2024-05-15T14:04:10-05:00 2023-06-30 593070669 MSL PA 255 S ORANGE AVENUE SUITE 600 ORLANDO FL 32801 990 2022-07-01 591561501 LIFESTREAM BEHAVIORAL CENTER INC LIFE 3523157500 PO BOX 491000 LEESBURG FL 34749 RICK HANKEY PRESIDENT & CEO 3523157500 2024-05-15 1 RICK HANKEY 999009999 1 VICKI L HINZ CPA P00356696 4077405400 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z RICK HANKEY PO BOX 491000 LEESBURG FL 34749 72965032 0 X WWW.LSBC.NET X 1971 FL SUPPORTING RECOVERY, PROMOTING HEALTH, AND CREATING HOPE 13 12 1111 10 0 0 44403542 51265966 14922375 17942810 248886 367427 540824 518480 60115627 70094683 0 0 0 0 37630872 43014710 0 0 0 17735234 19483884 55366106 62498594 4749521 7596089 63172332 72491247 17819095 18635251 45353237 53855996 X SUPPORTING RECOVERY, PROMOTING HEALTH, AND CREATING HOPE 0 0 44598584 15131869 SEE SCHEDULE O.(1) THE FLORIDA STATE LEGISLATURE RECOGNIZED LIFESTREAM'S COMMITMENT TO EXCELLENCE BY AWARDING RECURRING FUNDING TO THE AGENCY'S INNOVATIVE 16 BED RESIDENTIAL PROGRAM "ROAD TO HOME," WHICH HELPS INDIVIDUALS TRANSITION FROM COSTLY STATE LONG TERM PSYCHIATRIC HOSPITALS TO THEIR LOCAL COMMUNITY.(2) LIFESTREAM ESTABLISHED THE FIRST OF ITS KIND MEDICATION-ASSISTED TREATMENT FOR CONSUMERS STRUGGLING WITH DRUG AND ALCOHOL ADDICTIONS. THE FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES AND THE FLORIDA ALCOHOL AND DRUG ABUSE ASSOCIATION SELECTED LIFESTREAM TO PROVIDE MEDICATION ASSISTED THERAPY TO PERSONS WITH SUBSTANCE ABUSE DISORDERS WHO ARE ALSO INVOLVED WITH THE CRIMINAL JUSTICE SYSTEM.(3) WHEN THE JUVENILE TREATMENT ALTERNATIVES FOR SAFER COMMUNITIES (TASC) PROGRAM FOR THE FIVE COUNTIES IN JUDICIAL CIRCUIT 5 WERE ABOUT TO CLOSE, LUTHERAN SERVICES OF FLORIDA TURNED TO LIFESTREAM TO KEEP THIS VITAL SERVICE GOING AND GROWING.(4) THE FEDERAL SUBSTANCE ABUSE AND MENTAL HEALTH SERVICE ADMINISTRATION ACKNOWLEDGED LIFESTREAM AS A NATIONAL LEADER IN INTEGRATED PRIMARY/BEHAVIORAL HEALTH CARE BY AWARDING IT A SECOND GRANT TO OPEN AN INTEGRATED BEHAVIORAL HEALTH/PRIMARY CARE CLINIC IN CLERMONT, FL. THE CLINIC WAS AWARDED STATE FUNDING AS WELL TO REDUCE HOSPITAL AND EMERGENCY ROOM ADMISSION RATES BY PROVIDING PRIMARY CARE AND CARE COORDINATION SERVICES TO INDIVIDUALS WITH SEVERE AND CHRONIC MENTAL ILLNESS.(5) LIFESTREAM OPENED A VITAL FIFTEEN-BED RESIDENTIAL PROGRAM AT ANTHONY HOUSE TO CARE FOR PREGNANT AND POST-PARTUM WOMEN WITH SUBSTANCE USE DISORDERS AND THEIR CHILDREN.(6) LIFESTREAM PARTNERS WITH THE EUSTIS COMMUNITY FOUNDATION TO ESTABLISH THE OPEN DOOR, A DAY-SHELTER FOR HOMELESS PERSONS LIVING IN THE EUSTIS AREA. THE PROGRAM SERVES AN AVERAGE OF 25 HOMELESS INDIVIDUALS AND FAMILY MEMBERS DAILY.