FH ENTERPRISE SERVICES HOLDINGS INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
FH ENTERPRISE SERVICES HOLDINGS INC (EIN 20-2636686)
Tax period
2022-07-01 to 2023-06-30
Filed
2024-05-07
IRS object ID
202431289349301618
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-05-07T11:20:04-05:00ReturnTs
Tax Period End2023-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135565207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1191 WEST NATIONWIDE BLVD SUITE 500AddressLine1Txt
CityCOLUMBUSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP432152568ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN202636686EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1QHS 1 INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlQHS1BusinessNameControlTxt
Phone4148053000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19200 W WISCONSIN AVEAddressLine1Txt
CityMILWAUKEECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53226ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonALICIA M MAITLANDPersonNm
Person TitleSVP - FINANCEPersonTitleTxt
Phone4148053000PhoneNum
Signature2024-05-07SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstALICIAPersonFirstNm
Person LastMAITLANDPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMOLLIE P LONGHOUSEPreparerPersonNm
PTINP00294881PTIN
Phone6142492300PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCATHERINE JACOBSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line19200 W WISCONSIN AVEAddressLine1Txt
CityMILWAUKEECityNm
State AbbreviationWIStateAbbreviationCd
ZIP53226ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$393,040GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2005FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTO HOLD AND MANAGE OWNERSHIP INTERESTS IN HEALTH CARE RELATED ORGANIZATIONS, IN SUPPORT OF THE HEALTH CARE ACTIVITIES OF THE FROEDTERT HEALTH, INC. HEALTHCARE SYSTEM.ActivityOrMissionDesc
Voting Members Governing Body2VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$32,595TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$31,595NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$614,424PYProgramServiceRevenueAmt
CY Program Service Revenue$393,040CYProgramServiceRevenueAmt
PY Investment Income$50PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$614,474PYTotalRevenueAmt
CY Total Revenue$393,040CYTotalRevenueAmt
PY Grants And Similar Paid$645PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$805CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$547PYOtherExpensesAmt
CY Other Expenses$557CYOtherExpensesAmt
PY Total Expenses$1,192PYTotalExpensesAmt
CY Total Expenses$1,362CYTotalExpensesAmt
PY Revenues Less Expenses$613,282PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$391,678CYRevenuesLessExpensesAmt
Total Assets BOY-$164,724TotalAssetsBOYAmt
Total Assets EOY$226,952TotalAssetsEOYAmt
Total Liabilities BOY$58,001TotalLiabilitiesBOYAmt
Total Liabilities EOY$57,999TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$222,725NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$168,953NetAssetsOrFundBalancesEOYAmt
MissionTO HOLD AND MANAGE OWNERSHIP INTERESTS IN HEALTH CARE RELATED ORGANIZATIONS, IN SUPPORT OF THE HEALTH CARE EXEMPT ACTIVITIES OF THE FROEDTERT HEALTH, INC. HEALTHCARE SYSTEM.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$805ExpenseAmt
Grant$805GrantAmt
Revenue$393,040RevenueAmt
DescSUCCESSFUL MANAGEMENT OF OWNERSHIP INTERESTS IN HEALTH CARE RELATED ORGANIZATIONS, IN SUPPORT OF THE HEALTH CARE EXEMPT ACTIVITIES OF THE FROEDTERT HEALTH, INC. HEALTHCARE SYSTEM.Desc
Total Program Service Expenses$805TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related InvstYes (1)ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members2GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAVID DIRKSMEYERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4148053000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1N74 W12501 LEATHERWOOD CTAddressLine1Txt
CityMENOMONEE FALLSCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53051ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JACOBSON CATHERINE
DIRECTOR & PRESIDENT1.0049.00Yes (X)Yes (X)$0$3,435,812$441,556
HAWIG SCOTT
DIRECTOR & TREASURER1.0049.00Yes (X)Yes (X)$0$1,751,870$240,154
VAN DE KREEKE JEFFREY
FORMER - OFFICER (SECR)0.0050.00$0$545,072$28,202Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,732,754TotReportableCompRltdOrgAmt
Total Other Compensation$709,912TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
WDL K-1 INCOME621500$378,422$345,827$32,595
MFASC K-1 INCOME621990$14,618$14,618
FieldValueIRS element (for citing)
Total Program Service Revenue$393,040TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$393,040TotalRevenueColumnAmt
Related Or Exempt Func Income$360,445RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$32,595UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$805TotalAmt
