2022-05-11T17:29:46-05:00 2021-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2020-07-01 351097350 LIFESPRING INC LIFE 8122802080 460 SPRING STREET JEFFERSONVILLE IN 47130 NICK CLARK CFO 8122802080 2022-05-11 1 NICK CLARK 999009999 ANGELA N CRAWFORD CPA P00573197 3176334705 2022-05-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z LIFESPRING HEALTH SYSTEM NICK CLARK 460 SPRING STREET JEFFERSONVILLE IN 47130 40968428 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. 13 13 690 13 0 0 11256341 12302514 22735058 27352717 131410 250257 164516 164786 34287325 40070274 9848 2370 0 0 27170146 29148149 0 0 0 5917953 6345565 33097947 35496084 1189378 4574190 29469525 34322140 10865748 10711124 18603777 23611016 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 27869424 2370 27507266 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 2021, LIFESPRING PROVIDED 308,346 BEHAVIOR HEALTH SERVICES TO 11,179 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 2021, WE PROVIDED $2,635,283 IN UNCOMPENSATED CARE TO CLIENTS WHICH REPRESENTED 5.9% IN UNCOMPENSATED CARE TO OPERATING REVENUE. 27869424 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 33 0 1 690 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 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 LINDSAY FLEMING CHAIR 2.00 0.00 X X 0 0 0 RANDY DENNISON CHAIR ELECT 2.00 0.00 X X 0 0 0 CHRIS HOLLINDEN TREASURER 2.00 0.00 X X 0 0 0 DENISE EDEN SECRETARY 2.00 0.00 X X 0 0 0 WENDY BROUGHTON MEMBER-TERM BEGAN 10/'20 2.00 0.00 X 0 0 0 DARNELL JACKSON MEMBER-TERM BEGAN 10/'20 2.00 0.00 X 0 0 0 RAY OPPEL MEMBER-TERM BEGAN 10/'20 2.00 0.00 X 0 0 0 EMILY POE STUMLER MEMBER 2.00 0.00 X 0 0 0 ROSSINA SANDOVAL MEMBER-TERM BEGAN 10/'20 2.00 0.00 X 0 0 0 ALAN SMOCK MEMBER 2.00 0.00 X 0 0 0 JUDY STEEDLEY MEMBER 2.00 0.00 X 0 0 0 JACK VISSING MEMBER 2.00 2.00 X 0 0 0 JACKIE YOUNG MEMBER 2.00 0.00 X 0 0 0 TONYA HEIM MEMBER-TERM ENDED 9/'20 2.00 0.00 X 0 0 0 SUSAN UMPLEBY MEMBER-TERM ENDED 9/'20 2.00 0.00 X 0 0 0 NICK CLARK CFO/EXECUTIVE VP 40.00 2.00 X 160711 0 24776 TERRY STAWAR CEO/PRESIDENT 40.00 2.00 X 329467 0 35650 BETH KEENEY VP DEVELOPMENT & GRANTS 32.00 0.00 X 137259 0 8231 MISTY GILBERT VICE PRESIDENT 40.00 0.00 X 127686 0 25116 JOE HIGGINS VICE PRESIDENT 40.00 0.00 X 93992 0 12413 CHRISTIAN RICE VICE PRESIDENT 40.00 0.00 X 113994 0 12592 CHRIS GRIDER ASST VP 40.00 0.00 X 115430 0 13748 MARSHALL LOWERY ASST VP 40.00 0.00 X 96601 0 5765 STEPHANIE TAYLOR ASST VP 40.00 0.00 X 82846 0 25045 TEODORO BORDADOR PHYSICIAN 40.00 0.00 X 277017 0 21831 MARY BOULDIN PHYSICIAN 40.00 0.00 X 240459 0 14408 ERIC JAGGERS PHYSICIAN 40.00 0.00 X 283439 0 24164 SHERYL SCHNEIDER PHYSICIAN 40.00 0.00 X 169711 0 10610 AMANDA DAVIS-HOUCHEN NURSE PRACTITIONER 40.00 0.00 X 148043 0 10404 2376655 0 244753 12 0 1 0 MATRIX INTEGRATION 1225 S WALNUT STREET BLOOMINGTON