(7) THE LIFESTREAM LAKE ACADEMIES CONTINUE THEIR LONG PARTNERSHIP WITH THE LAKE COUNTY SCHOOL BOARD TO SERVE YOUNGSTERS WITH SERIOUS EMOTIONAL AND BEHAVIORAL DISORDERS. THE ACADEMIES INVOLVE KIDS' FAMILIES AS WELL THROUGH THE STRONG UNITED RESILIENT FAMILIES (SURF) PROGRAM, AN EDUCATIONAL AND SKILLS-BASED PARENTING PROGRAM RECOGNIZED NATIONALLY AS BOTH A BEST AND EVIDENCE-BASED PRACTICE.(8) THE NATIONAL COUNCIL ON BEHAVIORAL HEALTH SELECTED LIFESTREAM TO LEAD THE WAY AS A LEARNING COMMUNITY IN THE CESSATION OF TOBACCO USE BY CONSUMERS AND STAFF. BY THE END OF THE YEAR, ALL LIFESTREAM CAMPUSES AND FACILITIES HAD BEEN DESIGNATED TOBACCO-FREE.(9) LIFESTREAM WAS SELECTED BY ITS MANAGING ENTITY TO LEAD ITS ZERO SUICIDE INITIATIVE TO ELIMINATE TEEN SUICIDES THROUGH EDUCATION, IMPROVED SCREENING, EARLY INTERVENTION AND CARE COORDINATION.(10) LIFESTREAM'S ONGOING EFFORTS TO IMPROVE ITS CONSUMERS' EXPERIENCE AND HEALTH OUTCOMES WHILE SIMULTANEOUSLY LOWERING COSTS LED TO THE CREATION OF PROGRESS HEALTH SYSTEMS, INC., A NONPROFIT HEALTH SYSTEM DESIGNED TO HELP AFFILIATES INCREASE REVENUES AND REDUCE COSTS IN ORDER TO BETTER SERVE INDIVIDUALS WITH MENTAL ILLNESS AND SUBSTANCE USE DISORDERS IN LAKE, SUMTER, MARION, CITRUS, ORANGE, OSCEOLA, AND HERNANDO COUNTIES IN CENTRAL FLORIDA. 7902664 3329421 LIFESTREAM PROVIDES SERVICES TO THE YOUTH IN OUR COMMUNITY VIA ITS COMPREHENSIVE ARRAY OF CHILDREN'S SERVICES INCLUDING INTERVENTION, OUTPATIENT AND ON-SITE TREATMENT. EACH PROGRAM IS DESIGNED TO MEET THE RIGOROUS STANDARDS OF LIFESTREAM'S FUNDING SOURCES WHICH ALSO INCLUDES INCORPORATING EBP OR EVIDENCE-BASED-PRACTICES AS DOCUMENTED IN LIFESTREAM'S FULLY INTEGRATED EHR OR ELECTRONIC HEALTH RECORD SYSTEMS. FOR FY 2023, 7,185 CHILDREN WERE SEEN FOR ALMOST 83,071 VISITS. 52501248 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 1 257 0 1 1111 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 FL X ERIC FONTANA 3523157500 1616 S 14TH STREET LEESBURG FL 34748 TIMOTHY MORRIS CHAIRMAN 0.50 X X 0 0 0 PAUL M JONES VICE CHAIR 0.50 X X 0 0 0 MICHAEL SLEAFORD TREASURER 0.50 X X 0 0 0 DR HEATHER BIGARD SECRETARY 0.50 X X 0 0 0 BRUCE DUNCAN DIRECTOR 0.50 X 0 0 0 BRUCE SAYLOR DIRECTOR 0.50 X 0 0 0 DR CHARLES MOJOCK DIRECTOR 0.50 X 0 0 0 DOUG CHILDERS JR DIRECTOR 0.50 X 0 0 0 FRANK PELOT DIRECTOR 0.50 0.65 X 0 0 0 JENIFFER HILL DIRECTOR 0.50 X 0 0 0 JON SIMPSON DIRECTOR 0.50 X 0 0 0 MORGAN SCHROEDER DIRECTOR 0.50 X 0 0 0 RICK HANKEY PRESIDENT & CEO (BEG. JUNE 2023) 40.00 0.65 X 221840 0 38263 CAROL E DOZIER CHIEF FINANCIAL OFFICER 40.00 0.65 X 154837 0 26707 THOMAS VALENTE MEDICAL DIRECTOR 40.00 X 301560 0 52013 ABID DARR PSYCHIATRIST 40.00 X 326193 0 56262 MIGUEL CORREA PSYCHIATRIST 40.00 X 265024 0 45712 EDGAR WALKER PSYCHIATRIST 40.00 X 243148 0 