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Nonprofiteer
← FORT MEMORIAL HOSPITAL FOUNDATION INC

Form 990 for tax year 2024

Filed by FORT MEMORIAL HOSPITAL FOUNDATION INC.

Totals

Total revenue
$777,317
Total expenses
$598,336
Contributions and grants received
$154,105
Grants paid
$578,590
Program service revenue
$0
Investment income
$623,212
Other revenue
$0
Total assets, end of year
$12,127,959
Total liabilities, end of year
$806,693
Net assets or fund balances, end of year
$11,321,266
Program services expenses (Part IX)
$578,590
Management and general expenses
$0
Fundraising expenses
$19,746
Program service expenses (Part III)
$578,590

Program services were 96.7% 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

    $154,105

  • 3 · Investment income

    total $247,475 · excluded $247,475

  • 7a · Gross sales of assets other than inventory

    securities $375,737

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

    securities $0

  • 7c · Gain or loss

    securities $375,737

  • 7d · Net gain or loss

    total $375,737 · excluded $375,737

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $544,450 · program services $544,450

  • 2 · Grants to domestic individuals

    total $34,140 · program services $34,140

  • 11g · Fees: other

    total $2,210 · fundraising $2,210

  • 12 · Advertising and promotion

    total $150 · fundraising $150

  • 13 · Office expenses

    total $619 · fundraising $619

  • 20 · Interest

    total $3,173 · fundraising $3,173

  • 24a · Other expenses: DUES AND SUBSCRIPTIONS

    total $12,688 · fundraising $12,688

  • 24e · All other expenses

    total $906 · fundraising $906

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $392,682 · end of year $398,543

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $2,083

  • 11 · Investments: publicly traded securities

    beginning of year $10,531,061 · end of year $11,727,333

  • 17 · Accounts payable and accrued expenses

    beginning of year $304,584 · end of year $733,135

  • 25 · Other liabilities

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

  • 27 · Net assets without donor restrictions

    beginning of year $10,164,825 · end of year $10,921,118

  • 28 · Net assets with donor restrictions

    beginning of year $380,777 · end of year $400,148

Mission and programs · 2024

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 $34,140 · Grants $34,140

  • 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 $544,450 · Grants $544,450

As filed on the 2024 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Michael Wallace

    BOARD MEMBER

    Total calculated
    $1,038,716
    From this org
    $0
    From related orgs
    $1,025,323
    Other
    $13,393
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $66,239 related
    Bonus
    $0 + $958,547 related
    Other
    $0 + $537 related
    Deferred
    $0 + $12,220 related
    Nontaxable benefits
    $0 + $1,173 related
    Filer's total
    $0 + $1,038,716 related

  • Michael Anderson MD

    BOARD MEMBER

    Total calculated
    $1,029,843
    From this org
    $0
    From related orgs
    $973,643
    Other
    $56,200
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $762,716 related
    Bonus
    $0 + $196,405 related
    Other
    $0 + $14,522 related
    Deferred
    $0 + $13,800 related
    Nontaxable benefits
    $0 + $42,400 related
    Filer's total
    $0 + $1,029,843 related

  • James Nelson

    ASSISTANT TREASURER

    Total calculated
    $423,507
    From this org
    $0
    From related orgs
    $364,961
    Other
    $58,546
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $286,206 related
    Bonus
    $0 + $72,116 related
    Other
    $0 + $6,639 related
    Deferred
    $0 + $13,800 related
    Nontaxable benefits
    $0 + $44,746 related
    Filer's total
    $0 + $423,507 related

  • Jeff Cichocki

    BOARD MEMBER

    Total calculated
    $360,393
    From this org
    $0
    From related orgs
    $332,433
    Other
    $27,960
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $292,059 related
    Bonus
    $0 + $35,214 related
    Other
    $0 + $5,160 related
    Deferred
    $0 + $8,291 related
    Nontaxable benefits
    $0 + $19,669 related
    Filer's total
    $0 + $360,393 related

  • Carol Burrows

    PRESIDENT

    Total calculated
    $0
    Hours/week
    1

  • Thomas Vinz

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    1

  • James Fitzpatrick PhD

    TREASURER

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Andy Didion

    SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • Mary Beck Metzger

    SECRETARY (TERM 12/24)

    Total calculated
    $0
    Hours/week
    1 + 24 related

  • Roy Budlong

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Christi Ott

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • Donald Williams MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

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
2024
Filed
13 August 2026
IRS schema version
2024v5.5
Source object
202632269349302533

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