Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 1,000,000 | 500,000 | 681,781 | 2,181,781 | ||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | 64,802 | 146,991 | 211,793 | |||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | 1,000,000 | 564,802 | 828,772 | 2,393,574 | ||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 2,393,574 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 1,000,000 | 564,802 | 828,772 | 2,393,574 | ||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 1,000,000 | 564,802 | 828,772 | 2,393,574 | ||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| FORM 990, SCHEDULE A, PART III, COLUMN E | THE COLUMN FOR 2021 REPRESENTS A SHORT YEAR DUE TO IT BEING THE ORGANIZATION'S INITIAL YEAR. THE SHORT YEAR IS 10/22/21 - 6/30/22. |
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| Return Reference | Explanation |
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| FORM 990, PART VI, SECTION A, LINE 3 | THRESHOLDS HEALTH NFP HAS AN EMPLOYEE LEASING ARRANGEMENT WITH THE THRESHOLDS (FEIN: 36-2518901). COMPENSATION FOR THE ORGANIZATION'S CFO AND CMO WAS NOT PAID DIRECTLY TO THE INDIVIDUALS BUT PAID TO THE THRESHOLDS FOR THEIR SERVICES TO THRESHOLDS HEALTH AT AGREED UPON HOURLY RATES. THE FOLLOWING COMPENSATION WAS PAID TO THE THRESHOLDS FOR SERVICES PROVIDED UNDER THE EMPLOYEE LEASING ARRANGEMENT DURING THE CALENDAR YEAR ENDING 2023: TIMOTHY LOWDER, CHIEF FINANCIAL OFFICER - $15,575 J. WESLEY COOK, DO, CHIEF MEDICAL OFFICER - $57,248 |
| FORM 990, PART VI, SECTION A, LINE 4 | THRESHOLDS HEALTH NFP AMENDED ITS ARTICLES OF INCORPORATION AND BYLAWS ON FEBRUARY 12, 2024 TO MAKE THE THRESHOLDS, AN ILLINOIS NOT-FOR-PROFIT CORPORATION, ITS SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE THRESHOLDS IS THE SOLE MEMBER OF THRESHOLDS HEALTH NFP. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER HAS THE EXCLUSIVE RIGHT TO APPOINT AND REMOVE DIRECTORS AND BOARD OFFICERS OF THRESHOLDS HEALTH. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING GOVERNANCE DECISIONS ARE RESERVED TO THE SOLE MEMBER: -TO DEVELOP, APPROVE, AND MODIFY ANNUAL OPERATING AND CAPITAL BUDGETS, FINANCIAL PLANS AND STRATEGIC PLANS FOR THE CORPORATION; -TO DETERMINE ALL SUBSTANTIVE CHANGES IN THE CLINICAL PROGRAMS AND SERVICES TO BE PROVIDED BY THE CORPORATION, INCLUDING THE ESTABLISHMENTM EXPANSION, RECONFIGURATION, REDUCTION OR DISCONTINUATION OF CLINICAL PROGRAMS AND SERVICES, TAKING INTO ACCOUNT THE INPUT AND RECOMMENDATIONS OF THE BOARD; -TO ESTABLISH, AMEND OR TERMINATE THIRD-PARTY PAYOR RELATIONSHIPS; -TO HIRE, TERMINATE AND EVALUATE THE TERMS OF EMPLOYMENT OF THE CHIEF EXECUTIVE OFFICER AND OTHER KEY MANAGERS OF THE CORPORATION, FOLLOWING CONSULTATION WITH THE BOARD; -TO SELECT THE AUDITOR FOR, AND APPROVAL OF ALL AUDITS OF, THE CORPORATION; -TO SELECT OUTSIDE LEGAL COUNSEL AND APPROVE ANY WAIVER, SETTLEMENT OR COMPROMISE OF ANY LEGAL PROCEEDINGS, SUIT, CLAIM, OR ACTION AGAINST OR BROUGHT BU OR ON BEHALF OF THE CORPORATION IF THE UNINSURED PORTION OF THE AMOUNT IN CONTROVERSY IS IN EXCESS OF A DESIGNATED DOLLAR THRESHOLD SET FOR THE CORPORATION BY THE MEMBER FROM TIME TO TIME; -TO INITIATE AND APPROVE AMENDMENTS AND RESTATEMENTS OF THE GOVERNING DOCUMENTS OF THE CORPORATION, INCLUDING WITHOUT LIMITATION THE CORPORATION'S ARTICLES OF INCORPORATION AND THESE BYLAWS; -TO ESTABLISH AND ENSURE IMPLEMENTATION OF