STRATEGY STUDIO / PUBLIC DATA EXPLORER

GRAND ITASCA FOUNDATION: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
GRAND ITASCA FOUNDATION (EIN 41-1560554)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-10-26
IRS object ID
202312999349301901
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-10-26T18:30:29+00:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411560554EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Grand Itasca FoundationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGRANBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11601 Golf Course RoadAddressLine1Txt
CityGrand RapidsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55744ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJean MacDonellPersonNm
Person TitlePresident & CEOPersonTitleTxt
Signature2023-10-26SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJeanPersonFirstNm
Person LastMacDonellPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Jean MacDonellBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11601 Golf Course RoadAddressLine1Txt
CityGrand RapidsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55744ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$276,816GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttps://www.granditasca.org/FoundationWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1986FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTo build philanthropic partnerships to support the mission of Grand Itasca Clinic and Hospital.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$426,358PYContributionsGrantsAmt
CY Contributions Grants$213,712CYContributionsGrantsAmt
CY Program Service Revenue$1,793CYProgramServiceRevenueAmt
PY Investment Income$1,693PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$107,255PYOtherRevenueAmt
CY Other Revenue$21,856CYOtherRevenueAmt
PY Total Revenue$535,306PYTotalRevenueAmt
CY Total Revenue$237,361CYTotalRevenueAmt
PY Grants And Similar Paid$105,678PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$196,815CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$11,985PYOtherExpensesAmt
CY Other Expenses$37,393CYOtherExpensesAmt
PY Total Expenses$117,663PYTotalExpensesAmt
CY Total Expenses$234,208CYTotalExpensesAmt
PY Revenues Less Expenses$417,643PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,153CYRevenuesLessExpensesAmt
Total Assets BOY$1,726,764TotalAssetsBOYAmt
Total Assets EOY$1,724,500TotalAssetsEOYAmt
Total Liabilities BOY$262,457TotalLiabilitiesBOYAmt
Total Liabilities EOY$262,140TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,464,307NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,462,360NetAssetsOrFundBalancesEOYAmt
MissionTo build philanthropic partnerships to support the mission of Grand Itasca Clinic and Hospital.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$234,208ExpenseAmt
Grant$196,815GrantAmt
DescGrand Itasca Foundation enhances and helps to guarantee the delivery of contributions and provide financial support to Grand Itasca Clinic and Hospital. In 2022 Grand Itasca Foundation awarded $196,123 in total grant funding to organizations and individuals. This includes $172,793 to Grand Itasca Clinic and Hospital for patient focused projects, six individual scholarship awards totaling $12,500 and care to share grants to 22 recipients for a total of $10,830.Desc
Total Program Service Expenses$234,208TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Todd ChristensenBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2189991702PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11601 Golf Course RoadAddressLine1Txt
CityGrand RapidsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55744ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Elizabeth Miskovich
Co-Chair1.00.0Yes (X)Yes (X)$0$0$0
Rose Villenueve
Co-Chair1.00.0Yes (X)Yes (X)$0$125,671$36,558
Amber Burggraf
Secretary1.00.0Yes (X)$0$0$0
Charity Branstad RN
Director1.00.0Yes (X)$0$92,436$5,582
Cory Jackson
Vice Chair, end 12-31-221.00.0Yes (X)$0$0$0
Dale Adams
Director1.01.0Yes (X)$0$0$0
Joe Cargill
Chair, ended 12-31-221.00.0Yes (X)$0$0$0
Katie Troumbly
Director1.040.0Yes (X)$0$124,853$9,500
Kirk Gilbertson
Director1.00.0Yes (X)$0$0$0
Kristi Kane
Director1.00.0Yes (X)$0$0$0
Mike Aultman
Director, New 20221.00.0Yes (X)$0$0$0
Nick Rothstein
Treasurer1.01.0Yes (X)$0$0$0
Scott Gerling
Director1.00.0Yes (X)$0$0$0
Spencer Buchert
Director1.00.0Yes (X)$0$0$0
Sue Mattson
Director1.00.0Yes (X)$0$0$0
Brianne Wagner
Foundation Director40.00.0Yes (X)$0$116,243$37,835
James Hereford
Officer1.040.0Yes (X)$0$3,370,758$116,860
Jean MacDonell
Officer1.040.0Yes (X)$0$515,552$71,098
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,345,513TotReportableCompRltdOrgAmt
Total Other Compensation$277,433TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$86,988FundraisingAmt
All Other Contributions$126,724AllOtherContributionsAmt
Total Contributions$213,712TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,793TotalRevenueColumnAmt
Exclusion$1,793ExclusionAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,793TotalProgramServiceRevenueAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$61,311FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$86,988ContriRptFundraisingEventAmt
Fundraising Direct Expenses$39,455FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,856TotalRevenueColumnAmt
Exclusion$21,856ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$237,361TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$23,649ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$126,385TotalAmt
Program Services$126,385ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$70,430TotalAmt
Program Services$70,430ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$33,707TotalAmt
Program Services$33,707ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,686TotalAmt
Program Services$3,686ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc
Subscription fees
Printing
Bank Fees
Miscellaneous

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$234,208TotalAmt
Program Services$234,208ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,440,678BOYAmt
EOY$1,401,609EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,205BOYAmt
EOY$1,863EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$283,881BOYAmt
EOY$321,028EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,726,764BOYAmt
EOY$1,724,500EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$571BOYAmt
EOY$228EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$261,886BOYAmt
EOY$261,912EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$262,457BOYAmt
EOY$262,140EOYAmt