Program Services$805ProgramServicesAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescMEALS AND ENTERTAINMENTDesc
Total$557TotalAmt
Management And General$557ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,362TotalAmt
Program Services$805ProgramServicesAmt
Management And General$557ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,756BOYAmt
EOY$3,756EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$57,453BOYAmt
EOY$57,453EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY-$225,935BOYAmt
EOY$165,743EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY-$164,724BOYAmt
EOY$226,952EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$58,001BOYAmt
EOY$57,999EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$58,001BOYAmt
EOY$57,999EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY-$3,316,240BOYAmt
EOY-$3,316,240EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$3,093,515BOYAmt
EOY$3,485,193EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$222,725BOYAmt
EOY$168,953EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$164,724BOYAmt
EOY$226,952EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$391,678ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations3SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (3 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
FROEDTERT MEMORIAL LUTHERAN HOSPITAL
39610597030$0$0
COMMUNITY MEMORIAL HOSPITAL OF MF
39098702530$0$0
ST JOSEPH'S COMMUNITY HOSPITAL
39080630230$0$0
FieldValueIRS element (for citing)
Supported Organizations Total3SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing Doc0ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, SECTION A, LINE 1:FormAndLineReferenceDesc
ExplanationQHS 1, INC. HAS HAD A HISTORIC AND CONTINUING RELATIONSHIP WITH ITS SUPPORTED ORGANIZATIONS WHICH ARE RELATED ORGANIZATIONS THAT ARE OWNED OR CONTROLLED BY FROEDTERT HEALTH, INC., THE SOLE CORPORATE MEMBER OF QHS 1, INC.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescINVESTMENT IN WDL & MFASCDesc
Book Value$165,743BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$165,743TotalBookValueProgramRltdAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationFROEDTERT HEALTH, INC., THE PARENT ENTITY INTO WHICH QHS 1, INC.'S FINANCIAL RESULTS ARE CONSOLIDATED, APPLIES ASC NO. 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC NO. 740 PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC NO. 740, TAX POSITIONS ARE EVALUATED FOR RECOGNITION, DERECOGNITION AND MEASUREMENT USING CONSISTENT CRITERIA AND PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. AS OF JUNE 30, 2023 AND 2022, QHS 1, INC. DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED TAX POSITIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JACOBSON CATHERINE
DIRECTOR & PRESIDENT$0$1,547,248$0$1,497,354$0$391,210$0$406,217$0$35,339$0$3,877,368$0$388,747
HAWIG SCOTT
DIRECTOR & TREASURER$0$915,726$0$643,858$0$192,286$0$205,582$0$34,572$0$1,992,024$0$170,501
VAN DE KREEKE JEFFREY
FORMER - OFFICER (SECR)$0$184,071$0$144,602$0$216,399$0$19,300$0$8,902$0$573,274$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINES 4A-BSEVERANCE: VAN DE KREEKE, JEFFREY - $165,458 457(F) DISTRIBUTIONS: HAWIG, SCOTT - $170,501 JACOBSON, CATHERINE - $388,747 457(F) PLAN PARTICIPANTS: HAWIG, SCOTT JACOBSON, CATHERINE VAN DE KREEKE, JEFFREY NONQUALIFIED DISTRIBUTIONS: VAN DE KREEKE, JEFFREY - $33,370 (OF WHICH $0 WAS REPORTED AS DEFERRED ON A PRIOR FORM 990) NONQUALIFIED PARTICIPANTS: VAN DE KREEKE, JEFFREY
PART I, LINE 7BONUS COMPENSATION IS PAID BASED UPON ATTAINMENT OF SPECIFIC GOALS RELATED TO THE ORGANIZATION'S STRATEGY, SERVICE, QUALITY, AND FINANCIAL STRENGTH. THE AMOUNT OF COMPENSATION IS CALCULATED USING SPECIFIED PERCENTAGES OF BASE SALARY FOR ACHIEVEMENT OF PARTICULAR GOAL LEVELS. HOWEVER, THE FROEDTERT HEALTH SYSTEM BOARD COMMITTEE WHICH ADMINISTERS THE BONUS COMPENSATION PROGRAM HAS DISCRETION OVER WHETHER TO PAY THE BONUS IN ANY GIVEN YEAR OR TO AMEND, CHANGE, OR TERMINATE THE PROGRAM AT ANY TIME.
PART II, COLUMN (B)(II):BONUS AND INCENTIVE COMPENSATION AMOUNTS INCLUDE INCENTIVE COMPENSATION PAID.
PART II, COLUMN (B)(III):OTHER REPORTABLE COMPENSATION INCLUDES 457(F) DEFERRED COMPENSATION PLAN DISTRIBUTIONS PAID TO INDIVIDUALS, AMOUNTS PAID IN LIEU OF 457(F) DEFERRED COMPENSATION PLAN CONTRIBUTIONS, AND OTHER MISCELLANEOUS COMPENSATION.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2CATHERINE JACOBSON, SCOTT HAWIG, JEFFREY VAN DE KREEKE - BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 6FROEDTERT HEALTH, INC. (FH) IS THE SOLE CORPORATE MEMBER OF QHS 1, INC.
FORM 990, PART VI, SECTION A, LINE 7AFH AS THE SOLE CORPORATE MEMBER OF QHS 1, INC., APPOINTS ALL BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7BFH AS THE SOLE CORPORATE MEMBER OF QHS 1, INC., HAS CERTAIN RESERVED POWERS AND AUTHORITIES WITH RESPECT TO THE OPERATIONS AND MANAGEMENT OF QHS 1, INC.
