2026-05-15T15:44:05-05:00 2025-06-30 390859910 BAKER TILLY ADVISORY GROUP LP 333 BUSH STREET STE 1000 SAN FRANCISCO CA 94104 990 2024-07-01 200752156 INCLINE VILLAGE COMMUNITY HOSPITAL FOUNDATION INCL 7758334100 880 ALDER AVENUE INCLINE VILLAGE NV 89451 KARLI BUNNELL EXECUTIVE DIRECTOR 7758334100 2026-05-14 1 0 WENDY CAMPOS P00448102 4159561500 2026-05-14 2024 2025-03-06 01:10:19Z KARLI BUNNELL 880 ALDER AVENUE INCLINE VILLAGE NV 89451 20041637 0 X HTTPS://WWW.TFHD.COM/IVCH/GIVING/ X 2004 NV ASSIST INCLINE VILLAGE COMMUNITY HOSPITAL TO DELIVER QUALITY EMERGENCY & PRIMARY HEALTH CARE SERVICES 9 9 0 25 0 0 1318607 9290857 0 0 362590 237348 25102 20000 1706299 9548205 7180956 62995 0 0 0 0 0 0 0 54682 0 7235638 62995 -5529339 9485210 1875689 11419210 0 0 1875689 11419210 X OUR MISSION IS TO ASSIST THE INCLINE VILLAGE COMMUNITY HOSPITAL IN DELIVERING THE HIGHEST QUALITY EMERGENCY AND PRIMARY HEALTH CARE SERVICES BY PROCURING FINANCIAL RESOURCES, IMPROVING COMMUNITY AWARENESS AND INVOLVING COMMUNITY RESIDENTS AND VISITORS IN DEVELOPING A LONG-TERM VISION FOR COMPREHENSIVE HEALTH CARE IN THE COMMUNITIES OF THE NORTH SHORE OF LAKE TAHOE, INCLUDING KINGS BEACH, CRYSTAL BAY AND INCLINE VILLAGE. 0 1 45628 45628 0 THE IVCH FOUNDATION SUPPORTS STATE OF THE ART TECHNOLOGY AND MEDICAL EQUIPMENT ENHANCEMENTS THAT ASSIST WITH THE FUNCTIONALITY OF THE HOSPITAL TO PROVIDE COMPREHENSIVE PATIENT CARE TO THE RURAL COMMUNITY. 9324 9324 0 THE IVCH FOUNDATION SUPPORTS SUPPLY NEEDS THAT ASSIST WITH THE FUNCTIONALITY OF THE IVCH EMERGENCY DEPARTMENT TO PROVIDE 24/7 COMPREHENSIVE LIFESAVING CARE TO THE RURAL COMMUNITY. 5283 5283 0 THE IVCHF INCLINE VILLAGE ORAL HEALTH IMPROVEMENT FOR CHILDREN PROGRAM PROVIDES A COMPREHENSIVE ORAL HEALTH IMPROVEMENT PROGRAM OFFERING ORAL HEALTH SCREENINGS, FLUORIDE VARNISH APPLICATION, DENTAL SEALANT APPLICATION AND ORAL HEALTH EDUCATION TO CHILDREN AND YOUTH. EQUIPMENT, SUPPLIES AND PROVIDER FEES FOR THE PROGRAM ARE PURCHASED TO SUPPORT THE PROVISION OF ORAL HEALTH CARE SERVICES TO 400+ PUBLIC SCHOOL YOUTH IN INCLINE VILLAGE, NV. 2760 2760 0 THE IVCH FOUNDATION SUPPORTS CRITICAL CAPITAL UPGRADES THAT ASSIST WITH THE FUNCTIONALITY OF THE IVCH SURGICAL SERVICES DEPARTMENT AS WELL AS OPERATING EXPENSES FOR THE INCLINE HEALTH CENTER MULTI-SPECIALTY CLINIC. 