Nonprofit · EIN 39-1397028
FORT MEMORIAL HOSPITAL FOUNDATION INC
Tax-exempt · FORT ATKINSON, WI 53538
Financials
| Year ended | Form | Revenue | Expenses | Net income | Total assets | Liabilities | Net assets |
|---|---|---|---|---|---|---|---|
| September 30, 2025 | 990 | $777,317 | $598,336 | $178,981 | $12,127,959 | $806,693 | $11,321,266 |
| September 30, 2024 | 990 | $440,717 | $391,019 | $49,698 | $10,923,743 | $378,141 | $10,545,602 |
| September 30, 2023 | 990 | $334,006 | $136,902 | $197,104 | $8,979,321 | $141,747 | $8,837,574 |
Financial details: 990 for the year ended September 30, 2025
Revenue
- Contributions, gifts and grants
- $154,105
- Program service revenue
- $0
- Investment income
- $623,212
- Net gain from sales of assets
- $375,737
- Other revenue
- $0
Expenses
- Grants and similar amounts paid
- $578,590
- Salaries, compensation and benefits (total)
- $0
- Professional fundraising fees
- $0
- Program services (functional)
- $578,590
- Fundraising (functional)
- $19,746
Balance sheet and other
- Total assets, start of year
- $10,923,743
- Total assets, end of year
- $12,127,959
- Total liabilities, end of year
- $806,693
- Net assets, end of year
- $11,321,266
- Publicly traded securities
- $11,727,333
- Net assets without donor restrictions
- $10,921,118
- Net assets with donor restrictions
- $400,148
- Gross receipts
- $777,317
- Employees
- 0
- Volunteers
- 11
- Year formed
- 1981
- State of legal domicile
- WI
From the e-filed returns the IRS publishes as XML (latest three processing years; amended returns replace the original). PDF copies at the IRS.
Officers, directors and key employees
As listed on the 990 for the year ended September 30, 2025, highest compensation first.
| Name | Title | Hours / week | Compensation | From related orgs | Other / benefits |
|---|---|---|---|---|---|
| MICHAEL WALLACE | BOARD MEMBER Trustee or director | 1 | $0 | $1,025,323 | $13,393 |
| MICHAEL ANDERSON MD | BOARD MEMBER Trustee or director | 1 | $0 | $973,643 | $56,200 |
| JAMES NELSON | ASSISTANT TREASURER Trustee or director, Officer | 1 | $0 | $364,961 | $58,546 |
| JEFF CICHOCKI | BOARD MEMBER Trustee or director | 1 | $0 | $332,433 | $27,960 |
| CAROL BURROWS | PRESIDENT Trustee or director, Officer | 1 | $0 | $0 | $0 |
| THOMAS VINZ | VICE PRESIDENT Trustee or director, Officer | 1 | $0 | $0 | $0 |
| JAMES FITZPATRICK PHD | TREASURER Trustee or director, Officer | 1 | $0 | $0 | $0 |
| ANDY DIDION | SECRETARY Trustee or director, Officer | 1 | $0 | $0 | $0 |
| MARY BECK METZGER | SECRETARY (TERM 12/24) Trustee or director, Officer | 1 | $0 | $0 | $0 |
| ROY BUDLONG | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
| CHRISTI OTT | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
| DONALD WILLIAMS MD | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
990 for the year ended September 30, 2024: 11 people
| Name | Title | Hours / week | Compensation | From related orgs | Other / benefits |
|---|---|---|---|---|---|
| MICHAEL ANDERSON MD | BOARD MEMBER Trustee or director | 1 | $0 | $815,683 | $46,915 |
| MICHAEL WALLACE | BOARD MEMBER Trustee or director | 1 | $0 | $655,083 | $47,401 |
| JAMES NELSON | ASSISTANT TREASURER Officer | 1 | $0 | $355,156 | $49,391 |
| MARY BECK METZGER | SECRETARY Trustee or director, Officer | 1 | $0 | $67,470 | $16,023 |
| DONALD WILLIAMS MD | BOARD MEMBER Trustee or director | 1 | $0 | $33,909 | $3,730 |
| CAROL BURROWS | PRESIDENT Trustee or director, Officer | 1 | $0 | $0 | $0 |
| ROY BUDLONG | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
| ANDY DIDION | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
| JAMES FITZPATRICK PHD | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
| CHRISTI OTT | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
| THOMAS VINZ | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
990 for the year ended September 30, 2023: 11 people
| Name | Title | Hours / week | Compensation | From related orgs | Other / benefits |
|---|---|---|---|---|---|
| MICHAEL ANDERSON MD | BOARD MEMBER Trustee or director | 1 | $0 | $1,595,636 | $44,201 |
| MICHAEL WALLACE | SENIOR ADVISOR Trustee or director | 1 | $0 | $637,198 | $45,607 |
| JAMES NELSON | ASSISTANT TREASURER Officer | 1 | $0 | $363,506 | $45,461 |
| MARY BECK METZGER | SECRETARY Trustee or director, Officer | 1 | $0 | $65,927 | $15,750 |
| DONALD WILLIAMS MD | BOARD MEMBER Trustee or director | 1 | $0 | $29,479 | $1,406 |
| CAROL BURROWS | PRESIDENT Trustee or director, Officer | 1 | $0 | $0 | $0 |
| ROY BUDLONG | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
| ANDY DIDION | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
| JAMES FITZPATRICK PHD | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
| CHRISTI OTT | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
| THOMAS VINZ | BOARD MEMBER Trustee or director | 1 | $0 | $0 | $0 |
Address and contacts
- Address (IRS master file)
- 611 SHERMAN AVE E, FORT ATKINSON, WI 53538-1960
- In care of
- % JAMES J VANCE
- Principal officer (990 for 2024)
- JAMES NELSON, 611 SHERMAN AVE EAST, FORT ATKINSON, WI 53538
- Signed the 990
- JAMES NELSON, ASSISTANT TREASURER
- Phone
- (920) 568-5000
- Return prepared by
- WIPFLI ADVISORY LLC
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.
