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Nonprofiteer
← FINLEY TRI-STATES HEALTH GROUP INC

Form 990 for tax year 2023

Filed by FINLEY TRI-STATES HEALTH GROUP INC.

Totals

Total revenue
$0
Total expenses
$0
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$0
Other revenue
$0
Total assets, end of year
$14,037
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$14,037
Program services expenses (Part IX)
$0
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
not reported

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Balance sheet

Part X, book values.

  • 13 · Investments: program-related

    beginning of year $14,037 · end of year $14,037

  • 27 · Net assets without donor restrictions

    beginning of year $14,037 · end of year $14,037

Mission and programs · 2023

Mission

FINLEY TRI-STATES HEALTH GROUP'S MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IT SERVES, AND PROVIDE TANGIBLE BENEFITS TO THE COMMUNITY.

Activities or mission (Part I)

IMPROVE THE HEALTH OF THE PEOPLE IT SERVES, AND PROVIDE TANGIBLE BENEFITS TO THE COMMUNITY.

  • AFFILIATE SUPPORT SERVICESFINLEY TRI-STATES HEALTH GROUP, INC. IS ORGANIZED TO SUPPORT THE MISSIONS OF SEVERAL RELATED CHARITABLE, TAX-EXEMPT ORGANIZATIONS INCLUDING THE FINLEY HOSPITAL AND THE DUBUQUE VISITING NURSE ASSOCIATION. THE SUPPORT SERVICES PROVIDED TO THESE ORGANIZATIONS ARE TO CONSTRUCT, OWN, LEASE, MANAGE, OPERATE, PROVIDE AND MAINTAIN ANY FACILITIES, PROGRAMS, SERVICES (MANAGEMENT OR OTHERWISE) AND RELATED ACTIVITIES, IN FURTHERANCE OF HEALTH CARE OR HEALTH EDUCATION. FACILITIES INCLUDE A HOSPITAL, CLINICS, EDUCATIONAL FACILITIES, AND OTHER ESTABLISHMENTS CREATED TO CARRY THROUGH HEALTH-CARE AND EDUCATIONAL PROGRAMS. THE PRIMARY PURPOSE OF THE CORPORATION IS TO ENGAGE IN AND CONDUCT CHARITABLE, EDUCATIONAL, RELIGIOUS AND SCIENTIFIC ACTIVITIES IN ACCORDANCE WITH PREVIOUSLY STATED PURPOSES.

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • BILL ARNOLD

    BOARD MEMBER

    Total calculated
    $14,500
    From this org
    $0
    From related orgs
    $14,500
    Other
    $0
    Hours/week
    1 + 1 related

  • KATHY BUHR

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • ROY BUOL

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • MARK DICKSON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • SUSAN FARBER

    BOARD VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • SUE FREEMAN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • JENNIFER HAVENS FR 1023

    BOARD MEMBER & PRESIDENT/CEO

    Total calculated
    $430,360
    From this org
    $0
    From related orgs
    $386,520
    Other
    $43,840
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $250,513 related
    Bonus
    $0 + $62,640 related
    Other
    $0 + $73,367 related
    Deferred
    $0 + $18,585 related
    Nontaxable benefits
    $0 + $25,255 related
    Filer's total
    $0 + $430,360 related

  • MIKE JANSEN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • NICOLE JEDLICKA DPM

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • JASON KNOCKEL

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • KEVIN LYNCH

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • KATHLEEN NACOS-BURDS

    BOARD TREASURER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • RYAN PETERSON

    BOARD SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • KEISHA SAINCI

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • CHARLIE SKEMP

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • LORI THIELEN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • NICK THOMPSON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • LAURA WITTHOEFT MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • CHAD WOLBERS TO 823

    BOARD MEMBER & PRESIDENT/CEO

    Total calculated
    $1,013,762
    From this org
    $0
    From related orgs
    $975,976
    Other
    $37,786
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $240,112 related
    Bonus
    $0 + $369,682 related
    Other
    $0 + $366,182 related
    Deferred
    $0 + $8,574 related
    Nontaxable benefits
    $0 + $29,212 related
    Filer's total
    $0 + $1,013,762 related

  • CAROL CROSS

    VP FINANCE

    Total calculated
    $319,518
    From this org
    $0
    From related orgs
    $283,717
    Other
    $35,801
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $214,374 related
    Bonus
    $0 + $63,730 related
    Other
    $0 + $5,613 related
    Deferred
    $0 + $14,435 related
    Nontaxable benefits
    $0 + $21,366 related
    Filer's total
    $0 + $319,518 related

  • THEODORE TOWNSEND JR TO 119

    BOARD MEMBER & INTERIM PRESIDENT/CEO

    Total calculated
    $462,474
    From this org
    $0
    From related orgs
    $462,474
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $462,474 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $462,474 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINES 4A-B
SEVERANCE PAYMENTS: THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS DURING THE YEAR THAT WERE INCLUDED IN THEIR TAXABLE INCOME: CHAD WOLBERS $101,670. NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED CONTRIBUTIONS IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: JENNIFER HAVENS $ 4,538. NONQUALIFIED RETIREMENT PLAN DISTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED PLAN: CHAD WOLBERS $ 260,210 & THEODORE TOWNSEND JR $462,474. PAYOUTS ARE MADE WITH VESTED FUNDS, AS ESTABLISHED BY PLAN DOCUMENTS.
SCHEDULE J, PART I, LINE 3 - ESTABLISHING COMPENSATION
THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR THE TOP EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2023
Filed
12 November 2024
IRS schema version
2023v5.1
Source object
202423199349309707

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