Skip to content
Nonprofiteer
← TRI-STATE HEALTH SERVICES INC

Form 990 for tax year 2023

Filed by TRI-STATE HEALTH SERVICES INC.

Totals

Total revenue
$3,433,378
Total expenses
$4,657,005
Contributions and grants received
$2,169,825
Grants paid
$0
Program service revenue
$1,180,582
Investment income
$82,866
Other revenue
$105
Total assets, end of year
$9,712,708
Total liabilities, end of year
$2,075,664
Net assets or fund balances, end of year
$7,637,044
Program services expenses (Part IX)
$4,507,092
Management and general expenses
$149,913
Fundraising expenses
$0
Program service expenses (Part III)
$4,507,092

Program services were 96.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • JONATHAN TIMMIS

    CHAIR/SYS SVP-STRAT-TRANSFORMATION

    Total calculated
    $1,346,596
    From this org
    $0
    From related orgs
    $1,299,163
    Other
    $47,433
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $600,588 related
    Bonus
    $0 + $696,866 related
    Other
    $0 + $1,709 related
    Deferred
    $0 + $19,175 related
    Nontaxable benefits
    $0 + $28,258 related
    Filer's total
    $0 + $1,346,596 related

  • MATT GRIMSHAW

    PRESIDENT/CEO

    Total calculated
    $755,468
    From this org
    $0
    From related orgs
    $700,024
    Other
    $55,444
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $476,575 related
    Bonus
    $0 + $197,635 related
    Other
    $0 + $25,814 related
    Deferred
    $0 + $19,290 related
    Nontaxable benefits
    $0 + $36,154 related
    Filer's total
    $0 + $755,468 related

  • DAVE WERKIN

    SEC'Y/TREAS/CFO TRINITY HEALTH SYS

    Total calculated
    $306,405
    From this org
    $0
    From related orgs
    $277,649
    Other
    $28,756
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $266,033 related
    Bonus
    $0 + $11,616 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $28,756 related
    Filer's total
    $0 + $306,405 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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 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, LINE 3
DURING THE CALENDAR YEAR 2023, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY TRINITY HEALTH SYSTEM GROUP, A RELATED ORGANIZATION. TRINITY HEALTH SYSTEM GROUP, USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4A:
CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY.
PART I, LINE 4B:
DURING THE 2023 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2023 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2023, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: MATTHEW GRIMSHAW, $25,814.
PART II:
TRI STATE HEALTH SERVICES INC. FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2023.

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 May 2025
IRS schema version
2023v6.0
Source object
202521329349303132

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.