Tri State Medical Group Inc

Keokuk, IA
Tax-exempt since June 1995
EIN: 42-1435525

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This organization is not listed in the IRS's most recent list of tax exempt organizations, but we have data associated with this Employer Identification Number.

Type of Nonprofit

Designated as a 501(c)(3) Organizations for any of the following purposes: religious, educational, charitable, scientific, literary, testing for public safety, fostering national or international amateur sports competition (as long as it doesn't provide athletic facilities or equipment), or the prevention of cruelty to children or animals.

Category: Health — General and Rehabilitative / Ambulatory Health Center, Community Clinic (NTEE)

Revenue

$70k (2022)

Expenses

$0 (2022)

Total Assets

$0 (2022)

Total Liabilities

$0 (2022)

Years with multiple filings

Source: Form 990 tax filings from 2011 to 2022

Tax Filings by Year

Form 990 is an information return that most organizations claiming federal tax-exempt status must file yearly with the IRS. Nonprofit Explorer has IRS digitized Form 990 data for filings processed in 2012 and later. If this organization filed an amended return, it may not be reflected below. Duplicate download links may indicate a resubmission or amendment to this organization's original return. Form 990 data is from the IRS.

Fiscal Year Ending Sept.
2022

Revenue

$70,046

Expenses

Net Income

$70,046

Net Assets

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$108	0.2%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$69,938	99.8%
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$0

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$0

Assets/Debt
Total Assets	$0
Total Liabilities	$0
Net Assets	$0

Compensation

Key Employees and Officers	Compensation	Related	Other
Pat Gerveler (Trustee)	$0	$676,198	$133,260
Vickie Reneau (Administrato)	$0	$172,359	$22,566
Kristina Karre (Treasurer)	$0	$88,253	$883
Teresa Conlee (Secretary)	$0	$50,556	$0
Kyle Keck (Trustee)	$0	$0	$0
Donza Worden Md (Trustee)	$0	$0	$0
Kiran Khanolkar Md (Trustee)	$0	$0	$0
Michael Maher (Chair)	$0	$0	$0
Tom Richardson (Vice Chair)	$0	$0	$0
Barb Smidt (Trustee)	$0	$0	$0

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990

Filed on Aug. 3, 2023

Primary tax return for a nonprofit’s activities, finances, and governance

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Fiscal Year Ending Sept.
2021

Revenue

$59,174

Expenses

Net Income

$59,174

Net Assets

$1,428,685

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$104	0.2%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$59,070	99.8%
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$0

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$0

Assets/Debt
Total Assets	$1,428,685
Total Liabilities	$0
Net Assets	$1,428,685

Compensation

Key Employees and Officers	Compensation	Related	Other
Kyle Keck (Trustee)	$0	$0	$0
Donza Worden Md (Trustee)	$0	$0	$0
Kiran Khanolkar Md (Trustee)	$0	$0	$0
Michael Maher (Chair)	$0	$0	$0
Tom Richardson (Vice Chair)	$0	$0	$0
Barb Smidt (Trustee)	$0	$0	$0
Teresa Conlee (Secretary)	$0	$0	$0
Kristina Karre (Treasurer)	$0	$0	$0
Vickie Reneau (Administrato)	$0	$0	$0

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990

Filed on Aug. 11, 2022

Primary tax return for a nonprofit’s activities, finances, and governance

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Fiscal Year Ending Dec.
2020

Revenue

$112,719

Expenses

$23,342

Net Income

$89,377

Net Assets

-$3,013,226

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$751	0.7%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$111,968	99.3%
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$0

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$0

Assets/Debt
Total Assets	$823,854
Total Liabilities	$3,837,080
Net Assets	-$3,013,226

Compensation

Key Employees and Officers	Compensation	Related	Other
Jessica Bowman Md (Board Member)	$0	$154,165	$18,815
Paul Ealey (Board Member)	$0	$0	$0
Kiran Khanolkar Md (Board Member)	$0	$0	$0
Mike Maher (Board Member)	$0	$0	$0
Tom Richardson (Board Member)	$0	$0	$0
Barb Smidt (Board Member)	$0	$0	$0
Wendy Swank (Board Member)	$0	$0	$0

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990

Filed on Nov. 12, 2021

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Fiscal Year Ending Dec.
2019

