2023-11-14T11:47:28-06:00 2022-12-31 990 2022-01-01 421286953 FINLEY HEALTH FOUNDATION INC FINL 5635821881 350 NORTH GRANDVIEW AVE DUBUQUE IA 520016392 CAROL CROSS VP FINANCE 5635892522 2023-11-08 CAROL CROSS 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z CHAD WOLBERS 350 NORTH GRANDVIEW AVE DUBUQUE IA 520016392 13522624 0 X WWW.UNITYPOINT.ORG (SEE SCH O) X 1986 IA PROVIDES FINANCIAL SUPPORT TO THE FINLEY HOSPITAL AND THE DUBUQUE VISITING NURSE ASSOCIATION. 15 14 0 14 0 0 1737578 1660550 0 0 700789 2352818 33608 -16141 2471975 3997227 1528697 1022281 0 0 331507 282888 34991 29615 286725 173251 170271 2068446 1505055 403529 2492172 18899382 16761049 666145 548206 18233237 16212843 X THE FINLEY HEALTH FOUNDATION PROVIDES FINANCIAL SUPPORT TO THE FINLEY HOSPITAL AND THE DUBUQUE VISITING NURSE ASSOCIATION VIA ONGOING FUNDRAISING ACTIVITIES THROUGH THE CULTIVATION AND SOLICITATION OF GIFTS FROM PRIVATE INDIVIDUALS AND FAMILIES, AREA CORPORATIONS, FOUNDATIONS AND GOVERNMENT ENTITIES THAT CAN BE USED TO SUPPORT OPERATIONS, CLINICAL PROGRAMS AND MAJOR CAPITAL PROJECTS. 0 0 1022281 1022281 0 GRANTS, ALLOCATIONS, AND PROGRAM SUPPORTTHE FINLEY HEALTH FOUNDATION INC'S PURPOSE IS TO RAISE FUNDS TO MAINTAIN, DEVELOP, INCREASE AND EXTEND THE FACILITIES AND SERVICES OF THE FINLEY HOSPITAL AND DUBUQUE VISITING NURSE ASSOCIATION IN DUBUQUE IOWA, AND TO PROVIDE BROADER HOSPITAL, MEDICAL AND EDUCATIONAL SERVICE OPPORTUNITIES TO ITS PATIENTS, STUDENTS, STAFF, FACULTY AND RESIDENTS OF THE GEOGRAPHICAL AREA IT SERVES. IT SUPPORTS THE MISSIONS OF FINLEY TRI-STATES HEALTH GROUP, INC. AND ITS SUBSIDIARIES BY RAISING FINANCIAL CONTRIBUTIONS AND INVESTING THE PROCEEDS.THE GRANT, ALLOCATIONS AND PROGRAM SUPPORT SERVICES MAY INCLUDE:-CONTRIBUTIONS TO THE FINLEY HOSPITAL AND/OR DUBUQUE VISITING NURSE ASSOCIATION FOR EQUIPMENT PURCHASES, TO OFFSET OPERATING EXPENSES AND MISCELLANEOUS.-SCHOLARSHIPS AND/OR LECTURESHIPS AWARDED TO INDIVIDUALS ASSOCIATED WITH THE FINLEY HOSPITAL (KRITZ AND KEARNEY NURSING SCHOLARSHIPS).-MISCELLANEOUS GRANTS AND CONTRIBUTIONS TO ORGANIZATIONS AND/OR INDIVIDUALS ASSOCIATED WITH THE FINLEY HOSPITAL (HEINEN FUNDS). 1022281 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 X 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 15 14 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X DANIEL LAGRANGE VP FINANCE & OPERATIONS 5152416289 1415 WOODLAND AVE SUITE E-200 DES MOINES IA 50309 RANDY BENDER BOARD MEMBER 1.00 0.00 X 0 0 0 RYAN BURBACH BOARD MEMBER 1.00 0.00 X 0 0 0 POPPY CONLON BOARD VICE CHAIR 1.00 0.00 X X 0 0 0 GARY DOLPHIN BOARD MEMBER 1.00 0.00 X 0 0 0 TARA DUGGAN BOARD MEMBER 1.00 0.00 X 0 0 0 DUSTIN FARBER BOARD CHAIR 1.00 0.00 X X 0 0 0 SCOTT HARRIS BOARD MEMBER 1.00 0.00 X 0 0 0 KRISTEN IGO BOARD MEMBER 1.00 0.00 X 0 0 0 JASON KNOCKEL BOARD MEMBER 1.00 0.00 X 0 0 0 KATHYRN MORAN BOARD MEMBER 1.00 0.00 X 0 0 0 ANDY MOZENA BOARD MEMBER 1.00 0.00 X 0 0 0 NICOLE POWERS BOARD MEMBER 1.00 0.00 X 0 0 0 HILLARD SALAS MD BOARD MEMBER 1.00 0.00 X 0 0 0 CREED WAELCHLI BOARD SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 CHAD WOLBERS BOARD MEMBER & PRESIDENT/CEO 1.00 0.00 X X 456758 0 95958 456758 0 95958 0 0 1 1 0 54010 125207 1481333 1660550 704165 704165 11111740 9463087 1648653 1648653 