Program accomplishments
- 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
What it must file and when
IRS records say it files Form 990 or 990-EZ. Based on its last return; a smaller organization may file the 990-N. Its accounting year ends in September, so each return is due on the 15th day of the 5th month after that.
| Tax year | Year ended | Due | IRS public records |
|---|---|---|---|
| 2025 | September 30, 2026 | February 16, 2027 | Not due yet |
| 2024 | September 30, 2025 | February 17, 2026 | 990 on file |
| 2023 | September 30, 2024 | February 18, 2025 | 990 on file |
IRS record
- EIN
- 39-1397028
- Tax-exempt status
- 501(c)(3): Charitable, religious, educational or scientific organization
- Foundation status
- Supporting organization (509(a)(3))
- Donations deductible (Pub 78)
- Supporting organization of unknown type
- Exempt since
- 1983
- Accounting year ends
- September
- Files
- Form 990 or 990-EZ
- Category (NTEE)
- Health care (E22I)
- Assets (IRS master file)
- $12,127,959
- Income (IRS master file)
- $777,317
Filing history
| Form | Year ended | Revenue | Expenses | Assets | Return |
|---|---|---|---|---|---|
| 990 | September 2025 | $777,317 | $598,336 | $12,127,959 | XML |
| 990 | September 2024 | $440,717 | $391,019 | $10,923,743 | XML |
| 990 | September 2023 | $334,006 | $136,902 | $8,979,321 | XML |
| 990 | September 2022 | $330,313 | $158,558 | $7,976,529 | IRS |
| 990 | September 2021 | – | – | – | IRS |
| 990 | September 2020 | – | – | – | IRS |
| 990 | September 2019 | – | – | – | IRS |
| 990 | September 2018 | – | – | – | IRS |
990-N: the IRS bulk file holds only the latest e-Postcard per organization; earlier years come from archived copies of that file since 2020 and can have gaps (the IRS e-Postcard search lists every one). 990, 990-EZ, 990-PF, 990-T: every e-filed return in the IRS e-file index since 2019; XML for the latest three processing years, amounts from the IRS Statistics of Income extracts before that. PDF copies and determination letters at the IRS (search EIN 39-1397028).
Questions about FORT MEMORIAL HOSPITAL FOUNDATION INC
- What is the EIN of FORT MEMORIAL HOSPITAL FOUNDATION INC?
- The employer identification number (EIN) of FORT MEMORIAL HOSPITAL FOUNDATION INC is 39-1397028.
- Is FORT MEMORIAL HOSPITAL FOUNDATION INC tax-exempt?
- Yes. The IRS lists it as tax-exempt under section 501(c)(3) since 1983.
- Are donations to FORT MEMORIAL HOSPITAL FOUNDATION INC tax-deductible?
- Yes. It is listed in IRS Publication 78 (Supporting organization of unknown type).
- Which annual return does FORT MEMORIAL HOSPITAL FOUNDATION INC file?
- Form 990 or 990-EZ. Based on its last return; a smaller organization may file the 990-N.
- When is the next return of FORT MEMORIAL HOSPITAL FOUNDATION INC due?
- The return for tax year 2025 (the year ending September 30, 2026) is due February 16, 2027. Form 8868 extends it by six months; the 990-N cannot be extended.
- When did FORT MEMORIAL HOSPITAL FOUNDATION INC last file with the IRS?
- The latest return in the IRS public files is the 990 for the year ended September 2025.
- Who is the principal officer of FORT MEMORIAL HOSPITAL FOUNDATION INC?
- The 990 for the year ended September 30, 2025 names JAMES NELSON.
- Who are the officers and directors of FORT MEMORIAL HOSPITAL FOUNDATION INC?
- The 990 for the year ended September 30, 2025 lists 12 people; 0 received compensation from the organization.
- How much revenue does FORT MEMORIAL HOSPITAL FOUNDATION INC have?
- On its 990 for the year ended September 30, 2025 it reported revenue of $777,317, expenses of $598,336 and total assets of $12,127,959 at year end.
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