Revenue

$111,236

Expenses

$28,853

Net Income

$82,383

Net Assets

-$3,102,603

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$173	0.2%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$111,063	99.8%
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$0

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$0

Assets/Debt
Total Assets	$734,477
Total Liabilities	$3,837,080
Net Assets	-$3,102,603

Compensation

Key Employees and Officers	Compensation	Related	Other
Jessica Bowman Md (Board Member)	$0	$148,550	$4,909
Paul Ealey (Board Member)	$0	$0	$0
Carey Gehl To 1019 (Board Member & Uph Exec Dir Growth)	$0	$217,161	$29,986
Kiran Khanolkar Md (Board Member)	$0	$0	$0
Mike Maher (Board Member)	$0	$0	$0
Tom Richardson (Board Member)	$0	$0	$0
Barb Smidt (Board Member)	$0	$0	$0
Wendy Swank (Board Member)	$0	$0	$0

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990

Filed on Nov. 13, 2020

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Fiscal Year Ending Dec.
2018

Revenue

$95,120

Expenses

$31,686

Net Income

$63,434

Net Assets

-$3,184,986

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	-$15,819
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$110,939	> 100%
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$0

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$0

Assets/Debt
Total Assets	$656,284
Total Liabilities	$3,841,270
Net Assets	-$3,184,986

Compensation

Key Employees and Officers	Compensation	Related	Other
Jessica Bowman (Board Member (Fr 4/18))	$0	$0	$0
Neville Crenshaw Do (Board Member (To 4/18))	$0	$0	$0
Paul Ealey (Board Member)	$0	$0	$0
Carey Gehl (Board Member & Uph Exec Dir Growth)	$0	$223,644	$32,641
Kiran Khanolkar Md (Board Member)	$0	$0	$0
Mike Maher (Board Member)	$0	$0	$0
Kent Nixon (Board Vice Chair/Treasurer)	$0	$0	$0
Tom Richardson (Board Member)	$0	$0	$0
Ron Scott (Board Member)	$0	$0	$0
Barb Smidt (Board Member)	$0	$0	$0
Jack Smith (Board Member)	$0	$0	$0
Walt Stephens (Board Chair)	$0	$0	$0
Wendy Swank (Board Secretary)	$0	$0	$0

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990

Filed on Nov. 14, 2019

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Fiscal Year Ending Dec.
2017

Revenue

$208,355

Expenses

$523,231

Net Income

-$314,876

Net Assets

-$3,248,420

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$131,767	63.2%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$77,410	37.2%
Net Fundraising	$0
Sales of Assets	-$822
Net Inventory Sales	$0
Other Revenue	$0

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$303,024	57.9%

Assets/Debt
Total Assets	$604,649
Total Liabilities	$3,853,069
Net Assets	-$3,248,420

Compensation

Key Employees and Officers	Compensation	Related	Other
Neville Crenshaw Do (Board Member)	$0	$0	$0
Carey Gehl (Board Member & Uph Exec Dir Growth)	$0	$227,369	$37,630
Kiran Khanolkar Md (Board Member)	$0	$0	$0
Mike Maher (Board Member)	$0	$0	$0
Kent Nixon (Board Vice Chair/Treasurer)	$0	$0	$0
Tom Richardson (Board Member)	$0	$0	$0
Ron Scott (Board Member)	$0	$0	$0
Jack Smith (Board Member)	$0	$0	$0
Walt Stephens (Board Chair)	$0	$0	$0
Wendy Swank (Board Secretary)	$0	$0	$0

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990

Filed on Nov. 14, 2018

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Fiscal Year Ending Dec.
2016

Revenue

$294,666

Expenses

$398,562

Net Income

-$103,896

Net Assets

-$3,012,136

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$279,874	95.0%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$14,792	5.0%
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$0

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$268,005	67.2%

Assets/Debt
Total Assets	$824,618
Total Liabilities	$3,836,754
Net Assets	-$3,012,136

990

Primary tax return for a nonprofit’s activities, finances, and governance

PDF

Fiscal Year Ending Sept.
2016

Revenue

$1,217,485

Expenses

$2,064,126

Net Income

-$846,641

Net Assets

-$2,908,240

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$1,187,129	97.5%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$28,368	2.3%
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$1,988	0.2%