1648653 46169 125207 62310 -16141 -16141 3997227 0 0 2336677 1022281 1022281 228466 68540 159926 11006 3302 7704 27403 8221 19182 16013 4804 11209 11000 11000 29615 29615 110543 110543 22029 22029 2197 2197 8651 8651 7 7 3200 3200 158 158 MISCELLANEOUS EXPENSE 11854 11854 INCOME TAXES 632 632 1505055 1022281 196049 286725 315172 800704 396262 104371 3000 0 0 14959074 13117614 3208352 2704656 20522 30704 18899382 16761049 57942 40839 608203 507367 666145 548206 X 4441900 4436777 13791337 11776066 18233237 16212843 18899382 16761049 X 2492172 -4011591 -500975 X 0 1 X 1 0 X 928940 1509145 1250161 1737578 1660550 7086374 928940 1509145 1250161 1737578 1660550 7086374 477543 6608831 381950 423608 409810 434774 704165 2354307 9440681 265652 0.70000 0.71890 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9576928 423261 -642794 270315 9087080 8487268 126853 1101795 138988 9576928 8047036 25000 567642 152410 8487268 7311364 936143 200471 8047036 7761814 75 -225744 224781 7311364 0.40465 0.42095 0.17439 1 0 0 BENEFICIAL INTEREST IN CHARITABLE TRUST HELD BY OTHERS 2704656 F 2704656 DUE TO AFFILIATES 507367 507367 X -611672 -4011587 12539 -3999048 3387376 108870 500981 609851 3997227 1408722 12538 12538 1396184 108870 1 108871 1505055 PART V, LINE 4: THE ORGANIZATION RETAINS FUNDS FOR INTENDED FUTURE USES, INCLUDING PURCHASE OF EQUIPMENT, INDIGENT CARE, FUNDING OF MISSION RELATED OPERATIONS, AND HEALTH EDUCATION. IN ADDITION, SOME FUNDS ARE HELD FOR INVESTMENT IN PERPETUITY. IN ADDITION TO THE ENDOWED FUNDS HELD BY THE FINLEY HEALTH FOUNDATION WE RECEIVE INTEREST FROM THE ENDOWED FUNDS HELD BY THE COMMUNITY HEALTH FOUNDATION, A SEPARATE ORGANIZATION. THE FUNDS ARE INVESTED FOR LONG TERM GROWTH OF THE PRINCIPAL WHILE CREATING AN ANNUAL INCOME STREAM TO BE USED FOR ACTIVITIES IN ALIGNMENT WITH THE FOUNDATION'S MISSION. PART X, LINE 2: THE FOUNDATION IS ORGANIZED AS AN IOWA NON-PROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3), QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A)(VI) AND (VIII), AND HAS BEEN DETERMINED NOT TO BE A PRIVATE FOUNDATION UNDER SECTIONS 509(A)(1) AND (3), RESPECTIVELY. THE FOUNDATION IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE FOUNDATION IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSES. THE FOUNDATION HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS. THE FOUNDATION BELIEVES THAT IT HAS APPROPRIATE PURPOSE FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE FOUNDATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. PART XI, LINE 2D - OTHER ADJUSTMENTS: IN-KIND CONTRIBUTIONS 12,538. ROUNDING 1. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST OF CHARITABLE TRUST HELD BY OTHERS 500,981. PART XII, LINE 2D - OTHER ADJUSTMENTS: IN-KIND CONTRIBUTIONS 12,538. PART XII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING 1. X X X X X X 1 THOMPSON & ASSOCIATES OF IOWA 112 WESTWOOD PLACE SUITE 250 BRENTWOOD TN 50309 FUNDRAISING CONSULTANT 0 0 29615 0 29615 IA GALA 171376 125207 46169 6074 12494 37788 5954 171376 125207 46169 6074 12494 37788 5954 62310 -16141 SCHEDULE G, PART I, LINE 2B, COLUMN (V) THOMPSON & ASSOCIATES - MONTHLY CONSULTING FEE AND TRAVEL EXPENSES. 