Civic Intelligence

Converse County Hospital Foundation Inc.

990 • Fiscal year 2017 • EIN 83-0309209

Jul 01, 2016 to Jun 30, 2017 • Filed on Nov 13, 2017

Organization Profilewww.conversecountyhospitalfoundation.org
PO Box 393Douglas, WY 82633

(307) 358-2122

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

14th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2017 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2017

Liabilities / Revenue

14th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2017 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2017

Net Margin

99th percentile

95%

Higher net margin than 99% of similar nonprofits.

2017 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2017

Top Officer Pay

35th percentile

$0

Higher top officer pay than 35% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

2017 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2017

Asset Growth

88th percentile

38%

Faster asset growth than 88% of similar nonprofits.

2017 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2016 to 2017

Revenue Growth

95th percentile

147%

Faster revenue growth than 95% of similar nonprofits.

2017 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2016 to 2017

Balance Sheet
Liabilities / Assets14th percentile

Assets

Up

$1,344,305

Up $372,264 (+38%) from 2016

Net Assets

Up

$1,344,305

Up $372,264 (+38%) from 2016

Liabilities

Flat

$0

Flat from 2016

Revenue And Expenses
Liabilities / Revenue14th percentileNet Margin99th percentile

Revenue

Up

$345,816

Up $205,778 (+147%) from 2016

Expenses

Down

$17,920

Down $85,582 (-83%) from 2016

Net Income

Up

$327,896

Up $291,360 (+797%) from 2016

Historical Trend

Balance Sheet Trend

Asset Growth88th percentile

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$3.0M$2.0M$1.0M$0Assets 2011: $713,150Liabilities 2011: $0Net Assets 2011: $713,1502011Assets 2012: $848,626Liabilities 2012: $0Net Assets 2012: $848,6262012Assets 2013: $911,455Liabilities 2013: $0Net Assets 2013: $911,4552013Assets 2014: $926,503Liabilities 2014: $25Net Assets 2014: $926,4782014Assets 2015: $935,505Liabilities 2015: $0Net Assets 2015: $935,5052015Assets 2016: $972,041Liabilities 2016: $0Net Assets 2016: $972,0412016Assets 2017: $1,344,305Liabilities 2017: $0Net Assets 2017: $1,344,3052017Assets 2018: $1,028,732Liabilities 2018: $0Net Assets 2018: $1,028,7322018Assets 2019: $1,106,538Liabilities 2019: $313Net Assets 2019: $1,106,2252019Assets 2020: $1,194,446Liabilities 2020: $313Net Assets 2020: $1,194,1332020Assets 2021: $1,784,990Liabilities 2021: $792Net Assets 2021: $1,784,1982021Assets 2022: $1,665,301Liabilities 2022: $1,175Net Assets 2022: $1,664,1262022Assets 2023: $1,929,206Liabilities 2023: $576Net Assets 2023: $1,928,6302023Assets 2024: $2,278,041Liabilities 2024: $1,200Net Assets 2024: $2,276,8412024Assets 2025: $2,441,489Liabilities 2025: $1,318Net Assets 2025: $2,440,1712025

Highlighted filing

2017

Assets$1,344,305
Liabilities$0
Net Assets$1,344,305
Open 2017 Filing

Operations Trend

Revenue Growth95th percentile

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$2.0M$1.5M$1.0M$500K$0-$500KExpenses 2011: $30,0432011Expenses 2012: $24,7642012Revenue 2013: $90,902Expenses 2013: $28,073Net Income 2013: $62,8292013Revenue 2014: $95,540Expenses 2014: $80,517Net Income 2014: $15,0232014Revenue 2015: $125,002Expenses 2015: $115,975Net Income 2015: $9,0272015Revenue 2016: $140,038Expenses 2016: $103,502Net Income 2016: $36,5362016Revenue 2017: $345,816Expenses 2017: $17,920Net Income 2017: $327,8962017Revenue 2018: $258,644Expenses 2018: $605,516Net Income 2018: -$346,8722018Revenue 2019: $1,509,994Expenses 2019: $1,434,461Net Income 2019: $75,5332019Revenue 2020: $192,859Expenses 2020: $115,321Net Income 2020: $77,5382020Revenue 2021: $290,140Expenses 2021: $38,006Net Income 2021: $252,1342021Revenue 2022: $303,475Expenses 2022: $144,417Net Income 2022: $159,0582022Revenue 2023: $254,222Expenses 2023: $80,272Net Income 2023: $173,9502023Revenue 2024: $226,890Expenses 2024: $31,372Net Income 2024: $195,5182024Revenue 2025: $253,980Expenses 2025: $202,438Net Income 2025: $51,5422025

