatic 3-month extension on a previously filed Form 8868.• If you are filing for an Automatic 3-Month Extension, complete only Part I (on page 1).

Additional (not automatic) 3-Month Extension of Time-Must File Original and One Copy,Type or Name of Exempt Organization Employer identification numberprintFile by the Number, street, and room or suite no. If a P.O. box, see instructions. For IRS use onlyextendeddub date forfiling the City, town or post office, state, and ZIP code. For a foreign address, see instructions.return. Seeinstructions.

Check type of return to be filed (File a separate application for each return):

❑ Form 990 ❑ Form 990-T (sec. 401(a) or 408(a) trust) ❑ Form 5227❑ Form 990-BL ❑ Form 990-T (trust other than above) ❑ Form 6069❑ Form 990-EZ ❑ Form 1041-A ❑ Form 8870❑ Form 990-PF ❑ Form 4720STOP: Do not complete Part If if you were not already granted an automatic 3-month extension on a previously filed Form 8868.• The books are in the care of ► -------------------------------------------------------------------------------------Telephone No. ► (--------- )---------------------------- FAX No. ► f---------- ) -----------------------------

• If the organization does not have an office or place of business in the United States, check this box . . . . . . ► ❑• If this is for a Group Return, enter the organization's four digit Group Exemption Number (GEN) If this isfor the whole group, check this box ► ❑ . If it is for part of the group, check this box ► ❑ and attach a list with thenames and EINs of all members the extension is for.4 I request an additional 3-month extension of time until ----------------------------------------- - 20.....5 For calendar year -------- or other tax year beginning------------------------ - 20-----, and ending------------------------ , 20 .....6 If this tax year is for less than 12 months, check reason: ❑ Initial return ❑ Final return ❑ Change in accounting period7 State in detail why you need the extension ...........................................................................................

---------------------------------------------------------------------------------------------------------------------------------------------8a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any

nonrefundable credits. See instructions . . . . . . . . . . . . . . . . . . . . . $b If this application is for Form 990-PF, 990-T, 4720, or 6069, enter any refundable credits and estimated

tax payments made. Include any prior year overpayment allowed as a credit and any amount paidpreviously with Form 8868 . . . . . . . . . . . . . . . . . . . . . . . . . $

c Balance Due. Subtract line 8b from line 8a. Include your payment with this form, or, if required, depositwith FM coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System). See instructions, $

Signature and VerificationUnder penalties of perjury, I declare that I have examined this form, including accompanying schedules and statements, and to the best of my knowledge and beliefit is true, correq,.,at complete, and�that I authorized to prepare this form.

Signature ► (� U Title ► UH) Date ► log

otice to ApplicantTo Be Completed by the IRS❑ We have approved this application. Please attach this form to the organization 's return.❑ We have not approved this application . However, we have granted a 10-day grace period from the later of the date shown below or the due

date of the organization 's return (including any prior extensions). This grace period is considered to be a valid extension of time for electionsotherwise required to be made on a timely return . Please attach this form to the organization 's return.

❑ We have not approved this app lication . After considering the reasons stated in item 7, we cannot grant your request for an extension of timeto file. We are not granting a 10-day grace period.

❑ We cannot consider this application because it was filed after the extended due date of the return for which an extension was requested.❑ Other --------------------------------------------------------------------------------------------------------------------------------------

By:Director DateAlternate Mailing Address - Enter the address if you want the copy of this application for an addition al 3-month extensionreturned to an address different than the one entered above.

Name

Type or Number and street (include suite , room, or apt no .) or a P.O. box numberprint

City or town, province or state, and country (including postal or ZIP code)

Form 8868 (Rev. 12-2004)

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KEY POINT HEALTH SERVICES, INC 2 16 PM 2/14/2006

Amended Tax Return

Amended Return corrects Program Service Expenses reported on Form 990 Part IIinadvertantly included in the wrong column on return as originally filed. Amount should carry to line 13 ofreturn instead of line 15 on Part 1

H:\Human Resources\BethHymel\My Documents\TaxReturns\2004\H.\Human Resources\Beth Hymel\MyPAGE2 Documents\TaxReturns\2004\TAX RETURN ATTACHMENT6-30-05