2760 2760 0 62995 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X TIM CLEARY 7758334100 880 ALDER AVENUE INCLINE VILLAGE NV 89451 LOUIS WARD - INTERIM CEO, TFHD & DIRECTOR (THRU 03/25) 0.50 39.50 X X 0 635634 68180 ANNA ROTH CEO, TFHD & DIRECTOR (AS OF 03/25) 0.50 39.50 X X 0 0 0 WALTER L BINDER PRESIDENT 0.50 0.00 X X 0 0 0 DEBBIE CASTELLO VICE-PRESIDENT 0.50 0.00 X X 0 0 0 NAN HEALY SECRETARY 0.50 0.00 X X 0 0 0 DENISE SEMINETTA DIRECTOR 0.50 0.00 X 0 0 0 JULIE TEEL DIRECTOR 0.50 0.00 X 0 0 0 GARY FINCH MEMBER AT LARGE (THRU 01/25) 0.50 0.00 X 0 0 0 WARREN KOCMOND MEMBER AT LARGE 0.50 0.00 X 0 0 0 EARL NEMSER MEMBER AT LARGE 0.50 0.00 X 0 0 0 MYLES RINER MEMBER AT LARGE 0.50 0.00 X 0 0 0 CRYSTAL FELIX CFO, TFHD & TREASURER 0.50 39.50 X 0 553157 86315 KARLI BUNNELL EXECUTIVE DIRECTOR 24.00 16.00 X 0 249070 55746 JAYE CHASSEUR CONTROLLER, TFHD 0.50 39.50 X 0 274947 45138 HARRY WEIS FORMER OFFICER 0.00 0.00 X 0 1173027 67897 0 2885835 323276 0 1 1 0 0 876658 79509 8334690 9290857 237348 237348 10483432 10483432 0 30000 876658 10000 20000 20000 9548205 0 0 257348 62995 62995 62995 62995 0 0 330117 646822 0 34567 1429072 10608417 116500 129404 1875689 11419210 0 0 X 1553938 3266441 321751 8152769 1875689 11419210 1875689 11419210 X 9485210 45407 12904 X 0 1 X 1 0 X X 1 TAHOE FOREST HOSPITAL DISTRICT 946004062 6 1 62995 0 1 62995 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 116500 14122 1217 129404 104268 13325 1093 116500 89004 5500 10699 935 104268 105084 4300 -20380 89004 64806 20500 19778 105084 0.00000 1.00000 0.00000 1 0 0 10081780 45407 475264 12904 533575 9548205 0 9548205 538259 475264 475264 62995 0 62995 PART V, LINE 4: THE PURPOSE OF THE ENDOWMENT AND IMPROVEMENT FUNDS IS TO PROVIDE SUPPORT TO OR FOR THE BENEFIT OF THE FOUNDATION AND ITS ACTIVITIES IN PURSUIT OF ITS MISSION TO DELIVER OPTIMAL HEALTH CARE SERVICES IN THE COMMUNITIES SERVED BY INCLINE VILLAGE COMMUNITY HOSPITAL. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN TRUST 12,904. KERN EVENT 2024 547407 547407 10000 KERN EVENT 2025 359251 329251 30000 906658 876658 30000 10000 10000 20000 SCHEDULE G, PART II: SPECIAL EVENT EXPENSES WERE PAID PARTLY BY TAHOE FOREST HEALTH DISTRICT ON BEHALF OF INCLINE VILLAGE COMMUNITY HOSPITAL FOUNDATION. AS A RESULT, THE EXPENSES ASSOCIATED WITH THESE ACTIVITIES ARE EXCLUDED FROM SCHEDULE G. 1 TAHOE FOREST HOSPITAL DISTRICT PO BOX 759 TRUCKEE CA 96160 946004062 115(1) 62995 0 TO SUPPORT AND ENHANCE HEALTHCARE IN THE DISTRICT'S SERVICE AREA 1 0 PART I, LINE 2: THE FOUNDATION EXISTS TO SUPPORT AND ENHANCE HEALTH CARE IN THE INCLINE VILLAGE COMMUNITY HOSPITAL'S SERVICE AREA. ACCORDINGLY, THE FOUNDATION'S ASSISTANCE REPRESENTS PAYMENTS DIRECTLY MADE TO THE DISTRICT IN FURTHERANCE OF THESE PURPOSES. THE BOARD OF DIRECTORS FROM THE FOUNDATION AND THE DISTRICT PERFORM MONITORING PROCEDURES TO ENSURE THAT THE ASSISTANCE PROVIDED BY THE FOUNDATION IS USED TO SUPPORT AND ENHANCE HEALTH CARE IN