2023-05-15T07:40:47-05:00 2022-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2021-07-01 351097350 LIFESPRING INC LIFE 8122802080 460 SPRING STREET JEFFERSONVILLE IN 47130 NICK CLARK CFO 8122802080 2023-05-13 1 NICK CLARK 999009999 TYLER K GREENE CPA P00057872 3176334705 2023-05-13 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z LIFESPRING HEALTH SYSTEM NICK CLARK 460 SPRING STREET JEFFERSONVILLE IN 47130 50844034 0 X WWW.LIFESPRINGHEALTHSYSTEMS.ORG X 1964 IN PROVIDE COMPREHENSIVE BEHAVIORAL HEALTH, ADDICTION & RELATED SERVICES TO IMPROVE & SUSTAIN THE QUALITY OF LIFE IN OUR COMMUNITIES. 12 12 708 12 0 0 12302514 21790188 27352717 27648841 250257 205296 164786 215609 40070274 49859934 2370 3698 0 0 29148149 33077807 0 0 0 6345565 7156396 35496084 40237901 4574190 9622033 34322140 38059210 10711124 5447174 23611016 32612036 X LIFESPRING'S MISSION IS TO IMPROVE AND SUSTAIN THE QUALITY OF LIFE IN OUR COMMUNITIES BY PROVIDING COMPREHENSIVE BEHAVIORAL HEALTH, ADDICTION AND RELATED SERVICES. 0 0 31531747 3698 27857576 LIFESPRING, INC. IS A COMMUNITY MENTAL HEALTH CENTER WITH THE PURPOSE OF PROVIDING A FULL CONTINUUM OF BEHAVIORAL HEALTHCARE SERVICES TO CLIENTS WHO LIVE PRIMARILY IN CLARK, FLOYD, HARRISON, JEFFERSON, SCOTT, WASHINGTON, SPENCER, PERRY, ORANGE, DUBOIS, AND CRAWFORD COUNTIES IN SOUTHERN INDIANA. DURING THE FISCAL YEAR 2022, LIFESPRING PROVIDED 314,562 BEHAVIOR HEALTH SERVICES TO 11,412 INDIVIDUAL CLIENTS. LIFESPRING PROVIDES CARE TO CERTAIN CLIENTS UNDER REIMBURSEMENT AGREEMENTS WITH MEDICAID, MEDICARE AND OTHER THIRD-PARTY PAYORS. ADDITIONALLY, LIFESPRING ACCEPTS CLIENTS REGARDLESS OF THE CLIENT'S ABILITY TO PAY, THEIR RACE, AGE, SEX, CREED OR NATIONAL ORIGIN. THE MAJORITY OF OUR CLIENTS ARE INDIGENT. IN FISCAL YEAR 2022, WE PROVIDED $2,743,838 IN UNCOMPENSATED CARE TO CLIENTS WHICH REPRESENTED 5.1% IN UNCOMPENSATED CARE TO OPERATING REVENUE. 31531747 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 31 0 1 708 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IN X JULIE MOHAMED 8122802080 460 SPRING STREET JEFFERSONVILLE IN 47130 RANDY DENNISON CHAIR 2.00 X X 0 0 0 JACKIE YOUNG SECRETARY 2.00 X X 0 0 0 ALAN SMOCK TREASURER 2.00 X X 0 0 0 DENISE EDEN HOWSON BOARD MEMBER 2.00 X 0 0 0 EMILY STUMLER BOARD MEMBER 2.00 X 0 0 0 WENDY BROUGHTON BOARD MEMBER 2.00 X 0 0 0 RAY OPPEL BOARD MEMBER 2.00 X 0 0 0 CHRIS HOLLINDEN BOARD MEMBER-TERM BEGAN 10/21 2.00 X 0 0 0 DARNEL L JACKSON BOARD MEMBER 2.00 X 0 0 0 ROSSINA SANDOVAL MONSIVAIS BOARD MEMBER 2.00 X 0 0 0 PAUL KIGER BOARD MEMBER-TERM BEGAN 10/21 2.00 X 0 0 0 MELISSA R CAMPBELL BOARD MEMBER-TERM BEGAN 10/21 2.00 X 0 0 0 NICK CLARK CFO 40.00 X 161114 0 16817 TERRY STAWAR CEO 40.00 X 329541 0 27012 BETH KEENEY VP DEVELOPMENT & GRANTS 40.00 X 159244 0 9555 MISTY GILBERT VICE PRESIDENT - CLINICAL 40.00 X 133239 0 13994 MEARA GRANNAN VICE PRESIDENT - CLINICAL 40.00 X 110300 0 12618 CHRISTIAN RICE VICE PRESIDENT IT 40.00 X 114203 0 12852 CHRIS GRIDER VICE