Notable Expenses		Percent of Total Expenses
Executive Compensation	$121,472	5.9%
Professional Fundraising Fees	$0
Other Salaries and Wages	$1,276,737	61.9%

Assets/Debt
Total Assets	$798,700
Total Liabilities	$3,706,940
Net Assets	-$2,908,240

Compensation

Key Employees and Officers	Compensation	Related	Other
Christopher Dupuis Md (Orthopedic Surgeon)	$352,402	$0	$20,566
Kiran Khanolkar Md (Board Member)	$112,605	$1,350	$8,867
Neville Crenshaw Do (Board Member)	$0	$0	$0
Mike Maher (Board Member)	$0	$0	$0
Tom Marion (Board Member (To 12/15))	$0	$0	$0
Kent Nixon (Board Vice Chair/Treasurer)	$0	$0	$0
Tom Richardson (Board Member)	$0	$0	$0
Ron Scott (Board Member)	$0	$0	$0
Jack Smith (Board Member)	$0	$0	$0
Walt Stephens (Board Chair)	$0	$0	$0
Wendy Swank (Board Secretary)	$0	$0	$0

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990

Filed on Aug. 14, 2017

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Fiscal Year Ending Sept.
2015

Revenue

$1,421,725

Expenses

$2,950,312

Net Income

-$1,528,587

Net Assets

-$2,061,599

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$1,355,570	95.3%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$46,653	3.3%
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$19,502	1.4%

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$1,943,716	65.9%

Assets/Debt
Total Assets	$871,326
Total Liabilities	$2,932,925
Net Assets	-$2,061,599

Compensation

Key Employees and Officers	Compensation	Related	Other
Christopher Dupuis Md (Orthopedic Surgeon)	$352,402	$0	$16,597
Kiran Khanolkar Md (Member, Board Of Directors)	$112,605	$1,350	$5,532
Walt Stephens (Chairman, Board Of Directors)	$0	$0	$0
Kent Nixon (Member, Board Of Directors & Corporate Treasurer)	$0	$0	$0
Wendy Swank (Member, Board Of Directors & Corporate Secretary)	$0	$0	$0
Mike Maher (Member, Board Of Directors)	$0	$0	$0
Tom Marion (Member, Board Of Directors)	$0	$0	$0
Greg Miller (Member, Board Of Directors)	$0	$0	$0
Mike Klauser (Member, Board Of Directors)	$0	$0	$0
Ron Scott (Member, Board Of Directors)	$0	$0	$0
Neville Crenshaw Do (Member, Board Of Directors)	$0	$0	$0

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990

Filed on May 11, 2016

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Fiscal Year Ending Sept.
2014

Revenue

$2,973,270

Expenses

$3,903,579

Net Income

-$930,309

Net Assets

-$533,012

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$2,887,442	97.1%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$0
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$85,828	2.9%

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$2,815,848	72.1%

Assets/Debt
Total Assets	$1,633,153
Total Liabilities	$2,166,165
Net Assets	-$533,012

Compensation

Key Employees and Officers	Compensation	Related	Other
Christopher Dupuis Md (Orthopedic Surgeon)	$387,315	$0	$16,585
Thomas Helmsworth Md (General Surgeon)	$373,294	$0	$16,585
Kiran Khanolkar Md (Member, Board Of Directors)	$282,980	$0	$16,585
Mark Strope Md (Family Practice)	$182,316	$0	$4,829
Phillip Storm Md (Urologist)	$158,623	$0	$0
Alan Alexander Md (Pediatrician)	$121,792	$0	$0
Walt Stephens (Chairman, Board Of Directors)	$0	$0	$0
Kent Nixon (Member, Board Of Directors & Corporate Treasurer)	$0	$0	$0
Wendy Swank (Member, Board Of Directors & Corporate Secretary)	$0	$0	$0
Mike Maher (Member, Board Of Directors)	$0	$0	$0
Tom Marion (Member, Board Of Directors)	$0	$0	$0
Greg Miller (Member, Board Of Directors)	$0	$0	$0
Mike Klauser (Member, Board Of Directors)	$0	$0	$0
Ron Scott (Member, Board Of Directors)	$0	$0	$0
David Waddell Md (Member, Board Of Directors)	$0	$0	$0
Dick Logsdon (Member, Board Of Directors)	$0	$0	$0
Neville Crenshaw Do (Member, Board Of Directors)	$0	$0	$0