Highlighted filing

2017

Revenue$345,816
Expenses$17,920
Net Income$327,896
Open 2017 Filing
Jump To
Filing Snapshot
Filing Period
Jul 1, 2016 to Jun 30, 2017
Signed
Nov 13, 2017
Return Version
2016v3.0
Gross Receipts
$349,537
Mission and Program Overview

Mission

Build a strong financial foundation to promote and ensure the continued growth of quality healthcare in converse county.

Build a strong financial foundation to promote and ensure the continued growth of qualtiy healthcare in Converse County.

Balance Sheet Detail
LineBeginningEndChange
Assets
Savings and Temporary Cash Investments$633,295$959,858▲ $326,563
Investments in Publicly Traded Securities$237,531$309,969▲ $72,438
Cash and Non-Interest-Bearing Accounts$69,652$73,979▲ $4,327
Accounts Receivable$28,070--
Land, Buildings, and Equipment, Net$3,493$499▼ $2,994
Total Assets$972,041$1,344,305▲ $372,264
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Unrestricted Net Assets$423,793$631,065▲ $207,272
Permanently Rstr Net Assets$500,000$500,000→ $0
Temporarily Rstr Net Assets$48,248$213,240▲ $164,992
Total Net Assets Fund Balance$972,041$1,344,305▲ $372,264
Total Liabilities and Net Assets / Fund Balance$972,041$1,344,305▲ $372,264

Asset Categories

AssetBook ValueDepreciationBasis
Other Land Buildings$499$11,477$11,976

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2016$500,000-▲ $2,992-$500,000
2015$528,955-▲ $4,011$32,966$500,000
2014$534,907-▲ $4,048-$528,955
2013$529,858-▲ $5,049-$534,907
2012$444,509$79,942▲ $5,407-$529,858
Compensation and Service Providers
Top Officer Pay35th percentile

Board Members and Trustees

NameTitle
Laura DandridgeChairperson
Ross GormanVice Chairperson
Jennifer RinnFoundation Director
Gay BollnMember
Howard MiesslerMember
Jim TwifordMember
Keith MooreMember
Mary Julia WilsonMember
Merritt HarrisMember
Ryan SmithMember
Amy HughesSecretary/Treasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$330,676
Program Service Revenue
$0
Investment Income
$6,121
Other Revenue
$9,019
All Other Contributions
$330,676
Change in Net Assets
$327,896
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$10,240
Grants and Similar Amounts Paid$7,680
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Grants to Domestic Orgs$7,680--$7,680
Depreciation Depletion$2,994--$2,994
Fees for Services Accounting-$1,100-$1,100
Office Expenses-$394-$394
Occupancy-$52-$52
Other Expenses$4,000$28-$28
Total Functional Expenses$14,674$3,246$0$17,920
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Memorial Hospital of Converse CountyDouglas, WY-Capital campaign on behalf of Hospital$7,680
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Gross Income$12,740
Fundraising Direct Expenses$3,721
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, line 11B

“The Organization's contracted accountant will review the Form 990 for completeness and accuracy.”

Form 990, Part VI, Section C, line 19

“No documents available to the public.”

Filing and Contact Details

Filer

Filer Name
Converse County Hospital Foundation
EIN
83-0309209
Phone
3073582122
Address
PO Box 393, Douglas, WY 82633

Signing Officer

Name
Amy Hughes
Title
Treasurer
Phone
3072989379
Signed
2017-11-13
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Amy Hughes
Formed
1994
Legal Domicile
Wy
Voting Board Members
10
Independent Board Members
10
Employees
0
Volunteers
0

