Form 990 for tax year 2022
Filed by ELY HEALTH AND HOSPITAL FOUNDATION.
Totals
- Total revenue
- $44,777
- Total expenses
- $1,967
- Contributions and grants received
- $25,823
- Grants paid
- $0
- Program service revenue
- $0
- Investment income
- $18,954
- Other revenue
- $0
- Total assets, end of year
- $975,906
- Total liabilities, end of year
- $0
- Net assets or fund balances, end of year
- $975,906
- Program services expenses (Part IX)
- $0
- Management and general expenses
- $1,967
- Fundraising expenses
- $0
- Program service expenses (Part III)
- not reported
Program services were 0.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Line items
Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.
Revenue
Part VIII, the statement of revenue.
-
1f · All other contributions, gifts and grants
$25,823
-
3 · Investment income
total $19,206 · excluded $19,206
-
7a · Gross sales of assets other than inventory
securities $1,968
-
7b · Less cost or other basis and sales expenses
securities $2,220
-
7c · Gain or loss
securities -$252
-
7d · Net gain or loss
total -$252 · excluded -$252
Functional expenses
Part IX, the statement of functional expenses.
-
11f · Fees: investment management
total $1,967 · management and general $1,967
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $136,989 · end of year $162,931
-
11 · Investments: publicly traded securities
beginning of year $725,771 · end of year $812,975
-
27 · Net assets without donor restrictions
beginning of year $785,260 · end of year $898,406
-
28 · Net assets with donor restrictions
beginning of year $77,500 · end of year $77,500
Mission and programs · 2022
Mission
TO PROVIDE FINANCIAL RESOURCES TO SUPPORT THE MISSION OF EBCH IN ITS COMMITMENT TO CARE FOR AND ENHANCE THE HEALTH AND WELLBEING OF THE COMMUNITY IT SERVES.
-
SUPPORT OF THE ELY-BLOOMENSON COMMUNITY HOSPITAL IN ORDER FOR THEM TO IMPROVE THE QUALITY OF HEALTH CARE IN THE ELY COMMUNITY.
As filed on the 2022 return.
Listed in Part VII
-
Jo LanganJO LANGAN
DIRECTOR
- Total calculated
- $0
- Hours/week
- 0.1 + 1.1 related
-
Mary Ann SmithMARY ANN SMITH
DIRECTOR
- Total calculated
- $0
- Hours/week
- 0.1 + 1.1 related
-
Barb SoderbergBARB SODERBERG
DIRECTOR
- Total calculated
- $0
- Hours/week
- 0.1 + 1.1 related
-
Scott KellermanSCOTT KELLERMAN
DIRECTOR UNTIL 12/31/22
- Total calculated
- $0
- Hours/week
- 0.1 + 1.1 related
-
John SawJOHN SAW
DIRECTOR BEG. 1/1/23
- Total calculated
- $0
- Hours/week
- 0.1 + 1.1 related
-
Mike PechekMIKE PECHEK
TREAS. TIL 12/31/22-DIR. TIL 1/31/23
- Total calculated
- $0
- Hours/week
- 0.1 + 1.1 related
-
Todd HeimanTODD HEIMAN
DIR. TIL 12/31/22-TREAS. BEG. 1/1/23
- Total calculated
- $0
- Hours/week
- 0.1 + 1.1 related
-
Kelly KlunKELLY KLUN
SECRETARY
- Total calculated
- $0
- Hours/week
- 0.1 + 1.1 related
-
Devon LuthensDEVON LUTHENS
VICE PRESIDENT
- Total calculated
- $0
- Hours/week
- 0.1 + 1.1 related
-
Tim RileyTIM RILEY
PRESIDENT
- Total calculated
- $0
- Hours/week
- 0.1 + 1.6 related
-
Patti BanksPATTI BANKS
CEO
- Total calculated
- $259,283
- From this org
- $0
- From related orgs
- $247,560
- Other
- $11,723
- Hours/week
- 0.15 + 39.85 related
Schedule J breakdown matched by us
- Base
- $0 + $247,560 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $7,565 related
- Nontaxable benefits
- $0 + $4,158 related
- Filer's total
- $0 + $259,283 related
-
Curtis BachCURTIS BACH
CFO UNTIL 10/31/22
- Total calculated
- $158,910
- From this org
- $0
- From related orgs
- $139,815
- Other
- $19,095
- Hours/week
- 0.15 + 39.85 related
Schedule J breakdown matched by us
- Base
- $0 + $139,815 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $4,283 related
- Nontaxable benefits
- $0 + $14,812 related
- Filer's total
- $0 + $158,910 related
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
None.
Answered no
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
- 4c · Equity-based compensation arrangement
- 5a · Pay contingent on this organization's revenues
- 5b · Pay contingent on a related organization's revenues
- 6a · Pay contingent on this organization's net earnings
- 6b · Pay contingent on a related organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- PART I, LINE 3
- ELY HEALTH AND HOSPITAL FOUNDATION DOES NOT COMPENSATE ANY EMPLOYEES. THE CEO IS COMPENSATED BY THE ELY-BLOOMENSON COMMUNITY HOSPITAL, A RELATED ORGANIZATION. THE COMPENSATION IS ESTABLISHED USING: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVERY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
No itemized grants to organizations on this return.
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
ELY-BLOOMENSON COMMUNITY HOSPITAL
501(C)(3) · TO PROVIDE HEALTHCARE TO THE RESIDENTS AND VISITORS TO THE ELY, MN AREA · MN · controlled entity
Directly controlled by ELY HEALTH AND HOSPITAL FOUNDATION
-
501(C)(3) · TO PROVIDE SUPPORT TO ELY-BLOOMENSON COMMUNITY HOSPITAL FOR HEALTHCARE · MN · controlled entity
Directly controlled by ELY HEALTH AND HOSPITAL FOUNDATION
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 10 June 2024
- IRS schema version
- 2022v5.0
- Source object
- 202431649349301003
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