Civic Intelligence

Tri-State Health Services Foundation

990 • Fiscal year 2015 • EIN 34-1537408

Jan 01, 2015 to Dec 31, 2015 • Filed on Nov 14, 2016

One Ross Rark BlvdSteubenville, OH 43952

(740) 283-7842

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

8th percentile

0.00x

Higher debt load relative to assets than 8% of similar nonprofits.

2015 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2015

Liabilities / Revenue

26th percentile

0.09x

Higher debt load relative to revenue than 26% of similar nonprofits.

2015 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2015

Net Margin

99th percentile

98%

Higher net margin than 99% of similar nonprofits.

2015 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2015

Top Officer Pay

13th percentile

$28,197

Higher top officer pay than 13% of similar nonprofits.

Top officer pay equals 8.1% of source-year revenue.

2015 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2015

Asset Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2015

Revenue Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2015

Assets

$13,345,953

No earlier filing loaded for comparison.

Net Assets

$13,313,659

No earlier filing loaded for comparison.

Liabilities

$32,294

No earlier filing loaded for comparison.

Revenue

$348,120

No earlier filing loaded for comparison.

Expenses

$8,671

No earlier filing loaded for comparison.

Net Income

$339,449

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$15M$10M$5.0M$0Assets 2015: $13,345,953Liabilities 2015: $32,294Net Assets 2015: $13,313,6592015Assets 2016: $0Liabilities 2016: $0Net Assets 2016: $02016

Highlighted filing

2015

Assets$13,345,953
Liabilities$32,294
Net Assets$13,313,659

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$400K$300K$200K$100K$0Revenue 2015: $348,120Expenses 2015: $8,671Net Income 2015: $339,4492015Revenue 2016: $44,940Expenses 2016: $2,880Net Income 2016: $42,0602016

Highlighted filing

2015

Revenue$348,120
Expenses$8,671
Net Income$339,449
Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
Nov 14, 2016
Return Version
2015v2.1
Gross Receipts
$348,120
Mission and Program Overview

Mission

A community partner dedicated to excellence in serving the health needs of the tri-state area.

Tri-state foundation is a supporting organization of tri-state health services, inc., a 501 (c) (3) organization, which conducts programs, such as prime time, a seniors health services assistance program.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$13,578,294$13,340,724▼ $237,570
Cash and Non-Interest-Bearing Accounts$5,141$5,229▲ $88
Total Assets$13,583,435$13,345,953▼ $237,482
Liabilities
Accounts Payable and Accrued Expenses$25,149$32,294▲ $7,145
Total Liabilities$25,149$32,294▲ $7,145
Net Assets / Fund Balance
Unrestricted Net Assets$13,558,286$13,313,659▼ $244,627
Total Net Assets Fund Balance$13,558,286$13,313,659▼ $244,627
Total Liabilities and Net Assets / Fund Balance$13,583,435$13,345,953▼ $237,482
Compensation and Service Providers

Employees

NameTitleOtherTotal
Gerald JohnExecutive Director$28,197$28,197

Board Members and Trustees

NameTitle
Charles CavanaughChairman
Eugene CalabreseTrustee
Mark MorelliTrustee
Michael BarberTrustee
A Thomas PentesSecretary
Bob OklokTreasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$0
Investment Income
$348,120
Other Revenue
$0
Change in Net Assets
$339,449
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$8,671
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Service Investment Mgmnt Fees$8,446--$8,446
Other Expenses$225--$225
Total Functional Expenses$8,671$0$0$8,671
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, line 11

The tri-state board of trustees, represented by its executive committee, reviews the system's and related entities' form 990's at there regular meeting. Each document is reviewed in detail, including each of the related schedules in their entirety. The board's executive committee endorses the 990 filings. The board's executive committee reports on their review of the organization's 990's at its regular board of trustees meeting.

Form 990, Part VI, Section B, line 12C

Each board member, officer and vice president is required to complete a disclosure of potential conflicts, which are defined by the applicable policy, on an annual basis. Each submission is reviewed by the board chair and the system ceo, incorporated into a summary report that is provided to the board and the individual originals are maintained in each member's board book. Upon the hearing or deliberation of any matter that comes before the board of trustees, the board chair or any individual member of the board can raise a question related to any conflict that they may identify. The board chair in consultation with the ceo and the full board will make a determination on the question and the procedure to be followed in the individual case. The board chair, or his designee if the chair is conflicted, will manage the conflict to assure an unbiased and objective discussion and decision.