IN 47401 IT SERVICES 750417 ADP 1 ADP BLVD ROSELAND NJ 07068 PAYROLL SERVICES 177339 2 12273714 28800 12302514 PATIENT SERVICE REVENUE 900099 21131932 21131932 340B REVENUE 900099 3417498 3417498 MEDICAID ADMIN RECOVERY 900099 2271087 2271087 OFF SITE SERVICES 900099 240326 240326 HUD MANAGEMENT FEE 900099 101785 101785 190089 190089 27352717 65060 65060 95613 0 95613 95613 95613 1063726 19625 898154 0 165572 19625 185197 185197 2182 0 2182 2182 MEDICAL RECORDS REVENUE 900099 10237 10237 56754 56754 66991 40070274 27507266 0 260494 2370 2370 2523268 2523268 20726770 18051868 2674902 1621801 1445099 176702 2658346 1680953 977393 1617964 1383405 234559 105730 105730 20875 20875 711853 670329 41524 111199 90251 20948 973148 830699 142449 306368 248654 57714 1606046 1303495 302551 305236 294094 11142 87533 71043 16490 42215 34262 7953 906037 735356 170681 616271 500176 116095 FEDERAL AWARD EXPENDITU 222758 222758 MEDICATION & OTC MED. S 178634 178634 DUES AND LICENSES 115888 94057 21831 SUPPLIES 17793 14590 3203 17981 17331 650 35496084 27869424 7626660 0 102634 102631 8797368 11475186 1987336 1853228 732458 676928 554662 1048086 24821896 10327351 13635595 14494545 2637706 3274940 1021766 1396596 29469525 34322140 4109342 4336481 6159316 5811819 597090 562824 10865748 10711124 X 18603777 23611016 18603777 23611016 29469525 34322140 4574190 433049 0 X X 0 1 X 1 1 1 X 7662460 8365182 10177852 10881617 12302514 49389625 7662460 8365182 10177852 10881617 12302514 49389625 49389625 124291 123350 130834 135843 160673 674991 83137 83176 151067 94392 69173 480945 50545561 96648323 0.97710 0.94420 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2016 AMOUNT: $ 83,137. 2017 AMOUNT: $ 83,176. 2018 AMOUNT: $ 151,067. 2019 AMOUNT: $ 94,392. 2020 AMOUNT: $ 69,173. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1293853 1293853 16664861 5448537 11216324 6863182 4878814 1984368 14494545 ESTIMATED THIRD PARTY SETTLEMENTS 295389 DUE TO RESIDENTIAL PATIENTS 267435 562824 X 40482448 433049 433049 40049399 20875 20875 40070274 35475209 0 35475209 20875 20875 35496084 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, 2021 AND 2020, 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 X 0 0 0 0 0 0 0 0 0 TERRY STAWAR CEO/PRESIDENT 329467 0 0 0 0 0 20206 0 15444 0 365117 0 0 0 ERIC JAGGERS PHYSICIAN 283439 0 0 0 0 0 17606 0 6558 0 307603 0 0 0 TEODORO BORDADOR PHYSICIAN 277017 0 0 0 0 0 16982 0 4849 0 298848 0 0 0 MARY BOULDIN PHYSICIAN 240459 0 0 0 0 0 14408 0 0 0 254867 0 0 0 NICK CLARK CFO/EXECUTIVE VP 160711 0 0 0 0 0 10074 0 14702 0 185487 0 0 0 SHERYL SCHNEIDER PHYSICIAN 169711 0 0 0 0 0 10610 0 0 0 180321 0 0 0 AMANDA DAVIS-HOUCHEN NURSE PRACTITIONER 148043 0 0 0 0 0 8964 0 1440 0 158447 0 0 0 MISTY GILBERT VICE PRESIDENT 127686 0 0 0 0 0 8169 0 16947 0 152802 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