41938 DAVID DADA PSYCHIATRIST 40.00 X 223548 0 38557 SUSAN RESNIK APRN 40.00 X 172616 0 29772 JONATHAN CHERRY PRESIDENT & CEO (END. JUNE 2023) 40.00 0.65 X 365065 0 62966 2273831 0 392190 9 1 1 0 JAYKAY STAFFING PO BOX 823473 PHILADELPHIA PA 19182 STAFFING SERVICES 597291 GENOA HEALTHCARE PO BOX 77030 MINNEAPOLIS MN 554857730 PHARMACY SERVICES 481834 STREAMLINE HEALTHCARE SOLUTIONS 1301 W 22ND ST SUITE 305 OAK BROOK IL 60523 HR SERVICES 442363 MCKESSON DRUG PO BOX 409521 ATLANTA GA 30384 PHARMACY SERVICES 366635 ATTENTIVE MEDICAL STAFF 14007 BENVOLIO CIRCLE 102 ORLANDO FL 32824 STAFFING SERVICES 186145 23 20000 200000 48660663 2385303 2379036 51265966 NET PATIENT REVENUE 623990 15678481 15678481 OTHER OPERATING REVENUE 623990 2264329 2264329 17942810 165639 165639 518480 0 518480 518480 518480 3072137 2870349 201788 201788 201788 70094683 18461290 0 367427 1223250 658241 565009 34250370 28455119 5795251 1200216 971982 228234 3793256 3071926 721330 2547618 2063160 484458 92278 61525 30753 120623 80423 40200 30000 30000 55128 55128 2644948 2126080 518868 19675 14418 5257 195273 68868 126405 32416 23755 8661 2748031 2480374 267657 569886 457857 112029 692638 669405 23233 1957224 1871510 85714 1996235 1857989 138246 MEDICAL AND PHARMACY 3782623 3779337 3286 FOOD SERVICES 1431149 1417646 13503 MINOR AND RENTAL EQUIPM 1014354 799701 214653 TELEPHONE 607445 445147 162298 1493958 1096785 397173 62498594 52501248 9997346 0 12011852 16273702 3207834 2084655 8221241 9979035 3225345 3756529 373328 426628 411096 2300069 2635564 51692593 24198594 27458732 27493999 4989237 8675789 545484 545484 141127 644783 262066 63172332 72491247 8193193 5959308 3257980 8337852 700307 8220922 587743 1197041 17819095 18635251 X 45353237 53855996 45353237 53855996 63172332 72491247 X 7596089 605991 51921 248758 X X 0 1 X 1 1 1 X 39434624 43076270 45405367 44403542 51265966 223585769 39434624 43076270 45405367 44403542 51265966 223585769 223585769 693326 683104 733305 657941 684119 3451795 227037564 81912738 0.98480 0.98400 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 30000 30000 0 PART II-B, LINE 1: TO PROVIDE REPRESENTATION BEFORE THE FLORIDA LEGISLATURE, COMITTEES AND STATE AGENCIES TO ADVANCE THE ORGANIZATION'S MISSION IN LAKE, SUMTER AND CITRUS COUNTIES. 1271332 1271332 34904773 12764782 22139991 3212092 2065372 1146720 12203584 9368440 2835144 100812 100812 27493999 RESTRICTED CLIENT TRUST FUNDS 322011 DEFERRED HEALTH CLAIMS LIABILITY 800000 TENANT SECURITY DEPOSIT 19413 INTEREST RATE SWAP LIABILITY 55617 1197041 X PART X, LINE 2: THE ORGANIZATION AND ITS AFFILIATES HAVE RECEIVED DETERMINATION LETTERS FROM THE INTERNAL REVENUE SERVICE ("IRS") THAT THEY ARE EXEMPT FROM FEDERAL INCOME TAX AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC"). THEY ARE ALSO EXEMPT FROM STATE INCOME TAX PURSUANT TO FLORIDA LAW. 1 1 1 X 1 X 1 1 0 1 1 1109571 1519340 0 0.00000 984726 1348389 0 0.00000 2094297 2867729 0 0.00000 40675525 40675525 0.65080 40675525 40675525 0.65080 42769822 2867729 40675525 0.65080 3688603 3688603 567313 2261458 -1694145 X 1 1 LIFESTREAM BEHAVIORAL 2020 TALLY ROAD LEESBURG FL 34748 WWW.LSBC.NET 4075 X LIFESTREAM BEHAVIORAL 1 0 0 1 X X X X X X X X 22 1 0 0 1 X WWW.LSBC.NET 1 22 0 0 0 1 X 150.000000000000 300.000000000000 1 1 X 1 X SEE STATEMENT-SCH H, PART V, SECTION C X SEE STATEMENT-SCH H, PART V, SECTION C X SEE STATEMENT-SCH H, PART V, SECTION C X X X X X X X 1 X 1 X X X X X 1 0 0 LIFESTREAM BEHAVIORAL PART V, SECTION B, LINE 5: LIFESTREAM CONDUCTED ITS NEEDS ASSESSMENT BY MEETING WITH COMMUNITY LEADERS, ATTENDING RELATED COMMUNITY FORUMS, SURVEYING COMMUNITY RESIDENTS AND PARTNERING WITH WELLCARE OF FLORIDA AND THE LAKE COUNTY AND SUMTER COUNTY DEPARTMENTS OF HEALTH AS THEY COMPLETED THEIR NEEDS ASSESSMENTS. THE NEEDS ASSESSMENT IS AVAILABLE TO THE PUBLIC ON THE LIFESTREAM WEBSITE. LIFESTREAM BEHAVIORAL PART V, SECTION B, LINE 16J: FAP WEBSITE: HTTPS://WWW.LSBC.NET/CONSUMER-INFORMATION/FINANCIAL-SERVICES/ 34 1 - BEACON POINT - BLGS 1&3 717 SW MARTIN LUTHER KING AVE OCALA FL 34471 OUTPATIENT 2 - FACT YAFR 1017 W DIXIE AVE LEESBURG FL 34748 OUTPATIENT 3 - HOPE SPRINGS APARTMENTS 1103 BENTLEY RD LEESBURG FL 34748 RESIDENTIAL 4 - COMMUNITY SUPPORT BLD I & II 115 CITRUS AVE EUSTIS FL 32726 OUTPATIENT 5 - SUMTER OUTPATIENT CLINIC 119 N MARKET STREET BUSHNELL FL 33513 OUTPATIENT 6 - LAKE ACADEMY - E 1217 E HUFFSTETLER RD EUSTIS FL 32726 SCHOOL 7 - HOPE HOUSE - PUTNEY 12327 NORTH PUTNEY COURT LEESBURG FL 34788 RESIDENTIAL 8 - ADULT PREVJAIL DIVERSION 1300 DUNCAN DR TAVARES FL 32778 OUTPATIENT 9 - CHILD CTR - CITRUS 2417 2419 N LECANTO HWY LECANTO FL 34461 OUTPATIENT 10 - HOPE HOUSE - GROVE II 11339 GROVE STREET LEESBURG FL 34788 RESIDENTIAL 11 - HOPE HOUSE- PETERS DR 1318 PETERS DRIVE LEESBURG FL 34748 RESIDENTIAL 12 - KCI CM - WILDWOOD 1601 W GULF ATLANTIC HWY WILDWOOD FL 34785 OUTPATIENT 13 - OUR TURNING POINT RANCH 19812 E 5TH AVE UMATILLA FL 32784 RESIDENTIAL 14 - EUSTUS OUT PATIENT 201 MAGNOLIA AVE EUSTIS FL 32736 OUTPATIENT 15 - LAKE REGION HOUSE 2016 TALLY RD LEESBURG FL 34748 RESIDENTIAL 16 - HOPE & RECOVERY 2018 TALLY ROAD LEESBURG FL 34748 RESIDENTIAL 17 - LAKE ACADEMY - LEESBURG 2020 TALLY RD LEESBURG FL 34748 SCHOOL 18 - SOUTH LAKE OUTPATIENT CLINIC 2140 N DON WICKHAM DRIVE CLERMONT FL 34711 OUTPATIENT 19 - LEESBURG OUTPATIENT CLINIC WINN 215N 3RD STREET LEESBURG FL 34748 OUTPATIENT 20 - CHILD TASC 225 NE 14TH ST OCALA FL 34470 OUTPATIENT 21 - HOPE HOUSE - GROVE ST 24 S GROVE STREET EUSTIS FL 32726 RESIDENTIAL 22 - HEALTH DEPARTMENT 249 E COLLINS ST UMATILLA FL 32784 OUTPATIENT 23 - HOPE HOUSE - ESTES 34603 ESTES ROAD EUSTIS FL 32736 RESIDENTIAL 24 - AIMS - LAKE BLD I & II 404 WEBSTER STREET LEESBURG FL 34748 DAY TREATMENT 25 - PHEONIX HOUSE - NORTH AND SOUTH 411 S AND 427 S US 301 SUMTERVILLE FL 33585 RESIDENTIAL 26 - HOPE HOUSE - BRIARCLIFF 420 BRIARCLIFF AVE EUSTIS FL 32726 RESIDENTIAL 27 - ANTHONY HOUSE 6215 HOLLY STREET BLD I II III ZELLWOOD FL 32798 RESIDENTIAL 28 - MAT OCOEE 1554 BOREN DRIVE OCOEE FL 34761 OUTPATIENT 29 - ADULT CTR - CITRUS 1554 N MEADOWCREST BLVD CRYSTAL RIVER FL 34429 OUTPATIENT 30 - CHILD CTR - HILLSBOROUGH 51 W FORT DADE AVE BROOKSVILLE FL 34601 OUTPATIENT 31 - ACCESS CENTER - CITRUS 6 REGINA BLVD BEVERLY HILLS FL 34461 OUTPATIENT 32 - SOUTH LAKE OUTPATIENT CLINIC - CSU 2060 N DON WICKHAM DRIVE CLERMONT FL 34711 OUTPATIENT 33 - KCI CM - TAVARES 1300 DUNCAN DR - BLDG B TAVARES FL 32778 OUTPATIENT 34 - CITRUS - BLDG 2 3264 S LECANTO HWY LECANTO FL 34461 RESIDENTIAL PART I, LINE 7: COST TO CHARGE RATIO PART III, LINE 2: ACCOUNTS RECEIVABLE FROM PATIENTS ARE REDUCED BY CONTRACTUAL ALLOWANCES AND AN ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CENTER ANALYZES HISTORICAL TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES. FOR ACCOUNTS RECEIVABLE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CENTER ANALYZES THE COLLECTABILITY OF THE RELATED CONTRACTUALLY DUE AMOUNTS AS WELL AS THE COLLECTABILITY OF CO-PAYS AND DEDUCTIBLES DUE FROM THE SPECIFIC PATIENTS RECEIVING THOSE SERVICES. FOR ACCOUNTS RECEIVABLE ASSOCIATED WITH SELF-PAY PATIENTS, LIFESTREAM RECORDS SIGNIFICANT PROVISIONS FOR BAD DEBTS IN THE PERIOD IN WHICH THE SERVICE IS PERFORMED ON BOTH THE BASIS OF HISTORICAL TRENDS AS WELL AS SPECIFIC PATIENT-RELATEDTED COLLECTABILITY INFORMATION. MANAGEMENT REGULARLY REVIEWS DATA ABOUT ALL PAYER SOURCES OF REVENUES TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND THE PROVISION OF BAD DEBTS. PART III, LINE 8: ANNUALLY, THE CENTER REVIEWS ITS GROSS CHARGE MASTER AND ANY RESULTING CHANGES ARE APPROVED BY ITS BOARD OF DIRECTORS. DIFFERENCES BETWEEN GROSS CHARGES AND CONTRACTUAL RATES, AS WELL AS THE DIFFERENCES BETWEEN GROSS CHARGES AND NEGOTIATED RATES, ARE WRITTEN OFF AT THE TIME OF SERVICE. DIFFERENCES BETWEEN CONTRACTUAL OR NEGOTIATED ACCOUNTS RECEIVABLE ALONG WITH CO-PAY, DEDUCTIBLE, AND SELF-PAY ACCOUNTS RECEIVABLE ARE FURTHER WRITTEN OFF AT THE TIME OF SERVICE TO THE ESTIMATED AMOUNTS COLLECTIBLE AS CHARGES AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FURTHER COLLECTABILITY-RELATED ADJUSTMENTS TO ACCOUNTS RECEIVABLE ARE ALSOCHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOR