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Nonprofiteer
← FORT MEMORIAL HOSPITAL FOUNDATION INC

Form 990 for tax year 2023

Filed by FORT MEMORIAL HOSPITAL FOUNDATION INC.

Totals

Total revenue
$440,717
Total expenses
$391,019
Contributions and grants received
$140,950
Grants paid
$77,645
Program service revenue
$0
Investment income
$299,767
Other revenue
$0
Total assets, end of year
$10,923,743
Total liabilities, end of year
$378,141
Net assets or fund balances, end of year
$10,545,602
Program services expenses (Part IX)
$77,645
Management and general expenses
$0
Fundraising expenses
$313,374
Program service expenses (Part III)
$77,645

Program services were 19.9% 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

    $140,950

  • 3 · Investment income

    total $213,126 · excluded $213,126

  • 7a · Gross sales of assets other than inventory

    securities $1,212,936

  • 7b · Less cost or other basis and sales expenses

    securities $1,126,295

  • 7c · Gain or loss

    securities $86,641

  • 7d · Net gain or loss

    total $86,641 · excluded $86,641

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $17,645 · program services $17,645

  • 2 · Grants to domestic individuals

    total $60,000 · program services $60,000

  • 11g · Fees: other

    total $298,148 · fundraising $298,148

  • 20 · Interest

    total $1,350 · fundraising $1,350

  • 24e · All other expenses

    total $13,876 · fundraising $13,876

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $362,431 · end of year $392,682

  • 11 · Investments: publicly traded securities

    beginning of year $8,616,890 · end of year $10,531,061

  • 17 · Accounts payable and accrued expenses

    beginning of year $68,189 · end of year $304,584

  • 25 · Other liabilities

    beginning of year $73,558 · end of year $73,557

  • 27 · Net assets without donor restrictions

    beginning of year $8,504,644 · end of year $10,164,825

  • 28 · Net assets with donor restrictions

    beginning of year $332,930 · end of year $380,777

Mission and programs · 2023

Mission

THE FOUNDATION IS ORGANIZED AND SHALL BE OPERATED SOLELY FOR CHARITABLE PURPOSES EXCLUSIVELY FOR THE BENEFIT OF FORT ATKINSON MEMORIAL HOSPITAL, THE HOSPITAL OPERATED BY FORT HEALTHCARE, INC., AN INTEGRATED HEALTH CARE DELIVERY SYSTEM, INCLUDING THE CARRYING ON OF SUCH PROGRAMS AS THE BOARD OF DIRECTORS OF THIS CORPORATION FROM TIME TO TIME DEEMS TO BE SUITABLE AND APPROPRIATE.

  • ADVANCING CAREERS IN HEALTHCARE INCLUDES SCHOLARSHIPS AND TRAINING FOR EMPLOYEES.

    Expenses $60,000 · Grants $60,000

  • FORT MEMORIAL HOSPITAL FOUNDATION WAS CREATED FOR THE SOLE BENEFIT OF FORT HEALTHCARE. FOUR AREAS OF STRATEGIC FOCUS GUIDE OUR FUNDRAISING AND GRANTING PROCESS. BENEVOLENT CARE INCLUDES PROGRAM FUNDING TO ASSIST PATIENTS WHO CANNOT AFFORD CARE. PROVIDING EXCEPTIONAL CARE INCLUDES FUNDING FOR EQUIPMENT, TECHNOLOGY AND SERVICES THAT ENHANCE THE QUALITY OF CARE AND PATIENT SATISFACTION. LIVING HEALTHIER INCLUDES SERVICES FOCUSED ON COMMUNITY WELLNESS INITIATIVES.

    Expenses $17,645 · Grants $17,645

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Michael Anderson MD

    BOARD MEMBER

    Total calculated
    $862,598
    From this org
    $0
    From related orgs
    $815,683
    Other
    $46,915
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $764,441 related
    Bonus
    $0 + $40,000 related
    Other
    $0 + $11,242 related
    Deferred
    $0 + $13,200 related
    Nontaxable benefits
    $0 + $33,715 related
    Filer's total
    $0 + $862,598 related

  • Michael Wallace

    BOARD MEMBER

    Total calculated
    $702,484
    From this org
    $0
    From related orgs
    $655,083
    Other
    $47,401
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $246,348 related
    Bonus
    $0 + $391,961 related
    Other
    $0 + $16,774 related
    Deferred
    $0 + $13,200 related
    Nontaxable benefits
    $0 + $34,201 related
    Filer's total
    $0 + $702,484 related

  • Mary Beck Metzger

    SECRETARY

    Total calculated
    $83,493
    From this org
    $0
    From related orgs
    $67,470
    Other
    $16,023
    Hours/week
    1 + 24 related

  • Donald Williams MD

    BOARD MEMBER

    Total calculated
    $37,639
    From this org
    $0
    From related orgs
    $33,909
    Other
    $3,730
    Hours/week
    1

  • Carol Burrows

    PRESIDENT

    Total calculated
    $0
    Hours/week
    1

  • Roy Budlong

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Andy Didion

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • James Fitzpatrick PhD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Christi Ott

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Thomas Vinz

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • James Nelson

    ASSISTANT TREASURER

    Total calculated
    $404,547
    From this org
    $0
    From related orgs
    $355,156
    Other
    $49,391
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $279,993 related
    Bonus
    $0 + $70,031 related
    Other
    $0 + $5,132 related
    Deferred
    $0 + $13,200 related
    Nontaxable benefits
    $0 + $36,191 related
    Filer's total
    $0 + $404,547 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
THE TOP MANAGEMENT OFFICIAL IS COMPENSATED BY FORT HEALTHCARE, INC., A RELATED ORGANIZATION OF FORT MEMORIAL HOSPITAL FOUNDATION, INC. FORT HEALTHCARE, INC. ESTABLISHED THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL USING THE COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE METHODS.

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

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.

Provenance

Return type
form_990
Tax year
2023
Filed
14 August 2025
IRS schema version
2023v6.0
Source object
202532279349300233

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