FORM 990, PART VI, SECTION B, LINE 11BFROEDTERT HEALTH, INC. (FH) ACCOUNTING STAFF PREPARE FORM 990 WHICH IS REVIEWED BY FH'S FINANCIAL LEADERS. THE 990 IS THEN REVIEWED BY KPMG, FH'S OUTSIDE ACCOUNTING FIRM. NEXT, THE 990 IS PROVIDED TO THE FH AUDIT COMMITTEE AND BOARD OF DIRECTORS. FINALLY, THE 990 IS FILED AS REQUIRED.
FORM 990, PART VI, SECTION B, LINE 12CON AN ANNUAL BASIS, ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE DOCUMENT. THE DATA IS COMPILED, AND THE FH VICE PRESIDENT - CHIEF COMPLIANCE OFFICER (CCO), THE SENIOR VICE PRESIDENT - GENERAL COUNSEL AND/OR DELEGATE WILL REVIEW ALL FORMS AND NOTIFICATIONS TO DETERMINE IF ANY CONFLICTS OF INTEREST EXIST IN THE DISCLOSURE DOCUMENTS. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, THEN THE PERSON MAKING THE DISCLOSURE SHALL BE RELIEVED OF HIS/HER OBLIGATIONS ON BEHALF OF A FH AFFILIATE WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT THAT CREATES THE CONFLICT OF INTEREST. A REPORT OF ALL CONFLICTS OF INTEREST WILL BE MADE BY THE FH CCO AT LEAST ONCE ANNUALLY TO THE FH AUDIT COMMITTEE OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15LINE 15A - COMPENSATION OF TOP MANAGEMENT IS PAID BY FH, A RELATED ORGANIZATION, BUT A REVIEW IS PERFORMED. IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED, COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA, PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE FH (THE RELATED ORGANIZATION) BOARD OF DIRECTORS. IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. LINE 15B - COMPENSATION OF OFFICERS IS PAID BY A RELATED ORGANIZATION BUT A REVIEW IS PERFORMED. IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S OFFICERS, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED, COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA, PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE FH (THE RELATED ORGANIZATION) BOARD OF DIRECTORS. IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE CORPORATE OFFICE UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

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FROEDTERT HEALTH INC
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W180 N8085 TOWN HALL ROADMENOMONEE FALLSWI53051391635057HEALTH & WLFRWI501 (C) (3)100CMH INC
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3200 PLEASANT VALLEY ROADWEST BENDWI53095392034296HEALTH & WLFRWI501 (C) (3)70SJH INC
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W180 N8085 TOWN HALL ROADMENOMONEE FALLSWI53051390987025HOSPITALWI501 (C) (3)30FH INC
COMMUNITY OUTPATIENT HEALTH SERVICES
W180 N8085 TOWN HALL ROADMENOMONEE FALLSWI53051391743056HLTHCARE SVCSWI501 (C) (3)30CMH INC
HOLY FAMILY MEMORIAL INC
2300 WESTERN AVENUEMANITOWOCWI542211450390806395HOSPITALWI501 (C) (3)30FH INC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)

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D1 SPORTS TRAINING OF MILWAUKEE LLC
9200 W WISCONSIN AVENUEMILWAUKEEWI53226473322294SPORTS THERAPYWIN/AN/A00
FMLH MCW REAL ESTATE VENTURES LLC
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WISCONSIN DIAGNOSTIC LABORATORIES LLC
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FROEDERT & MEDICAL COLLEGE OF WI ACOLLC
8710 WATERTOWN PLANK RDMILWAUKEEWI53226833159534HLTHCARE SVCSWIN/AN/A00
DREXEL TOWN SQUARE SURGERY CENTER LLC
7901 S 6TH STREET 2ND FLOOROAK CREEKWI53154814904300SURGERY CENTERWIN/AN/A00
THP-FROEDTERT HEALTH VENTURE LLC
1415 LOUISANA FL 27THHOUSTONTX77002823559342HLTHCARE SVCSTXN/AN/A00
F&MCW NETWORK LLC
9200 W WISCONSIN AVENUEMILWAUKEEWI53226814382585HLTHCARE SVCSWIN/AN/A00
MENOMONEE FALLS AMBULATORY SURGERY CTR
W180 N8045 TOWN HALL RDMENOMONEE FALLSWI53051391745697HLTHCARE SVCSWIN/ARELATED00$14,618$49,5860.01000
FROEDTERT SURGERY CENTER LLC
9200 W WISCONSIN AVENUEMILWAUKEEWI53226201499345SURGERY CENTERWIN/AN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLegal Domicile StateLegalDomicileStateCd
HART'S MILLS INSURANCE COMPANY
62 FORUM LANE 3RD FL CAMANA BAYGRAND CAYMANCJKY1-1203981311808SELF-INSURANCECJN/AC0
HOLY FAMILY HEALTH SERVICES INC
391572253HEALTH SERVICESN/AC01650 SOUTH 41ST STREETMANITOWOCWI54220WI
FieldValueIRS element (for citing)
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Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
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Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
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Div Related Organization0DivRelatedOrganizationInd
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Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
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Transfer From Other Org0TransferFromOtherOrgInd

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