Form 990, Part VI, Section C, line 19

Tri-state health services foundation does not make it's governing documents, conflict of interest policies or financial statements available to the general public. Financial statements are provided upon request at the offices of tri-state health services.

Filing and Contact Details

Filer

Filer Name
Tri-state Health Services Foundation
EIN
34-1537408
Phone
7402837842
Address
ONE ROSS RARK BLVD, STEUBENVILLE, OH 43952

Signing Officer

Name
Dave Werkin
Title
CFO
Phone
7402837842
Signed
2016-11-14
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Dave Werkin
Formed
1996
Legal Domicile
Oh
Voting Board Members
5
Independent Board Members
5
Employees
0
Volunteers
6

Preparer

Firm
Plante & Moran Pllc
Address
1111 Superior Ave Suite 1250, Cleveland, OH 44114
Preparer
Jeremy S Herman
Phone
2165231010
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IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0THE TRI-STATE BOARD OF TRUSTEES, REPRESENTED BY ITS EXECUTIVE COMMITTEE, REVIEWS THE SYSTEM'S AND RELATED ENTITIES' FORM 990'S AT THERE REGULAR MEETING. EACH DOCUMENT IS REVIEWED IN DETAIL, INCLUDING EACH OF THE RELATED SCHEDULES IN THEIR ENTIRETY. THE BOARD'S EXECUTIVE COMMITTEE ENDORSES THE 990 FILINGS. THE BOARD'S EXECUTIVE COMMITTEE REPORTS ON THEIR REVIEW OF THE ORGANIZATION'S 990'S AT ITS REGULAR BOARD OF TRUSTEES MEETING.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1EACH BOARD MEMBER, OFFICER AND VICE PRESIDENT IS REQUIRED TO COMPLETE A DISCLOSURE OF POTENTIAL CONFLICTS, WHICH ARE DEFINED BY THE APPLICABLE POLICY, ON AN ANNUAL BASIS. EACH SUBMISSION IS REVIEWED BY THE BOARD CHAIR AND THE SYSTEM CEO, INCORPORATED INTO A SUMMARY REPORT THAT IS PROVIDED TO THE BOARD AND THE INDIVIDUAL ORIGINALS ARE MAINTAINED IN EACH MEMBER'S BOARD BOOK. UPON THE HEARING OR DELIBERATION OF ANY MATTER THAT COMES BEFORE THE BOARD OF TRUSTEES, THE BOARD CHAIR OR ANY INDIVIDUAL MEMBER OF THE BOARD CAN RAISE A QUESTION RELATED TO ANY CONFLICT THAT THEY MAY IDENTIFY. THE BOARD CHAIR IN CONSULTATION WITH THE CEO AND THE FULL BOARD WILL MAKE A DETERMINATION ON THE QUESTION AND THE PROCEDURE TO BE FOLLOWED IN THE INDIVIDUAL CASE. THE BOARD CHAIR, OR HIS DESIGNEE IF THE CHAIR IS CONFLICTED, WILL MANAGE THE CONFLICT TO ASSURE AN UNBIASED AND OBJECTIVE DISCUSSION AND DECISION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2TRI-STATE HEALTH SERVICES FOUNDATION DOES NOT MAKE IT'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES OR FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST AT THE OFFICES OF TRI-STATE HEALTH SERVICES.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Form 990, Part VI, Section B, line 11
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Form 990, Part VI, Section B, line 12c
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2Form 990, Part VI, Section C, line 19
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IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt2TRINITY EAST
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt3TRINITY WEST
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt4TRINITY HEALTH SYSTEM FOUNDATION
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN0341522484
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN1341842025
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN2340714474
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN3340875691
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN4311329423
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt0501(c) (3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt1501(c) (3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt2501(c) (3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt3501(c) (3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt4501(c) (3)
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd0OH
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd1OH
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd2OH
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd3OH
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd4OH
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PublicCharityStatusTxt0Line 11a, I
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PublicCharityStatusTxt1Line 3
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PublicCharityStatusTxt2Line 3
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PublicCharityStatusTxt3Line 3
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PublicCharityStatusTxt4Line 11a, I
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt01 ROSS PARK BLVD
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt1380 SUMMIT AVENUE
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt2380 SUMMIT AVENUE
