2020-04-29T14:30:10-05:00 2019-06-30 351178661 BLUE & CO LLC 500 N MERIDIAN ST SUITE 200 INDIANAPOLIS IN 46204 990 2018-07-01 351097350 LIFESPRING INC LIFE 8122802080 460 SPRING STREET JEFFERSONVILLE IN 47130 NICK CLARK CFO 8122802080 2020-04-29 1 ANGELA N CRAWFORD CPA P00573197 3176334705 2020-04-29 184.170.167.146 2020-04-29 11:54:41 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AF923E04E140C4DE71FD41AF2127CF5344A3E036 2018 2020-09-23 17:36:50Z LIFESPRING HEALTH SYSTEM NICK CLARK 460 SPRING STREET JEFFERSONVILLE IN 47130 29932499 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 12 484 12 0 0 8365182 10177852 14244718 18420930 97957 144736 140740 210271 22848597 28953789 2855 2210 0 0 17607442 23448546 0 0 0 4159694 5489301 21769991 28940057 1078606 13732 18598545 22925661 3963392 5486465 14635153 17439196 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 23729472 2210 18631201 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 AND WASHINGTON COUNTIES IN SOUTHERN INDIANA. DURING THE FISCAL YEAR 2019, LIFESPRING PROVIDED 393,598 BEHAVIOR HEALTH SERVICES TO 7,211 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 2019, WE PROVIDED $816,340 IN UNCOMPENSATED CARE TO CLIENTS WHICH REPRESENTED 2.9% IN UNCOMPENSATED CARE TO OPERATING REVENUE. LIFESPRING PROVIDES A WIDE ARRAY OF SERVICES TO OUR CLIENTS RANGING FROM OUTPATIENT COUNSELING TO PSYCHIATRIC SUB-ACUTE RESIDENTIAL SERVICES. WE ALSO PROVIDE CASE MANAGEMENT SERVICES WHICH ASSIST OUR CLIENTS IN OBTAINING ANY AVAILABLE BENEFITS FOR WHICH THEY MAY BE ELIGIBLE. THIS INVOLVES LINKING, REFERRING AND MONITORING OF CLIENTS, WITH FOLLOW THROUGH SERVICES TO MAINTAIN THOSE BENEFITS ONCE ACQUIRED. LIFESPRING'S OVERARCHING GOAL IS TO IMPROVE THE QUALITY OF LIFE FOR ITS CLIENTS. 23729472 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 21 0 1 484 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 12 12 0 0 1 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 ELECT TO CHAIR SEP'18 2.00 0.00 X X 0 0 0 RANDY DENNISON CHAIR ELECT-TERM BEGAN OCT'18 2.00 0.00 X X 0 0 0 CHRIS HOLLINDEN TREASURER-TERM BEGAN OCT'18 2.00 0.00 X X 0 0 0 JENNIFER LAWYER SECRETARY 2.00 0.00 X X 0 0 0 SAM ECKART MEMBER 2.00 0.00 X 0 0 0 TONYA HEIM MEMBER-TERM BEGAN OCT'18 2.00 0.00 X 0 0 0 AUBREY MCCLURE MEMBER-TERM BEGAN OCT'18 2.00 0.00 X 0 0 0 ALAN SMOCK MEMBER-TERM BEGAN APR'19 2.00 0.00 X 0 0 0 JUDY STEEDLEY MEMBER 2.00 0.00 X 0 0 0 SUSAN UMPLEBY MEMBER-TERM BEGAN JUN'19 2.00 0.00 X 0 0 0 JACK VISSING MEMBER 2.00 2.00 X 0 0 0 JACKIE YOUNG MEMBER-TERM BEGAN OCT'18 2.00 0.00 X 0 0 0 LARRY HOLLAN MEMBER OCT'18-JAN'19 2.00 0.00 X 0 0 0 ROBERT HOUSTON CHAIR/MEMBER-TERM ENDED JAN'19 2.00 0.00 X X 0 0 0 JERRY HUNEFELD MEMBER OCT'18-NOV'18 2.00 0.00 X 0 0 0 GREG INMAN TREASURER-TERM ENDED SEPT'18 2.00 0.00 X X 0 0 0 CHAD LEWIS MEMBER-TERM ENDED SEPT'18 2.00 0.00 X 0 0 0 DWIGHT LINDSAY MEMBER-TERM ENDED SEPT'18 2.00 0.00 X 0 0 0 LARRY MEDLOCK MEMBER-TERM ENDED SEPT'18 2.00 0.00 X 0 0 0 KATHI MILLER MEMBER-TERM ENDED SEPT'18 2.00 0.00 X 0 0 0 DAN MOORE MEMBER-TERM ENDED SEPT'18 2.00 0.00 X 0 0 0 LISA TETRICK MEMBER-TERM ENDED SEPT'18 2.00 0.00 X 0 0 0 JAN VETRHUS MEMBER-TERM ENDED SEPT'18 2.00 0.00 X 0 0 0 NICK CLARK CFO/EXECUTIVE VP 40.00 2.00 X 140306 0 15455 TERRY STAWAR CEO/PRESIDENT 40.00 2.00 X 253348 0 22911 KAREN JONES SENIOR VP HR 40.00 0.00 X 108048 0 6807 WANDA BOOKER VP NURSING SERVICES 40.00 0.00 X 97126 0 6119 GREG DUNCAN VP PERFORMANCE IMPROVEMENT 40.00 0.00 X 96474 0 14838 ASAD ISMAIL VP MEDICAL SERVICES 40.00 0.00 X 154620 0 18501 BETH KEENEY VP DEVELOPMENT & GRANTS 32.00 0.00 X 122410 0 7712 MARTA MYSZAK VP AREA SERVICES 40.00 0.00 X 127221 0 10973 MISTY GILBERT VICE PRESIDENT 40.00 0.00 X 87788 0 13157 JOE HIGGINS VICE PRESIDENT 40.00 0.00 X 84770 0 8299 MEARA GRANNAN VICE PRESIDENT 40.00 0.00 X 78076 0 11535 CHRISTIAN RICE VICE PRESIDENT 