PRESIDENT - AR 40.00 X 115180 0 12911 WANDA BOOKER VICE PRESIDENT - NURSING 40.00 X 112858 0 12771 THERESA K JONES VICE PRESIDENT - HR 40.00 X 125847 0 7551 TEODORO BORDADOR PHYSICIAN 40.00 X 278407 0 22704 MARY BOULDIN PHYSICIAN 40.00 X 241609 0 20497 ERIC JAGGERS PHYSICIAN 40.00 X 286753 0 23205 DEBORAH KERCHEVAL PHYSICIAN 40.00 X 210611 0 18637 ERIC YAZEL PHYSICIAN - MEDICAL DIRECTOR 32.00 X 173922 0 16435 2552828 0 227559 23 0 1 0 MATRIX INTEGRATION 1225 S WALNUT STREET BLOOMINGTON IN 47401 IT SERVICES 747311 ADP 1 ADP BLVD ROSELAND NJ 07068 PAYROLL SERVICES 182400 2 21785040 5148 21790188 NET PATIENT SERVICE REVENUE 621399 21244478 21244478 340B REVENUE 621399 4182923 4182923 MEDICAID ADMIN RECOVERY 621399 1621677 1621677 OFF SITE SERVICES 621399 368449 368449 PATIENT SERVICES 621399 101412 101412 129902 129902 27648841 106045 106045 96395 0 96395 96395 96395 1063726 19625 964345 19755 99381 -130 99251 99251 1830 0 1830 1830 OTHER OPERATING REVENUE 900099 110510 110510 MEDICAL RECORDS REVENUE 900099 6874 6874 117384 49859934 27857576 0 212170 3698 3698 2187690 2187690 24521440 20808942 3712498 1508737 1332035 176702 2982955 1729155 1253800 1876985 1642426 234559 124838 124838 23328 23328 729301 729301 138227 111781 26446 987694 809961 177733 423553 342517 81036 1476811 1194263 282548 407517 382143 25374 131575 106402 25173 31648 25593 6055 1041645 842354 199291 729938 590284 139654 MEDICATION & OTC MED. S 395164 395164 FEDERAL AWARD EXPENDITU 306807 306807 DUES AND LICENSES 122780 99289 23491 SUPPLIES 21179 17367 3812 64391 62265 2126 40237901 31531747 8706154 0 102631 102360 11475186 15040608 1853228 2656070 676928 728695 1048086 572139 25965313 11248756 14494545 14716557 3274940 2831018 1396596 1411763 34322140 38059210 4336481 4202114 5811819 704756 562824 540304 10711124 5447174 X 23611016 32612036 23611016 32612036 34322140 38059210 9622033 -621013 0 X X 0 1 X 1 1 1 X 8365182 10177852 10881617 12302514 21790188 63517353 8365182 10177852 10881617 12302514 21790188 63517353 63517353 123350 130834 135843 160673 202440 753140 83176 151067 94392 69173 119214 517022 64787515 110776988 0.98040 0.97710 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2017 AMOUNT: $ 83,176. 2018 AMOUNT: $ 151,067. 2019 AMOUNT: $ 94,392. 2020 AMOUNT: $ 69,173. 2021 AMOUNT: $ 119,214. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 924 924 0 SCHEDULE C, PART II-B, LINE 1I: LIFESPRING, INC. PAYS ANNUAL DUES TO INDIANA COUNCIL OF COMMUNITY MENTAL HEALTH CENTERS, INC. 4.2% OF THEIR COUNCIL PORTION MEMBERSHIP DUES ARE ALLOCATED FOR LEGISLATION. 