BAD DEBTS RESULTING AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN MADE. ANNUALLY THE CENTER ALSO UPDATES ITS SLIDING FEE SCALES IN COORDINATION WITH THE ANNUAL PUBLICATION OF THE FEDERAL POVERTY GUIDELINES AND THE REQUIREMENTS OF CHAPTER 65E-14 OF THE FLORIDA ADMINISTRATIVE CODE. THE RESULTING SLIDING FEE DISCOUNTS AND CO-PAYS FOR QUALIFYING PATIENTS ARE REDUCED AT THE TIME OF SERVICE. THE INCREASE IN CHARITY CARE REPRESENTS THE INCREASE IN SERVICES TO INDIVIDUALS WHO DO NOT HAVE A THIRD-PARTY PAYER SOURCE OR EMPLOYMENT. PART VI, LINE 2: NEEDS ASSESSMENT - LIFESTREAM USES A VARIETY OF DATA SOURCES TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES. MANY OF THESE REPORTS DRAW FROM INTERNAL SOURCES SUCH AS THE DAILY HOSPITAL CENSUS, OUTPATIENT CLINIC WAITING LISTS AND TIME FROM INITIAL CONTACT TO APPOINTMENT, PROGRAM WAITING LIST, CONSUMER SURVEYS AND POPULATION HEALTH DATA. THE AGENCY ALSO USES DATA FROM FEDERAL, STATE AND COUNTY AGENCIES RANGING FROM HHS AND ITS MANY ADMINISTRATIVE UNITS SUCH AS SAMHSA OR NIMH TO COUNTY DEPARTMENTS OF HEALTH, WHICH PRODUCE THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT. THESE VARIOUS NEEDS ASSESSMENTS FEED INTO THE AGENCY'S STRATEGIC PLANNING PROCESS AND ALSO INFORM ITS RESOURCE DEVELOPMENT AND ANNUAL PLANNING EFFORTS. TWO RECENT EXAMPLES WERE THE DECISIONS TO EXPAND THE AGENCY'S INTEGRATED PRIMARY CARE CLINIC TO A THIRD LOCATION IN SOUTH LAKE COUNTY AND THE MOVE TO BECOME A CENTRAL RECEIVING FACILITY, WHICH INCLUDES THE ADDITION OF 10 DUALLY LICENSED BAKER ACT/ADDICTIONS BEDS TO ITS 10-BED CRISIS STABILIZATION UNIT. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - AS PART OF THE COMPREHENSIVE INTAKE THAT IS COMPLETED FOR EACH PATIENT WHO IS ADMITTED TO LIFESTREAM'S HOSPITAL, AN ASSESSMENT IS MADE OF THE PATIENT'S NEED FOR ASSISTANCE. WHERE PRACTICAL, AGENCY STAFF REVIEW WITH CONSUMERS THE AGENCY'S FEE POLICIES AND SLIDING FEE SCALE, OPTIONS FOR FINANCIAL ASSISTANCE AND ELIGIBILITY REQUIREMENTS, AND LIFESTREAM'S BILLING AND COLLECTION PRACTICES. PATIENTS ARE CONTACTED AGAIN BEFORE OR UPON DISCHARGE BY THE HOSPITAL BUSINESS OFFICE WHO CONTINUE THE EDUCATION PROCESS, FURTHER REVIEWING WITH CONSUMERS OPPORTUNITIES FOR FINANCIAL ASSISTANCE AND PROVIDING CONSUMERS WITH INFORMATION ABOUT RESOURCES SUCH AS MEDICAID, MEDICARE OR SOAR. LIFESTREAM ALSO PARTICIPATES IN THE STATE OF FLORIDA ACCESS PROGRAM WHERE PATIENTS CAN USE PUBLIC COMPUTER TERMINALS TO REGISTER FOR A VARIETY OF BENEFIT PROGRAMS, SUCH AS MEDICAID. PART VI, LINE 4: DESCRIPTION OF COMMUNITY INFORMATION - FOR NEARLY 46 YEARS, LIFESTREAM STAFF AND VOLUNTEERS HAVE MADE THE PROMISE OF RECOVERY FROM SERIOUS MENTAL ILLNESS AND CHRONIC