INCLINE VILLAGE COMMUNITY HOSPITAL'S SERVICE AREA. 1 0 0 0 0 0 1 1 0 HARRY WEIS FORMER OFFICER 0 776111 0 0 0 396916 0 52394 0 15503 0 1240924 0 0 LOUIS WARD - INTERIM CEO, TFHD & DIRECTOR (THRU 03/25) 0 539562 0 85632 0 10440 0 37173 0 31007 0 703814 0 0 CRYSTAL FELIX CFO, TFHD & TREASURER 0 454964 0 86261 0 11932 0 46542 0 39773 0 639472 0 0 JAYE CHASSEUR CONTROLLER, TFHD 0 244298 0 26788 0 3861 0 29778 0 15360 0 320085 0 0 KARLI BUNNELL EXECUTIVE DIRECTOR 0 206548 0 28990 0 13532 0 15973 0 39773 0 304816 0 0 PART I, LINE 3 THE FOUNDATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THE METHODS TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. PART I, LINE 4A HARRY WEIS RECEIVED A SEVERANCE PAYMENT OF $396,916 IN 2024. DETAILS OF THE ARRANGEMENT ARE AVAILABLE TO THE IRS UPON REQUEST. PART I, LINE 6 CURRENT EMPLOYEES OF THE RELATED ORGANIZATION, TAHOE FOREST HOSPITAL DISTRICT (DISTRICT) WHO MEET THE PLAN CRITERIA ARE ELIGIBLE TO PARTICIPATE IN A GAIN SHARING PROGRAM. CERTAIN PROGRAM METRICS MUST BE ACHIEVED IN ORDER FOR THE GAIN SHARING POOL TO BE ACTIVE FOR THE FISCAL YEAR. THE POOL OF GAIN SHARING FUNDS IS CALCULATED AS A PERCENTAGE OF AUDITED NET INCOME OF THE DISTRICT, TIERED FOR DIFFERENT LEVELS OF NET INCOME OF THE DISTRICT OVERALL. ELIGIBLE EMPLOYEES, WHICH MAY INCLUDE OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES OF THE DISTRICT THAT ALSO SERVE THE FOUNDATION THAT ARE EMPLOYED BY THE DISTRICT RECEIVE A PRO-RATA SHARE OF THE GAIN SHARING POOL BY ALLOCATING THE EMPLOYEE'S SALARY AGAINST THE TOTAL SALARY OF ALL ELIGIBLE EMPLOYEES. THE FOUNDATION DOES NOT INCUR ANY EXPENSES UNDER THIS PLAN. PART I, LINE 7 CERTAIN KEY PERSONNEL OF THE RELATED ORGANIZATION, TAHOE FOREST HOSPITAL DISTRICT (DISTRICT) THAT SERVE THE FOUNDATION ARE ELIGIBLE FOR THE INCENTIVE COMPENSATION PLAN WHICH AWARDS A PERCENTAGE OF BASE COMPENSATION FOR THE FISCAL YEAR. ELIGIBLE EMPLOYEES OF THE DISTRICT INCLUDE OFFICERS, KEY PERSONNEL, AND OTHER EMPLOYEES AT THE DISCRETION OF THE CEO THAT MAY ALSO SERVE THE FOUNDATION. FOR THE INCENTIVE COMPENSATION TO BE AWARDED, CERTAIN FINANCIAL TARGETS AND ACHIEVEMENT OF ANNUAL GOALS AND STRATEGIC OBJECTIVES MUST BE MET. THE CEO MAY USE DISCRETION OVER THE INCENTIVE COMPENSATION AWARDED, BUT ALL PAYOUTS UNDER THE PLAN ARE DETERMINED AFTER ACCEPTANCE OF THE DISTRICT'S AUDITED FINANCIAL STATEMENT BY THE BOARD OF DIRECTORS. THE FOUNDATION DOES NOT INCUR ANY EXPENSES UNDER THIS PLAN. FORM 990, PART III, LINE 3 THE ORGANIZATION CEASED CONDUCTING THE BEHAVIORAL HEALTH PROGRAM AND THE DIAGNOSTIC IMAGING IMPROVEMENT PROJECT IN 2024. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE FOUNDATION IS TAHOE FOREST HOSPITAL DISTRICT. FORM 990, PART VI, SECTION A, LINE 7A THE FOUNDATION'S BOARD OF DIRECTORS ARE ELECTED BY THE SOLE MEMBER, TAHOE FOREST HOSPITAL DISTRICT. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENTS TO THE BYLAWS AND CHANGES TO THE NUMBER OF DIRECTORS MUST BE APPROVED BY THE SOLE MEMBER, TAHOE FOREST HOSPITAL DISTRICT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR. THE EXECUTIVE DIRECTOR ALSO REVIEWS THE FORM 990 WITH THE CHAIRMAN OR TREASURER OF THE BOARD AND THE FOUNDATION'S ACCOUNTANT IN PERSON, VIA EMAIL, OR THROUGH A BOARD MEETING. A COPY OF FORM 990 IS DISTRIBUTED TO THE REMAINDER OF THE BOARD VIA EMAIL OR THROUGH A BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL PERSONS HOLDING POSITIONS OF RESPONSIBILITY AND TRUST ON BEHALF OF INCLINE VILLAGE COMMUNITY HOSPITAL FOUNDATION, INCLUDING, BUT NOT LIMITED TO MEMBERS OF THE BOARD OF DIRECTORS, VOLUNTEER COMMITTEE MEMBERS, AND TAHOE FOREST HOSPITAL DISTRICT STAFF (BOARD/STAFF/VOLUNTEERS). COVERED PERSONS ARE REQUIRED TO ANNUALLY COMPLETE A DISCLOSURE STATEMENT FOR POTENTIAL RELATIONSHIPS AS WELL AS DISCLOSING ANY INTEREST THAT MAY IMPACT THE DECISION-MAKING PROCESS WHENEVER THERE IS ANY DOUBT ABOUT WHETHER DISCLOSURE IS REQUIRED. IF A COVERED PERSON HAS AN INTEREST IN A PROPOSED TRANSACTION WITH THE FOUNDATION, HE OR SHE MUST MAKE FULL DISCLOSURE OF SUCH INTEREST BEFORE ANY DISCUSSION OR NEGOTIATION OF THE TRANSACTION AND ABSTAIN FROM DECISION-TAKING ACTIONS. IF A CONFLICT, OR THE POTENTIAL APPEARANCE OF A CONFLICT EXISTS, THE BOARD MEMBER MUST RECUSE THEMSELVES BY NOT INFLUENCING, ATTEMPTING TO INFLUENCE, OR PARTICIPATING IN THAT DISCUSSION AND/OR VOTE MADE BY REMAINING MEMBERS THAT DO NOT HAVE AN INTEREST. FORM 990, PART VI, SECTION C, LINE 19 ANY INTERESTED PARTIES WHO DESIRE TO OBTAIN A COPY OF ANY OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS CAN CONTACT THE OFFICE AND REQUEST A PAPER COPY. ANY DOCUMENTS REQUESTED ARE PRINTED AND HANDED TO THE INTERESTED PARTY AT THE OFFICE. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN TRUST 12,904. TAHOE FOREST HOSPITAL DISTRICT PO BOX 759 TRUCKEE CA 96160 946004062 HEALTH CARE CA N/A 0 TAHOE FOREST HEALTH SYSTEM FOUNDATION PO BOX 2508 TRUCKEE CA 96160 943047869 HEALTH CARE CA 501(C)(3) LINE 12A, I TAHOE FOREST HOSPITAL DISTRICT 0 THE TRUCKEE SURGERY CENTER LLC 10770 DONNER PASS ROAD SUITE 201 TRUCKEE CA 96161 273943102 AMBULATORY SURGERY CENTER CA N/A 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 TAHOE FOREST HOSPITAL DISTRICT B 62995 FMV TAHOE FOREST HOSPITAL DISTRICT C 475264 FMV