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt34000 JOHNSON ROAD
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt4380 SUMMIT AVENUE
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm0STEUBENVILLE
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm1STEUBENVILLE
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm2STEUBENVILLE
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm3STEUBENVILLE
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm4STEUBENVILLE
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd0OH
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd1OH
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd2OH
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd3OH
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd4OH
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd043952
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd143952
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd243952
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd343952
IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd443952
IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd00
IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd00
IRS990ScheduleR/PaidEmployeesSharingInd00
IRS990ScheduleR/PerformOfServicesByOtherOrgInd00
IRS990ScheduleR/PerformOfServicesForOthOrgInd00
IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd00
IRS990ScheduleR/ReimbursementPaidByOtherOrgInd00
IRS990ScheduleR/ReimbursementPaidToOtherOrgInd00
IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd00
IRS990ScheduleR/RentalOfFcltsFromOthOrgInd00
IRS990ScheduleR/SharingOfFacilitiesInd00
IRS990ScheduleR/TransferFromOtherOrgInd00
IRS990ScheduleR/TransferToOtherOrgInd00
IRS990/SchoolOperatingInd00
IRS990/SignificantChangeInd00
IRS990/SignificantNewProgramSrvcInd00
IRS990/SubjectToProxyTaxInd00
IRS990/TaxablePartyNotificationInd00
IRS990/TaxExemptBondsInd00
IRS990/TempOrPermanentEndowmentsInd00
IRS990/TerminateOperationsInd00
IRS990/TotalAssetsBOYAmt013583435
IRS990/TotalAssetsEOYAmt013345953
IRS990/TotalAssetsGrp/BOYAmt013583435
IRS990/TotalAssetsGrp/EOYAmt013345953
IRS990/TotalCompGreaterThan150KInd00
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt00
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt08671
IRS990/TotalFunctionalExpensesGrp/TotalAmt08671
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt025149
IRS990/TotalLiabilitiesEOYAmt032294
IRS990/TotalLiabilitiesGrp/BOYAmt025149
IRS990/TotalLiabilitiesGrp/EOYAmt032294
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt013558286
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt013313659
IRS990/TotalOtherCompensationAmt04177
IRS990/TotalProgramServiceExpensesAmt08671
IRS990/TotalReportableCompFromOrgAmt00
IRS990/TotalRevenueGrp/ExclusionAmt0348120
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt00
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0348120
IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt00
IRS990/TotalVolunteersCnt06
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt013583435
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt013345953
IRS990/TotReportableCompRltdOrgAmt024020
IRS990/TrnsfrExmptNonChrtblRltdOrgInd00
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd00
IRS990/UnrestrictedNetAssetsGrp/BOYAmt013558286
IRS990/UnrestrictedNetAssetsGrp/EOYAmt013313659
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0ONE ROSS PARK BLVD
IRS990/USAddress/CityNm0STEUBENVILLE
IRS990/USAddress/StateAbbreviationCd0OH
IRS990/USAddress/ZIPCd043952
IRS990/VotingMembersGoverningBodyCnt05
IRS990/VotingMembersIndependentCnt05
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd01
ReturnHeader/BuildTS02017-02-10 21:41:12Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0DAVE WERKIN
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0CFO
ReturnHeader/BusinessOfficerGrp/PhoneNum07402837842
ReturnHeader/BusinessOfficerGrp/SignatureDt02016-11-14
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0TRI-STATE HEALTH SERVICES FOUNDATION
ReturnHeader/Filer/BusinessNameControlTxt0TRI-
ReturnHeader/Filer/EIN0341537408
ReturnHeader/Filer/PhoneNum07402837842
ReturnHeader/Filer/USAddress/AddressLine1Txt0ONE ROSS RARK BLVD
ReturnHeader/Filer/USAddress/CityNm0STEUBENVILLE
ReturnHeader/Filer/USAddress/StateAbbreviationCd0OH
ReturnHeader/Filer/USAddress/ZIPCd043952
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0381357951
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0PLANTE & MORAN PLLC
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt01111 Superior Ave Suite 1250
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0Cleveland

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