ADDICTION A REALITY FOR THOUSANDS OF CHILDREN, WOMEN AND MEN, REGARDLESS OF ABILITY TO PAY. THIS PAST YEAR, THE AGENCY ENABLED NEARLY 12,000 LAKE AND SUMTER COUNTY RESIDENTS TO RECLAIM THEIR LIVES AND TAKE WHAT, FOR MANY, WAS THEIR FIRST STEP TOWARD HOPE. FOR MANY OF THESE INDIVIDUALS, THE PATH TO RECOVERY WAS OPENED TO THEM BY THE NEARLY $2 MILLION IN FREE OR REDUCED-COST SERVICES THAT LIFESTREAM PROVIDED. IN FACT, OVER HALF OF ALL THE VITAL, LIFE-TRANSFORMING PROGRAMS THAT LIFESTREAM OFFERED WOULD NOT HAVE BEEN POSSIBLE WITHOUT AN AGENCY SUBSIDY RANGING FROM A FEW TO SEVERAL HUNDRED THOUSAND DOLLARS. IT'S BECAUSE OF LIFESTREAM'S UNWAVERING COMMITMENT TO ITS MISSION AS A NONPROFIT ORGANIZATION THAT IT HAS HISTORICALLY EXCEEDED FLORIDA'S HEALTH CARE RESPONSIBILITY ACT AND AGENCY FOR HEALTH CARE ADMINISTRATION CHARITY CARE REQUIREMENTS. IT'S ALSO WHY LIFESTREAM'S 550 EMPLOYEES AND NUMEROUS VOLUNTEERS ARE INVOLVED IN EVERY MAJOR COMMUNITY ORGANIZATION WITH LAKE AND SUMTER COUNTY AS BOARD OFFICERS AND MEMBERS. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM - N/A PART VI, LINE 7, REPORTS FILED WITH STATES FL X 0 0 0 0 0 0 0 0 0 JONATHAN CHERRY PRESIDENT & CEO (END. JUNE 2023) 365065 0 0 0 0 0 14018 0 48948 0 428031 0 0 0 ABID DARR PSYCHIATRIST 326193 0 0 0 0 0 12526 0 43736 0 382455 0 0 0 THOMAS VALENTE MEDICAL DIRECTOR 301560 0 0 0 0 0 11580 0 40433 0 353573 0 0 0 MIGUEL CORREA PSYCHIATRIST 265024 0 0 0 0 0 10177 0 35535 0 310736 0 0 0 EDGAR WALKER PSYCHIATRIST 243148 0 0 0 0 0 9337 0 32601 0 285086 0 0 0 DAVID DADA PSYCHIATRIST 223548 0 0 0 0 0 8584 0 29973 0 262105 0 0 0 RICK HANKEY PRESIDENT & CEO (BEG. JUNE 2023) 221840 0 0 0 0 0 8519 0 29744 0 260103 0 0 0 SUSAN RESNIK APRN 172616 0 0 0 0 0 6628 0 23144 0 202388 0 0 0 CAROL E DOZIER CHIEF FINANCIAL OFFICER 154837 0 0 0 0 0 5946 0 20761 0 181544 0 0 0 PART I, LINE 3 THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS OF THE ORGANIZATION, PROVIDED THAT PERSONS WITH CONFLICTS OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE ARE NOT INVOLVED. COMPENSATION IS REVIEWED USING DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SUITED ORGANIZATIONS. THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT. ERNIE MORRIS ENTERPRISES LLC BUSINESS 256158 PURCHASE SUPPLIES 0 SCHEDULE L, PART V - ADDITIONAL INFORMATION A BOARD MEMBER IS AN OFFICER OF THE BUSINESS LISTED IN PART IV. THE ORGANIZATION PURCHASES OFFICE SUPPLIES AND FURNITURE AT ARMS LENGTH. X 28220 2379036 FMV 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B ORGANIZATION'S PROCESS TO REVIEW FORM 990: BOARD MEMBERS ARE PROVIDED A DRAFT COPY OF THE FORM 990 FOR REVIEW, CHANGES NOTED BY MEMBERS ARE MADE IF NECESSARY, AND THE FINAL FORM 990 IS THEN