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Nonprofiteer
← FOX VALLEY FAMILY PRACTICE RESIDENCY IN APPLETON INC

Form 990 for tax year 2022

Filed by FOX VALLEY FAMILY PRACTICE RESIDENCY IN APPLETON INC.

Totals

Total revenue
$453,549
Total expenses
$396,924
Contributions and grants received
$393,000
Grants paid
$105,500
Program service revenue
$60,000
Investment income
$549
Other revenue
$0
Total assets, end of year
$2,193,879
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$2,193,879
Program services expenses (Part IX)
$314,481
Management and general expenses
$82,443
Fundraising expenses
$0
Program service expenses (Part III)
$314,481

Program services were 79.2% 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

    $393,000

  • 2a · Program service revenue: RENTAL INCOME

    total $60,000 · related or exempt $60,000

  • 3 · Investment income

    total $549 · excluded $549

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $105,500 · program services $105,500

  • 11b · Fees: legal

    total $78,225 · management and general $78,225

  • 11c · Fees: accounting

    total $4,218 · management and general $4,218

  • 11g · Fees: other

    total $129,132 · program services $129,132

  • 13 · Office expenses

    total $209 · program services $209

  • 22 · Depreciation, depletion and amortization

    total $79,640 · program services $79,640

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $41,403 · end of year $176,118

  • 2 · Savings and temporary cash investments

    beginning of year $60,140 · end of year $60,689

  • 10a · Land, buildings and equipment: cost or other basis

    $4,437,625

  • 10b · Land, buildings and equipment: accumulated depreciation

    $2,990,566

  • 10c · Land, buildings and equipment, net

    beginning of year $1,526,699 · end of year $1,447,059

  • 15 · Other assets

    beginning of year $493,252 · end of year $510,013

  • 27 · Net assets without donor restrictions

    beginning of year $2,121,494 · end of year $2,193,879

Mission and programs · 2022

Mission

TO CONSTRUCT AND EQUIP AN EDUCATION FACILITY FOR LEASE TO MOSAIC FAMILY HEALTH, INC. FOR OPERATION OF THE CLINICAL HOME OF THE FOX VALLEY FAMILY MEDICINE RESIDENCY PROGRAM, AFFILIATED WITH THE MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS; TO BE THE RECIPIENT OF CONTRIBUTIONS TO FACILITATE THE PURCHASE OF REAL ESTATE, CONSTRUCTION OF A BUILDING AND PURCHASE OF EQUIPMENT RELATING TO FAMILY MEDICINE RESIDENCY TRAINING; TO FURTHER FACILITATE THE ACQUISITION OF REAL ESTATE, CONSTRUCTION OF A CLINIC BUILDING AND PURCHASES OF EQUIPMENT, AS A MODEL CLINIC FOR THE FAMILY MEDICINE RESIDENTS AND FAMILY MEDICINE RESIDENCY TRAINING; AND TO WORK WITH LEADERSHIP AND MEMBERS OF MOSAIC FAMILY HEALTH, INC. TO ASSIST WITH MANAGEMENT OF FACILITIES TO SUPPORT THE MISSION OF THE FOX VALLEY FAMILY MEDICINE RESIDENCY.

Activities or mission (Part I)

TO EQUIP, MAINTAIN, AND LEASE AN EDUCATIONAL FACILITY TO A FAMILY MEDICINE RESIDENCY PROGRAM.

  • PROVIDED A WELL EQUIPPED MEDICAL FACILITY FOR USE BY MOSAIC FAMILY HEALTH, INC., A FAMILY MEDICINE RESIDENCY PROGRAM. THE RENT CHARGED TO MOSAIC WAS WELL BELOW FAIR MARKET RENT. MOSAIC USED THE MEDICAL FACILITY FOR ITS CHARITABLE AND EDUCATIONAL PURPOSES.

    Expenses $314,481 · Grants $105,500 · Revenue $60,000

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Bret Salscheider

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.1

  • Lee Marie Vogel MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.1

  • Kristina Smith

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.1

  • Janine Buffo MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.1

  • Don Hietpas

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.1

  • Jon Kester

    PRESIDENT/TREASURER

    Total calculated
    $0
    Hours/week
    0.1

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.

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
2022
Filed
2 April 2024
IRS schema version
2022v5.0
Source object
202401019349301005

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