40.00 0.00 X 99831 0 8803 CHRIS GRIDER ASST VP 40.00 0.00 X 101615 0 9360 MARSHALL LOWERY ASST VP 40.00 0.00 X 82632 0 5206 STEPHANIE TAYLOR ASST VP 40.00 0.00 X 72297 0 13315 TEODORO BORDADOR PHYSICIAN 40.00 0.00 X 245901 0 22212 MARY BOULDIN PHYSICIAN 40.00 0.00 X 214629 0 13522 ERIC JAGGERS PHYSICIAN 40.00 0.00 X 194727 0 21028 SHERYL SCHNEIDER PHYSICIAN 40.00 0.00 X 148928 0 16332 BRADFORD WHITEHEAD NURSE PRACTITIONER 40.00 0.00 X 116896 0 14990 2627643 0 261075 11 0 1 0 0 10153517 24335 10177852 PATIENT SERVICE REVENUE 900099 16607185 16607185 MEDICAID ADMIN RECOVERY 900099 1130759 1130759 OFF SITE SERVICES 900099 369762 369762 REVOCERY WORK 900099 197605 197605 PATIENT SERVICES 900099 69401 69401 46218 46218 18420930 71630 71630 59204 0 59204 59204 59204 1051816 978710 73106 73106 73106 4263 0 4263 4263 146804 146804 146804 28953789 18631201 0 144736 2210 2210 1879553 1879553 17873760 16263687 1610073 844039 667337 176702 1486857 1125567 361290 1364337 1129778 234559 172448 75459 96989 17352 17352 542604 497337 45267 83791 68493 15298 833419 643051 190368 239453 195736 43717 1274030 1041430 232600 348263 333108 15155 128782 105306 23476 59836 50287 9549 664026 542795 121231 515781 421615 94166 GRANTS EXPENDITURES 242663 242663 MEDICATION AND OTC MEDI 173602 173602 DUES AND LICENSES 112603 92045 20558 SUPPLIES 32538 26681 5857 48110 31285 16825 28940057 23729472 5210585 0 102666 102903 3725797 3919104 713050 1675134 790712 1719490 402734 417919 22190908 9856942 10263843 12333966 2426554 2555136 173189 202009 18598545 22925661 2083076 2927028 1308444 2097441 571872 461996 3963392 5486465 X 14635153 17439196 14635153 17439196 18598545 22925661 X 13732 -8542 2798853 X X 0 1 X 1 1 1 X 6135993 7444450 7662460 8365182 10177852 39785937 6135993 7444450 7662460 8365182 10177852 39785937 39785937 68018 62772 124291 123350 130834 509265 1677764 1643657 83137 83176 151067 3638801 43934003 68084952 0.90560 0.86870 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2014 AMOUNT: $ 1,677,764. 2015 AMOUNT: $ 1,643,657. 2016 AMOUNT: $ 83,137. 2017 AMOUNT: $ 83,176. 2018 AMOUNT: $ 151,067. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1114653 1114653 14304581 4534331 9770250 6626950 5322611 1304339 144724 144724 12333966 ESTIMATED THIRD PARTY SETTLEMENTS 259987 DUE TO RESIDENTIAL PATIENTS 202009 461996 X 31726748 -8542 2798853 2790311 28936437 17352 17352 28953789 28922705 0 28922705 17352 17352 28940057 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, 2019 AND 2018, 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN ON ACQUISITION/MERGER 2,798,853. X X X X X 0 0 0 0 0 0 0 0 0 NICK CLARK CFO/EXECUTIVE VP 140306 0 0 0 0 0 8839 0 6616 0 155761 0 0 0 TERRY STAWAR CEO/PRESIDENT 253348 0 0 0 0 0 15961 0 6950 0 276259 0 0 0 ASAD ISMAIL VP MEDICAL SERVICES 154620 0 0 0 0 0 9741 0 8760 0 173121 0 0 0 TEODORO BORDADOR PHYSICIAN 245901 0 0 0 0 0 15492 0 6720 0 268113 0 0 0 MARY BOULDIN PHYSICIAN 214629 0 0 0 0 0 13522 0 0 0 228151 0 0 0 ERIC JAGGERS PHYSICIAN 194727 0 0 0 0 0 12268 0 8760 0 215755 0 0 0 SHERYL SCHNEIDER PHYSICIAN 148928 0 0 0 0 0 9382 0 6950 0 165260 0 0 0 FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION AMENDED ITS BYLAWS TO REFLECT A BOARD COMPOSITION OF UP TO SIXTEEN MEMBERS, RATHER THAN THE PREVIOUS COMPOSITION OF AT LEAST NINE BUT NO MORE THAN FIFTEEN. ADDITIONALLY, THE ORGANIZATION AMENDED ITS BYLAWS TO REFLECT A REQUIREMENT THAT ALL SITTING MEMBERS MUST CAST AN AFFIRMATIVE VOTE TO AMEND, REPEAL, OR ALTER THE ORGANIZATION'S BYLAWS, RULES OR REGULATIONS. THE PREVIOUS REQUIREMENT WAS THAT A MAJORITY OF VOTES MUST BE IN THE AFFIRMATIVE AT A MEETING OF THE BOARD OF DIRECTORS IN WHICH A QUORUM IS PRESENT. 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. FORM 990, PART XI, LINE 9: GAIN/LOSS ON ACQUISITION 2,798,853. 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