FILED UPON SIGNATURE OF AN AUTHORIZED OFFICER. FORM 990, PART VI, SECTION B, LINE 12C ENFORCEMENT OF CONFLICTS POLICY: EACH DIRECTOR, OFFICER AND MANAGEMENT STAFF MEMBER SHALL SIGN ANNUALLY A STATEMENT THAT AFFIRMS THE FOLLOWING: 1) THEY HAVE RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY 2) HAVE READ AND UNDERSTOOD 3) HAVE AGREED TO COMPLY WITH THE PROCEDURE 4) UNDERSTAND LIFESTREAM MUST ENGAGE ONLY IN ITS EXEMPT PURPOSE ACTIVITIES. IF THERE IS REASONABLE CAUSE TO BELIEVE THEY HAVE FAILED TO DISCLOSE, AN INVESTIGATION MAY BE WARRANTED. FORM 990, PART VI, SECTION B, LINE 15 FORM 990, PART VI, LINE 15A - COMPENSATION PROCESS FOR TOP OFFICIAL THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER AND KEY EMPLOYEES IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS OF THE ORGANIZATION, PROVIDED THAT PERSONS WITH CONFLICTS OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE ARE NOT INVOLVED. COMPENSATION IS REVIEWED USING DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SUITED ORGANIZATIONS. THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING WITH RESPECT TO THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT. FORM 990, PART VI, LINE 15B - COMPENSATION PROCESS FOR OFFICERS THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER AND KEY EMPLOYEES IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS OF THE ORGANIZATION, PROVIDED THAT PERSONS WITH CONFLICTS OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE ARE NOT INVOLVED. COMPENSATION IS REVIEWED USING DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SUITED ORGANIZATIONS. THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS DISCLOSURE EXPLANATION: GOVERNING DOCS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FOR A REASONABLE COPYING CHARGE. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP LIABILITY 248,758. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS ARE RESPONSIBLE FOR THE OVERSIGHT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THERE WAS NO CHANGE IN THIS PROCESS FROM THE PRIOR YEAR. LIFESTREAM BEHAVIORAL CENTER FOUNDATION INC PO BOX 491000 LEESBURG FL 34749 592976392 FUNDRAISING FOR LIFESTREAM BEHAVIORAL CENTER, INC. FL 501(C)(3) LINE 10 LIFESTREAM BEHAVIORAL CENTER INC 0 LAKE REGION HOMES INC PO BOX 491000 LEESBURG FL 34749 592411947 APTS FOR CLIENTS OF LIFESTREAM BEHAVIORAL CENTER, INC. FL 501(C)(3) LINE 12A, I LIFESTREAM BEHAVIORAL CENTER INC 1 ANTHONY HOUSE PO BOX 491000 LEESBURG FL 34749 592944839 HOMELESS SHELTER FL 501(C)(3) LINE 10 LIFESTREAM BEHAVIORAL CENTER INC 1 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 LAKE REGION HOMES INC A 12027 IMPUTED INTEREST LIFESTREAM BEHAVIORAL CENTER FOUNDATION INC C 200000 FAIR MARKET VALUE