1 THE DUBUQUE VISITING NURSE ASSOCIATION 1454 IOWA ST DUBUQUE IA 52001 420680410 501(C)(3) 237303 0 PROGRAM SUPPORT THE FINLEY HOSPITAL 350 NORTH GRANDVIEW AVE DUBUQUE IA 52001 420680354 501(C)(3) 784978 0 PROGRAM SUPPORT 2 0 PART I, LINE 2: FINLEY HEALTH FOUNDATION FUNDS REQUESTS FROM THE FINLEY HOSPITAL. THE REQUESTS ARE REVIEWED AND APPROVED BY FINLEY HEALTH FOUNDATION'S BOARD OF DIRECTORS. 0 1 0 0 0 0 0 0 0 CHAD WOLBERS BOARD MEMBER & PRESIDENT/CEO 333875 0 116829 0 6054 0 66850 0 29108 0 552716 0 0 0 PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED CONTRIBUTIONS IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: CHAD WOLBERS $ 54,461. FORM 990, SECTION VII, LINE 5 THE FINLEY HOSPITAL PAYS COMPENSATION TO CHAD WOLBERS, IN THE AMOUNTS OF: BASE PAY $333,875, BONUS & INCENTIVE COMPENSATION $116,829, OTHER COMPENSATION $6,054, DEFERRED COMPENSATION $66,850, NONTAXABLE BENEFITS $29,108. FINLEY HEALTH FOUNDATION, INC. RECEIVES AN IN-KIND DONATION FROM THE FINLEY HOSPITAL FOR PART OF THE COMPENSATION THAT THE FINLEY HOSPITAL PAID TO CHAD WOLBERS. FORM 990, PART V, LINES 1A & 1B CASH DISBURSEMENTS ARE CENTRALIZED THROUGH THE PARENT ORGANIZATION, IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH SYSTEM). THE PARENT MAKES THE PAYMENTS AND FILES THE RELATED FORMS 1099 AND 1096 ON BEHALF OF ALL UNITYPOINT HEALTH SYSTEM RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 7A FINLEY TRI-STATES HEALTH GROUP, INC. APPOINTS AND REMOVES BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B FINLEY TRI-STATES HEALTH GROUP, INC. APPOINTS AND REMOVES BOARD OF DIRECTORS, APPROVES AMENDMENTS TO ARTICLES AND BYLAWS, AND APPOINTS PRESIDENT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE IOWA HEALTH SYSTEM TAX SERVICES DEPARTMENT USING INFORMATION GATHERED FROM THE FINANCIAL SERVICES AND ADMINISTRATIVE OFFICES OF THE ORGANIZATION. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. ONCE REVIEWED A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C A DISCLOSURE QUESTIONNAIRE IS SENT TO ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES. PERSONS REQUIRED TO REPORT, WHO HAVE NOT RETURNED QUESTIONNAIRES, WILL BE CONTACTED AND FOLLOW-UP WILL CONTINUE ON A REGULAR BASIS IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE INFORMATION DISCLOSED WILL BE USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS QUESTIONNAIRES. THE DUTY TO IDENTIFY AND DISCLOSE POTENTIAL CONFLICTS OF INTEREST IS A DUTY THAT IS ONGOING. ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES SHALL IMMEDIATELY DISCLOSE SUCH POTENTIAL CONFLICT OR DUALITY OF INTEREST AS SOON AS THE INTEREST OCCURS. DISCLOSURE SHOULD BE MADE TO THE COVERED PERSON'S SUPERVISOR, DIRECTOR OF THE ORGANIZATION, OR THE BOARD CHAIR OF THE ORGANIZATION, AS APPLICABLE. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION RELIES ON AN UNRELATED ORGANIZATION TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION BASED ON FAIR MARKET VALUE. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE THROUGH THE SECRETARY OF STATE'S OFFICE. OTHER GOVERNING DOCUMENTS MAY BE AVAILABLE UPON REQUEST. THE ORGANIZATION WILL PROVIDE COPIES OF ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST OF CHARITABLE TRUST HELD BY OTHERS -500,981. ROUNDING 6. FORM 990, LINE J, WEBSITE: WWW.UNITYPOINT.ORG/GIVING/FINLEY-HEALTH-FOUNDATION-DUBUQUE