FINANCIAL GOALS AND STANDARDS THAT PROTECT AND ENHANCE THE OPERATIONS OF THE MEMBER AND THE CORPORATION; -TO TAKE ANY ACTION NECESSARY TO PRESERVE THE TAX-EXEMPT STATUS OF THE CORPORATION IN FURTHERANCE OF ITS CHARITABLE PURPOSE; -TO REQUIRE THE CORPORATION TO TRANSFER ASSETS, INCLUDING BUT NOT LIMITED TO CASH, TO THE MEMBER OR TO ANY EQUITY EXEMPT FROM FEDERAL INCOME TAX AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISION OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW, WHICH IS CONTROLLED BY THE MEMBER, TO THE EXTENT NECESSARY TO ACCOMPLISH THE MISSION, GOALS AND OBJECTIVES OF THE CORPORATION AND THE MEMBER PROVIDED THAT SUCH TRANSFER WOULD NOT RESULT IN A DEFAULT BY THE CORPORATION UNDER ANY BOND INDENTURE, LOAN AGREEMENT OR SIMILAR INSTRUMENT; AND -TO DETERMINE THE EXTENT TO WHICH AND THE MANNER IN WHICH THE POWERS DESCRIBED IN THIS SECTION WHICH ARE RESERVED TO THE MEMBER WITH RESPECT TO THE CORPORATION ARE TO BE INCLUDED IN THE GOVERNING DOCUMENTS OF THE CORPORATION AND EXERCISED WITH RESPECT TO THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD RETAINS THE SERVICES OF AN INDEPENDENT CPA FIRM TO PREPARE THE ORGANIZATION'S FORM 990. MANAGEMENT REVIEWS THE COMPLETED FORM 990 AND PROVIDES A FULL COPY TO ALL MEMBERS OF THE FINANCE COMMITTEE. THE FINANCE COMMITTEE REVIEWS THE COPY AND MEETS WITH THE INDEPENDENT CPA FIRM. AFTER FORM 990 IS ACCEPTED BY THE FINANCE COMMITTEE A COPY IS PROVIDED TO ALL VOTING MEMBERS OF THE GOVERNING BODY PRIOR TO FILING. THE GOVERNING BODY IS PROVIDED A REASONABLE AMOUNT OF TIME TO REVIEW THE RETURN AND ASK ANY QUESTIONS DIRECTLY TO ORGANIZATION MANAGEMENT OR THE CONTACT AT THE INDEPENDENT CPA FIRM PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD OFFICERS AND DIRECTORS ARE ANNUALLY REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AS A PRECURSOR TO THEIR SERVICE TO THE ORGANIZATION. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY DIRECTOR ARE DISCLOSED TO OTHER MEMBERS OF THE BOARD AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THIS INTEREST BECOMES A MATTER OF BOARD ACTION. ANY DIRECTOR HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER WILL NOT VOTE OR USE PERSONAL INFLUENCE ON THE MATTER AND WILL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION IS DETERMINED BY A RELATED ORGANIZATION, THE THRESHOLDS. THE CEO HAS AN EMPLOYMENT CONTRACT THAT IS EVALUATED ANNUALLY BY THE BOARD'S EXECUTIVE COMMITTEE. THE BOARD MEETS IN EXECUTIVE SESSION TO DETERMINE THE CEO'S ANNUAL COMPENSATION PACKAGE THAT MAY INCLUDE A DISCRETIONARY BONUS. THE BOARD USES COMPARABLE DATA IN ITS ASSESSMENT OF EXECUTIVE COMPENSATION. THE BOARD PRESIDENT DOCUMENTS THE RESULTS OF THIS ASSESSMENT AND THE COMMITTEE'S DECISION AND ROUTES THIS INFORMATION TO HUMAN RESOURCES FOR PROCESSING. THE CFO'S COMPENSATION WAS DETERMINED WITH ASSISTANCE OF AN INDEPENDENT CONSULTING AGENCY. REMAINING KEY EMPLOYEES ARE DETERMINED WITH HUMAN RESOURCES REVIEW AND MARKET COMPARISONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE THROUGH APPLICABLE GOVERNMENTAL AGENCIES; THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON WRITTEN REQUEST TO THE ORGANIZATION. |
| FORM 990, PART IX, LINE 11G | CONSULTANTS: PROGRAM SERVICE EXPENSES 118,693. MANAGEMENT AND GENERAL EXPENSES 17,230. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 135,923. |
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