Preparer

Firm
Skogen Cometto & Associates PC
Address
104 South Wolcott Suite 735, Casper, WY 82601
Preparer
Roxy L Skogen CPA
Phone
3072345395
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IRS990ScheduleA/SupportedOrgInformationGrp/SupportedOrganizationName/BusinessNameLine1Txt0Memorial Hospital of Converse County
IRS990ScheduleA/SupportingOrganization509a3Ind0X
IRS990ScheduleA/SupportingOrgType3FuncIntInd0X
IRS990ScheduleA/SupportSumAmt07680
IRS990ScheduleB/ContributorInformationGrp/ContributorBusinessName/BusinessNameLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorNum0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine20RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/City0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/ZIPCode0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt0RESTRICTED
IRS990/ScheduleBRequiredInd01
IRS990ScheduleD/CYEndwmtFundGrp/BeginningYearBalanceAmt0500000
IRS990ScheduleD/CYEndwmtFundGrp/EndYearBalanceAmt0500000
IRS990ScheduleD/CYEndwmtFundGrp/InvestmentEarningsOrLossesAmt02992
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/BeginningYearBalanceAmt0528955
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/EndYearBalanceAmt0500000
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/InvestmentEarningsOrLossesAmt04011
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/OtherExpendituresAmt032966
IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/BeginningYearBalanceAmt0534907
IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/EndYearBalanceAmt0528955
IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/InvestmentEarningsOrLossesAmt04048
IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/BeginningYearBalanceAmt0529858
IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/EndYearBalanceAmt0534907
IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/InvestmentEarningsOrLossesAmt05049
IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/BeginningYearBalanceAmt0444509
IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/ContributionsAmt079942
IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/EndYearBalanceAmt0529858
IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/InvestmentEarningsOrLossesAmt05407
IRS990ScheduleD/EndowmentsHeldRelatedOrgInd00
IRS990ScheduleD/EndowmentsHeldUnrelatedOrgInd00
IRS990ScheduleD/OtherLandBuildingsGrp/BookValueAmt0499
IRS990ScheduleD/OtherLandBuildingsGrp/DepreciationAmt011477
IRS990ScheduleD/OtherLandBuildingsGrp/OtherCostOrOtherBasisAmt011976
IRS990ScheduleD/TotalBookValueLandBuildingsAmt0499
IRS990ScheduleI/GrantRecordsMaintainedInd00
IRS990ScheduleI/RecipientTable/CashGrantAmt07680
IRS990ScheduleI/RecipientTable/PurposeOfGrantTxt0Capital campaign on behalf of Hospital
IRS990ScheduleI/RecipientTable/RecipientBusinessName/BusinessNameLine1Txt0Memorial Hospital of Converse County
IRS990ScheduleI/RecipientTable/RecipientEIN0836000097
IRS990ScheduleI/RecipientTable/USAddress/AddressLine1Txt0111 S 5th St
IRS990ScheduleI/RecipientTable/USAddress/CityNm0Douglas
IRS990ScheduleI/RecipientTable/USAddress/StateAbbreviationCd0WY
IRS990ScheduleI/RecipientTable/USAddress/ZIPCd082633
IRS990ScheduleI/Total501c3OrgCnt01
IRS990/ScheduleJRequiredInd00
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0The Organization's contracted accountant will review the Form 990 for completeness and accuracy.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1No documents available to the public.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Form 990, Part VI, Section B, line 11b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Form 990, Part VI, Section C, line 19
IRS990/SchoolOperatingInd00
IRS990/SignificantChangeInd00
IRS990/SignificantNewProgramSrvcInd00
IRS990/SubjectToProxyTaxInd00
IRS990/TaxablePartyNotificationInd00
IRS990/TaxExemptBondsInd00
IRS990/TemporarilyRstrNetAssetsGrp/BOYAmt048248
IRS990/TemporarilyRstrNetAssetsGrp/EOYAmt0213240
IRS990/TempOrPermanentEndowmentsInd01
IRS990/TerminateOperationsInd00
IRS990/TotalAssetsBOYAmt0972041
IRS990/TotalAssetsEOYAmt01344305
IRS990/TotalAssetsGrp/BOYAmt0972041
IRS990/TotalAssetsGrp/EOYAmt01344305
IRS990/TotalCompGreaterThan150KInd00
IRS990/TotalContributionsAmt0330676
IRS990/TotalEmployeeCnt00
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt03246
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt014674
IRS990/TotalFunctionalExpensesGrp/TotalAmt017920
IRS990/TotalGrossUBIAmt00
IRS990/TotalLiabilitiesBOYAmt00
IRS990/TotalLiabilitiesEOYAmt00
IRS990/TotalLiabilitiesGrp/BOYAmt00
IRS990/TotalLiabilitiesGrp/EOYAmt00
IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt0972041
IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt01344305
IRS990/TotalOtherCompensationAmt00
IRS990/TotalProgramServiceExpensesAmt014674
IRS990/TotalReportableCompFromOrgAmt00
IRS990/TotalRevenueGrp/ExclusionAmt015140
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt00
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0345816
IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt00
IRS990/TotalVolunteersCnt00
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0972041
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt01344305
IRS990/TotReportableCompRltdOrgAmt00
IRS990/TrnsfrExmptNonChrtblRltdOrgInd00
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd00
IRS990/UnrestrictedNetAssetsGrp/BOYAmt0423793
IRS990/UnrestrictedNetAssetsGrp/EOYAmt0631065
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0PO Box 689
IRS990/USAddress/CityNm0Douglas
IRS990/USAddress/StateAbbreviationCd0WY
IRS990/USAddress/ZIPCd082633
IRS990/VotingMembersGoverningBodyCnt010
IRS990/VotingMembersIndependentCnt010
IRS990/WebsiteAddressTxt0www.conversecountyhospitalfoundation.org
IRS990/WhistleblowerPolicyInd00
ReturnHeader/BuildTS02017-02-10 21:41:12Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0Amy Hughes
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0Treasurer
ReturnHeader/BusinessOfficerGrp/PhoneNum03072989379
ReturnHeader/BusinessOfficerGrp/SignatureDt02017-11-13
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0Converse County Hospital Foundation
ReturnHeader/Filer/BusinessNameControlTxt0CONV
ReturnHeader/Filer/EIN0830309209
ReturnHeader/Filer/PhoneNum03073582122
ReturnHeader/Filer/USAddress/AddressLine1Txt0PO Box 393
ReturnHeader/Filer/USAddress/CityNm0Douglas
ReturnHeader/Filer/USAddress/StateAbbreviationCd0WY
ReturnHeader/Filer/USAddress/ZIPCd082633
ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId0B699985A00C83E7CA24391BB334E8E9AD2106178
ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId05BB9F9B5B5850B9357A1CAF56DBAB95BD5010748
ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd0P
ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt098.127.154.242
ReturnHeader/FilingSecurityInformation/IPDt02017-11-13
ReturnHeader/FilingSecurityInformation/IPTimezoneCd0MS
ReturnHeader/FilingSecurityInformation/IPTm014:36:24