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990

Filed on May 5, 2015

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Fiscal Year Ending Sept.
2013

Revenue

$3,263,676

Expenses

$4,019,640

Net Income

-$755,964

Net Assets

$8,636

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$3,263,676	100%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$0
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$0

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$2,333,309	58.0%

Assets/Debt
Total Assets	$1,423,514
Total Liabilities	$1,414,878
Net Assets	$8,636

990

Filed on July 2, 2014

Primary tax return for a nonprofit’s activities, finances, and governance

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Fiscal Year Ending Sept.
2012

Revenue

$3,661,677

Expenses

$4,501,273

Net Income

-$839,596

Net Assets

$9,390

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$3,661,677	100%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$0
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$0

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$2,491,033	55.3%

Assets/Debt
Total Assets	$1,030,513
Total Liabilities	$1,021,123
Net Assets	$9,390

990

Primary tax return for a nonprofit’s activities, finances, and governance

PDF

Fiscal Year Ending Sept.
2011

Revenue

$3,765,500

Expenses

$4,588,139

Net Income

-$822,639

Net Assets

$8,996

Notable Sources of Revenue		Percent of Total Revenue
Contributions	$0
Program Services	$3,765,500	100%
Investment Income	$0
Bond Proceeds	$0
Royalties	$0
Rental Property Income	$0
Net Fundraising	$0
Sales of Assets	$0
Net Inventory Sales	$0
Other Revenue	$0

Notable Expenses		Percent of Total Expenses
Executive Compensation	$0
Professional Fundraising Fees	$0
Other Salaries and Wages	$2,441,035	53.2%

Assets/Debt
Total Assets	$1,121,929
Total Liabilities	$1,112,933
Net Assets	$8,996

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Tri State Medical Group Inc

Organization summary

Organization summary might be incomplete or out of date

Type of Nonprofit

Summary charts: organization finances over time

Revenue $70k (2022)

Expenses $0 (2022)

Total Assets $0 (2022)

Total Liabilities $0 (2022)

Tax Filings by Year

Fiscal Year Ending Sept. 2022

Extracted Financial Data

Extracted Financial Data from Form 990

Compensation

Document Links

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Fiscal Year Ending Sept. 2021

Extracted Financial Data

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Compensation

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Fiscal Year Ending Dec. 2020

Extracted Financial Data

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Compensation

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990

Fiscal Year Ending Dec. 2019

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Compensation

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Fiscal Year Ending Dec. 2018

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Compensation

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Fiscal Year Ending Dec. 2017

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Compensation

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Fiscal Year Ending Dec. 2016

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Fiscal Year Ending Sept. 2016

Extracted Financial Data

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Compensation

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Fiscal Year Ending Sept. 2015

Extracted Financial Data

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Compensation

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Fiscal Year Ending Sept. 2014

Extracted Financial Data

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Fiscal Year Ending Sept. 2013

Extracted Financial Data

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990

Fiscal Year Ending Sept. 2012

Extracted Financial Data

Extracted Financial Data from Form 990

Document Links

990

Fiscal Year Ending Sept. 2011

Revenue

$70k (2022)

Expenses

$0 (2022)

Total Assets

$0 (2022)

Total Liabilities

$0 (2022)

Fiscal Year Ending Sept.
2022

Fiscal Year Ending Sept.
2021

Fiscal Year Ending Dec.
2020

Fiscal Year Ending Dec.
2019

Fiscal Year Ending Dec.
2018

Fiscal Year Ending Dec.
2017

Fiscal Year Ending Dec.
2016

Fiscal Year Ending Sept.
2016

Fiscal Year Ending Sept.
2015

Fiscal Year Ending Sept.
2014

Fiscal Year Ending Sept.
2013

Fiscal Year Ending Sept.
2012

Fiscal Year Ending Sept.
2011

Fiscal Year Ending Sept.
2010

Fiscal Year Ending Sept.
2009

Fiscal Year Ending Sept.
2008

Fiscal Year Ending Sept.
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Fiscal Year Ending Sept.
2001