Form 990 for tax year 2023

Filed by FILLMORE COUNTY HOSPITAL FOUNDATION.

Totals

Total revenue: $462,084
Total expenses: $85,803
Contributions and grants received: $391,291
Grants paid: $61,837
Program service revenue: $0
Investment income: $71,924
Other revenue: -$1,131
Total assets, end of year: $3,958,924
Total liabilities, end of year: $0
Net assets or fund balances, end of year: $3,958,924
Program services expenses (Part IX): $72,903
Management and general expenses: $10,735
Fundraising expenses: $2,165
Program service expenses (Part III): $72,903

Program services were 85.0% 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.

1c · Fundraising events

$36,586
1f · All other contributions, gifts and grants

$354,705
3 · Investment income

total $71,924 · excluded $71,924
8a · Fundraising events: gross income

$14,468
8a · Fundraising events: contributions included on line 1c

$36,586
8b · Fundraising events: direct expenses

$15,599
8c · Net income from fundraising events

total -$1,131 · excluded -$1,131

Functional expenses

Part IX, the statement of functional expenses.

1 · Grants to domestic organizations and governments

total $1,967 · program services $1,967
2 · Grants to domestic individuals

total $59,870 · program services $59,870
11c · Fees: accounting

total $3,700 · management and general $3,700
11f · Fees: investment management

total $7,035 · management and general $7,035
12 · Advertising and promotion

total $2,145 · program services $2,145
13 · Office expenses

total $8,254 · program services $8,254
17 · Travel

total $667 · program services $667
24e · All other expenses

total $2,165 · fundraising $2,165

Balance sheet

Part X, book values.

2 · Savings and temporary cash investments

beginning of year $700,799 · end of year $548,024
3 · Pledges and grants receivable

beginning of year $255,813 · end of year $84,913
4 · Accounts receivable

beginning of year $20,000 · end of year $261,667
11 · Investments: publicly traded securities

beginning of year $2,200,284 · end of year $2,783,182
12 · Investments: other securities

beginning of year $267,173 · end of year $267,174
15 · Other assets

beginning of year $16,495 · end of year $13,964
27 · Net assets without donor restrictions

beginning of year $1,530,361 · end of year $1,765,636
28 · Net assets with donor restrictions

beginning of year $1,930,203 · end of year $2,193,288

Mission and programs · 2023

Mission

THE PURPOSE OF THE FOUNDATION SHALL BE TO SUPPORT FILLMORE COUNTY HOSPITAL OF GENEVA, NEBRASKA IN ITS ENDEAVORS OF NEW TECHNOLOGIES, RECRUITMENT, EXPANSION, CONTINUING EDUCATION, MARKETING, PURCHASING OF SUPPLIES AND EQUIPMENT, AND PROVIDING SUPPORT AND HELP FOR THE CITIZENS OF FILLMORE COUNTY AND SURROUNDING AREAS IN THEIR PHYSICAL AND MENTAL HEALTH NEEDS.

Activities or mission (Part I)

SEE SCHEDULE O.THE PURPOSE OF THE FOUNDATION SHALL BE TO SUPPORT FILLMORE COUNTY HOSPITAL OF GENEVA, NEBRASKA IN ITS ENDEAVORS OF NEW TECHNOLOGIES, RECRUITMENT, EXPANSION, CONTINUING EDUCATION, MARKETING, PURCHASING OF SUPPLIES AND EQUIPMENT, AND PROVIDING SUPPORT AND HELP FOR THE CITIZENS OF FILLMORE COUNTY AND SURROUNDING AREAS IN THEIR PHYSICAL AND MENTAL HEALTH NEEDS.

THE FOUNDATION'S PRIMARY EXEMPT PURPOSE FOR EXPENSES IS FOR FUNDRAISING. FUNDRAISING AIDS THE HOSPITAL IN THE PURCHASE OF SUPPLIES AND EQUIPMENT, PROVIDING SUPPORT TO EMPLOYEES AND EXPANSION AND UPKEEP OF THE BUILDING. IN ADDITION, ADVERTISING AND POSTAGE EXPENSES ASSOCIATED WITH THOSE FUNDRAISING EFFORTS.

Expenses $72,903 · Grants $61,837

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

Listed in Part VII

James DonovanJAMES DONOVAN

PRESIDENT

Total calculated

$0

Hours/week

1
Mitchell SchlegelmilchMITCHELL SCHLEGELMILCH

VICE PRESIDENT

Total calculated

$0

Hours/week

1
Shaun FarmerSHAUN FARMER

SECRETARY/TREASURER

Total calculated

$0

Hours/week

1
Shelly CassidySHELLY CASSIDY

DIRECTOR

Total calculated

$0

Hours/week

1
Richard WalterRICHARD WALTER

DIRECTOR

Total calculated

$0

Hours/week

1
Nancy MeyerNANCY MEYER

DIRECTOR

Total calculated

$0

Hours/week

1
Kristi BriskeKRISTI BRISKE

DIRECTOR THRU 03/24

Total calculated

$0

Hours/week

1
Jay LynchJAY LYNCH

DIRECTOR THRU 12/23

Total calculated

$0

Hours/week

1
Jack GalushaJACK GALUSHA

DIRECTOR

Total calculated

$0

Hours/week

1
Megan NunnsMEGAN NUNNS

DIRECTOR

Total calculated

$0

Hours/week

1
Judy LichtiJUDY LICHTI

DIRECTOR

Total calculated

$0

Hours/week

1
Mary HouchinMARY HOUCHIN

DIRECTOR

Total calculated

$0

Hours/week

1
Taylor SlukaTAYLOR SLUKA

DIRECTOR

Total calculated

$0

Hours/week

1
Jenny HoartyJENNY HOARTY

DIRECTOR

Total calculated

$0

Hours/week

1
Dayle HarlowDAYLE HARLOW

EXECUTIVE DIRECTOR

Total calculated

$194,319

From this org

$0

From related orgs

$154,622

Other

$39,697

Hours/week

5 + 35 related

Schedule J breakdown matched by us

Base

$0 + $144,512 related

Bonus

$0 + $10,110 related

Other

$0

Deferred

$0 + $8,364 related

Nontaxable benefits

$0 + $31,333 related

Filer's total

$0 + $194,319 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 COMPENSATION FOR DAYLE HARLOW, EXECUTIVE DIRECTOR, IS PAID BY FILLMORE COUNTY HOSPITAL, A RELATED ENTITY. FILLMORE COUNTY HOSPITAL HAS A COMPENSATION COMMITTEE COMPRISED OF THE CEO, CFO, COO, AND CHRO. ANNUALLY, THE COMMITTEE MEETS TO REVIEW WAGES OF DEPARTMENTS AND INDIVIDUAL STAFF WITH DATA FROM THE NEBRASKA HOSPITAL ASSOCIATION SALARY SURVEY PERFORMED BY GALLAGHER. THE COMPENSATION AMOUNTS REPORTED ON SCHEDULE J, PART II IS FOR SERVICES PROVIDED TO BOTH THE FILLMORE COUNTY HOSPITAL AND THE FILLMORE COUNTY HOSPITAL FOUNDATION. ONLY 10% OF HER TIME IS FOR SERVICES PROVIDED TO THE FOUNDATION.

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.

FILLMORE COUNTY HOSPITAL

GOVT. · HOSPITAL · NE

Provenance

Return type: form_990
Tax year: 2023
Filed: 1 May 2025
IRS schema version: 2023v6.0
Source object: 202511269349301946

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