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Displayed year

2017 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$1,344,305
Liabilities
$0
Net assets
$1,344,305
Revenue
$345,816
Expenses
$17,920
Net income
$327,896
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2025Detailed filing. Detailed filing data is available for this year.$2.44$0.00$2.44$0.25$0.20$0.05
2024Detailed filing. Detailed filing data is available for this year.$2.28$0.00$2.28$0.23$0.03$0.20
2023Detailed filing. Detailed filing data is available for this year.$1.93$0.00$1.93$0.25$0.08$0.17
2022Detailed filing. Detailed filing data is available for this year.$1.67$0.00$1.66$0.30$0.14$0.16
2021Detailed filing. Detailed filing data is available for this year.$1.78$0.00$1.78$0.29$0.04$0.25
2020Detailed filing. Detailed filing data is available for this year.$1.19$0.00$1.19$0.19$0.12$0.08
2019Detailed filing. Detailed filing data is available for this year.$1.11$0.00$1.11$1.51$1.43$0.08
2018Detailed filing. Detailed filing data is available for this year.$1.03$0.00$1.03$0.26$0.61$0.35
2017Detailed filing. Detailed filing data is available for this year.$1.34$0.00$1.34$0.35$0.02$0.33
2016Detailed filing. Detailed filing data is available for this year.$0.97$0.00$0.97$0.14$0.10$0.04
2015Detailed filing. Detailed filing data is available for this year.$0.94$0.00$0.94$0.13$0.12$0.01
2014Detailed filing. Detailed filing data is available for this year.$0.93$0.00$0.93$0.10$0.08$0.02
2013Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.91$0.00$0.91$0.09$0.03$0.06
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.85$0.00$0.85$0.02
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.71$0.00$0.71$0.03