1293853 1293853 17217369 5895492 11321877 51573 41034 10539 6232724 4416910 1815814 1169794 895320 274474 14716557 ESTIMATED THIRD PARTY SETTLEMENTS 369128 DUE TO RESIDENTIAL PATIENTS 171176 540304 X 49215593 -621013 -621013 49836606 23328 23328 49859934 40214573 0 40214573 23328 23328 40237901 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT AS OF JUNE 30, 2022 AND 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. X X X X 0 0 0 0 0 0 0 0 0 TERRY STAWAR CEO 329541 0 0 0 0 0 19772 0 7240 0 356553 0 0 0 ERIC JAGGERS PHYSICIAN 286753 0 0 0 0 0 17205 0 6000 0 309958 0 0 0 TEODORO BORDADOR PHYSICIAN 278407 0 0 0 0 0 16704 0 6000 0 301111 0 0 0 MARY BOULDIN PHYSICIAN 241609 0 0 0 0 0 14497 0 6000 0 262106 0 0 0 DEBORAH KERCHEVAL PHYSICIAN 210611 0 0 0 0 0 12637 0 6000 0 229248 0 0 0 ERIC YAZEL PHYSICIAN - MEDICAL DIRECTOR 173922 0 0 0 0 0 10435 0 6000 0 190357 0 0 0 NICK CLARK CFO 161114 0 0 0 0 0 9667 0 7150 0 177931 0 0 0 BETH KEENEY VP DEVELOPMENT & GRANTS 159244 0 0 0 0 0 9555 0 0 0 168799 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEWING THE FORM 990 ENTAILS A DETAILED REVIEW BY THE ORGANIZATION'S CHIEF FINANCIAL OFFICER, CHIEF EXECUTIVE OFFICER, AND BOARD TREASURER. A COPY OF THE FORM 990, INCLUDING ALL SCHEDULES, IS AVAILABLE TO THE GOVERNING BODY FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY AND/OR AT ANY TIME A CONFLICT OF INTEREST ARISES BOARD MEMBER MUST FULLY DISCLOSE THIS CONFLICT TO THE REST OF THE BOARD AND REFRAIN FROM VOTING ON ANY ISSUES RELATING TO THIS CONFLICT; PRESIDENT/CEO FULLY DISCLOSE THIS CONFLICT TO THE BOARD AND REFRAIN FROM PARTICIPATING IN THE DECISION MAKING PROCESS RELATING TO THIS CONFLICT; EXECUTIVE MANAGEMENT TEAM MEMBERS INCLUDING ANY KEY EMPLOYEES FULLY DISCLOSE THIS CONFLICT TO THE PRESIDENT/CEO AND REFRAIN FROM PARTICIPATING IN THE DECISION MAKING PROCESS RELATING TO THIS CONFLICT. THE DISCLOSURE DURING BOARD MEETINGS IS NOTED IN THE BOARD MINUTES. FAILURE TO DISCLOSE CONFLICTS OF INTEREST SHALL BE SUBJECT TO DISCIPLINARY ACTION IN ACCORDANCE WITH THE BOARD'S BY-LAWS AND THE CENTER'S PERSONNEL POLICIES AND PROCEDURES. FORM 990, PART VI, SECTION B, LINE 15 CEO COMPENSATION: ANNUAL EVALUATIONS IS PERFORMED BY THE BOARD OF DIRECTORS FOR THE CEO AND ANY WAGE INCREASES. HUMAN RESOURCE MANAGER CONDUCTS A SALARY SURVEY AS NEEDED FOR REVIEW BY THE BOARD OF DIRECTORS. THE RESOLUTIONS OF THE BOARD ARE DOCUMENTED AND INCLUDED IN THE BOARD MINUTES. OTHER OFFICERS: HUMAN RESOURCE MANAGER MAINTAINS AND UPDATES INFORMATION REGARDING OTHER OFFICERS/ KEY EMPLOYEE'S SALARY AND WAGE PLANS THAT ARE COMPETITIVE AND FAIR. EACH PLAN IS REVIEWED ON THE EMPLOYEE'S ANNIVERSARY DATE OF HIRE AND ANY CHANGES ARE APPROVED BY THE CEO. WAGE INCREASES ARE DETERMINED BY THE BOARD OF DIRECTORS. HR MANAGER PARTICIPATES IN SALARY SURVEYS AS NEEDED AND ON A CONTINUOUS BASIS WITH OTHER LOCAL/STATE AGENCIES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC VIA ITS WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC FOR REVIEW UPON REQUEST. PART XI, LINE 2C THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND NO PROCESSES HAVE CHANGED FROM THE PRIOR YEAR. LIFESPRING FOUNDATION OF INDIANA INC 460 SPRING ST JEFFERSONVILLE IN 47130 200177427 SUPPORT OF LOCAL NON-PROFITS COMMUNITY MENTAL HEALTH AGENCY IN 501C3 LINE 9 N/A 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0