Four Rivers Behavioral Health
Legal name: Western Ky Regional Mental Health & Ment Dba Four Rivers Behavioral
Nonprofit profile at a glance
- EIN
- 610659633
- IRS 990 coverage
- 2013–2024
- Official website data refreshed
- Sep 2026
- Forms available
- Form 990 2024
- Location
- Paducah, KY, US
- Phone
- 270-442-7121
- Rating
- 81
- Verdict
- STRONG
- Rating confidence
- Standard
- Sector
- Mental Health Treatment F31 Psychiatric, Mental Health Hospital
Reported finances
- Revenue
- $25,935,914
- Expenses
- $27,058,091
- Assets
- $8,151,928
- Liabilities
- $6,116,039
Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.
Leadership & pay
23 people listed
Executive titles in this filing
- GRETCHEN ROOF (CEO/PRESIDENT (TERM START 1/1/25))
- TERRY HUDSPETH (CEO/PRESIDENT (TERM END 7/31/25))
Highest reported compensation
- DUNCAN DARNELL (PSYCHIATRIST): $313,784 total reported compensation
- TERRY HUDSPETH (CEO/PRESIDENT (TERM END 7/31/25)): $235,025 total reported compensation
- GRETCHEN ROOF (CEO/PRESIDENT (TERM START 1/1/25)): $160,382 total reported compensation
Source: IRS Form 990. Selected filing: tax year 2024. Names and roles reflect this filing, not necessarily current officeholders.
Overview
Mission
To provide quality behavioral health services that promote the health and quality of life of our community members.
What it reported doing in 2024
Western Kentucky regional mental health (wkrmh) provides mental health services, mental retardation services and substance abuse disorder services to the surrounding community.
Operating model
- Revenue model
- Mixed. Its operating money came from several sources; no one source provided a clear majority.
- Distribution model
- Direct operator. The filing allocates 100% of reported program-service expenses outside its grant, affiliate-payment, and member-benefit lines. This expense classification does not rule out separately announced grant awards.
The verdict
STRONG - A large share of available resources goes toward mission work and the filed numbers largely add up. Expenses are high relative to revenue and total assets are small relative to annual expenses; liquid coverage is unknown.
Rating breakdown
- Financial Efficiency: 84
- Transparency & Controls: 79
- Accountability: 95
- Sustainability: 18
- Growth: 80
Detailed rating inputs
Financial Efficiency
- Mission deployment rate: 83.7%; rating input score 84
- Program expense ratio: 80.2%; rating input score 80
- Fundraising efficiency: $2,006.5 raised per $1 spent on fundraising; rating input score 98; 98th percentile among comparable filings
Transparency & Controls
- Consistency checks: 100%; rating input score 100; 62nd percentile among comparable filings
- Pay-setting controls: 2 of 6 controls in place; rating input score 33
- Compensation committee: Missing
- Independent consultant: Missing
- Other Form 990s reviewed: Missing
- Written employment contract: Missing
- Compensation survey or study: Pass
- Board or committee approval: Pass
- Foreign activity oversight: Limited
- Grant itemization coverage: Limited
- Major donor itemization: Yes; rating input score 100
- Related-party transparency: Limited
Accountability
- Independent voting board: 100%; rating input score 100; 66th percentile among comparable filings
- Governance controls: 8 of 9 controls in place; rating input score 89
- Conflict-of-interest policy: Pass
- Whistleblower policy: Pass
- Document-retention policy: Pass
- CEO compensation review process: Pass
- Other executive compensation review process: Pass
- Form 990 shared with the board: Fail
- Board meeting minutes documented: Pass
- Audit committee oversight: Pass
- Independent financial-statement audit: Pass
Sustainability
- Operating margin: -4.3%; rating input score 18; 18th percentile among comparable filings
- Total-asset coverage ratio: 0.3; rating input score 8; 8th percentile among comparable filings
- Liabilities to assets ratio: 0.75; rating input score 16; 16th percentile among comparable filings
- Officer compensation ratio: 5.5%; rating input score 46; 46th percentile among comparable filings
Growth
- Program expense growth: 2.1% per year; rating input score 100; 20th percentile among comparable filings
- Revenue growth: 2.4% per year; rating input score 100; 21st percentile among comparable filings
- Asset growth: -1.5% per year; rating input score 0; 7th percentile among comparable filings
Details
- What they do: 8 programs and campaigns described on the official site · 1 operating location identified
- Where the money goes: 83.7% of revenue deployed · 80.2% of spending went to programs
- Governance: 10 of 10 board members independent · 8 of 9 filing controls reported
- Programs: 1 filed program accomplishment · $21.7M in reported program spending
- Leadership: top reported pay $314K · 23 people listed · 2 of 6 pay-setting controls reported
- Highest-paid contractors: 5 contractors listed · $6.3M reported
- Consistency: 34 of 34 current checks pass
- Schedules: 9 filed schedules · includes major donors and executive pay
- Filing history: 8 filing years from 2013 to 2024
- Contacts: How to reach this organization
- Money network: 9 filed money-flow records
- Related organizations: 6 filed related-organization links
- Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
- People: Everyone the filings name, and which of them the filings identify by more than a name.
Key Signals
Signals prioritize questions for review. They are not findings of misconduct.
- High — Sustainability: Operating margin scored 18/100.
- High — Sustainability: Total-asset coverage ratio scored 8/100.
- High — Growth: Asset growth scored 0/100.
- Review — Accountability: Governance controls: Form 990 shared with the board not reported.
- High — Sustainability: Liabilities to assets ratio scored 16/100.
- Moderate — Sustainability: Officer compensation ratio scored 46/100.