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$152,958BOYAmt
EOY-$270,574EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,617,265BOYAmt
EOY$1,732,934EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,464,307BOYAmt
EOY$1,462,360EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,726,764BOYAmt
EOY$1,724,500EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,153ReconcilationRevenueExpnssAmt
Prior Period Adjustments-$5,100PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Grand Itasca Clinic and HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN411865874EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$126,385SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$126,385SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescAssets limited as to use - restricted fund investmentDesc
Book Value$321,028BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$321,028TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescIntercompany PayableDesc
Amt$261,912Amt
FieldValueIRS element (for citing)
Total Liability$261,912TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationGrand Itasca Foundation as part of Fairview recognizes all tax positions, including those positions in a previously filed tax return or a position expected to be taken in a future tax filing that is reflected in measuring current or deferred income tax assets and liabilities, when it is more likely than not (likelihood of greater than 50%) that, based on technical merits, the position will be sustained upon examination. There are $8,400,000 and $14,540,000 uncertain tax positions recorded on the consolidated balance sheets as of December 31, 2022 and 2021, respectively. Fairview has made reasonable estimates of the provision for income taxes and on existing deferred tax balances based on accounting guidance included in ASC 740, Income Taxes. Fairview does not expect that there will be a significant change in the total amount of unrecognized tax benefits within the next 12 months.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Caring Fore Kids Golf TournamentEvent1Nm
Gross Receipts Event1$148,299GrossReceiptsEvent1Amt
Charitable Contri Event1$86,988CharitableContriEvent1Amt
Gross Revenue Event1$61,311GrossRevenueEvent1Amt
Cash Prizes Event1$3,500CashPrizesEvent1Amt
Non Cash Prizes Event1$5,876NonCashPrizesEvent1Amt
Rent Facility Costs Event1$11,089RentFacilityCostsEvent1Amt
Food And Beverage Event1$14,510FoodAndBeverageEvent1Amt
Entertainment Event1$400EntertainmentEvent1Amt
Other Direct Expenses Event1$4,080OtherDirectExpensesEvent1Amt
Gross Revenue Event2$0GrossRevenueEvent2Amt
Gross Revenue Other Events$0GrossRevenueOtherEventsAmt
Gross Receipts Total$148,299GrossReceiptsTotalAmt
Charitable Contributions Tot$86,988CharitableContributionsTotAmt
Gross Revenue Total Events$61,311GrossRevenueTotalEventsAmt
Cash Prizes Total Events$3,500CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$5,876NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$11,089RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$14,510FoodAndBeverageTotalEventsAmt
Entertainment Total Events$400EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$4,080OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$39,455DirectExpenseSummaryEventsAmt
Net Income Summary$21,856NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Grand Itasca Clinic and HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11601 Golf Course RoadAddressLine1Txt
CityGrand RapidsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55744ZIPCd
FieldValueIRS element (for citing)
Recipient EIN411865874RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$126,385CashGrantAmt
Purpose Of GrantTO SUPPORT THE PROGRAM SERVICES OF THE HOSPITALPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (7 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
Scholarships6$12,500
Care to Share Grants22$10,830
Employee Giving Fund27$13,340
Employee Recognition108$8,717
Close to Home Infusion/Cancer Patients53$1,651
Caring Fore Kids - Pediatric Patients511$11,585
Patient and Visitor Experience257$11,807

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule I, Part I, Line 2 Procedures for Monitoring the Use of Grant FundsAll grant requests are approved or denied by the Foundation board prior to approval and/or payment and must be in line with the Foundation's mission of helping to support the internal needs of Grand Itasca Clinic & Hospital, promoting a healthy community, and raising awareness of the impact and value of Grand Itasca Clinic & Hospital. Scholarship funds are sent directly to the school on behalf of the recipient. If a student has any changes (transfers, etc.) we receive funds back for unused dollars, but the Foundation does not follow-up with students/recipients specifically about their scholarship funds.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.All grant requests are approved or denied by the Foundation board prior to approval and/or payment and must be in line with the Foundation's mission of helping to support the internal needs of Grand Itasca Clinic & Hospital, promoting a healthy community, and raising awareness of the impact and value of Grand Itasca Clinic & Hospital. Scholarship funds are sent directly to the school on behalf of the recipient. If a student has any changes (transfers, etc.) we receive funds back for unused dollars, but the Foundation does not follow-up with students/recipients specifically about their scholarship funds.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Rose Villenueve
Co-Chair$0$110,201$0$15,367$0$103$0$7,809$0$28,749$0$162,229$0$0
James Hereford
Officer$0$1,753,793$0$1,399,311$0$217,654$0$100,535$0$16,325$0$3,487,618$0$208,150
Jean MacDonell
Officer$0$372,868$0$142,100$0$584$0$69,797$0$1,302$0$586,650$0$0
Brianne Wagner
Foundation Director$0$104,654$0$9,175$0$2,414$0$7,474$0$30,361$0$154,078$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planTHE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD, JEAN MACDONELL, DUE TO A VESTING EVENT, THE FOLLOWING INDIVIDUALS HAD INCOME IN PART VII AND SCHEDULE J RELATED TO A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD $208,150
Schedule J, Part I, Line 7 Non-fixed paymentsFairview Health Services provides lump sum financial awards based on system-wide, business unit and/or departments financial and quality measures. Annual goals, specifically tied to productivity and quality indicators, are set for the year and an incentive paid out annually if key goals and measures are achieved.
Schedule J, Part I, Line 3 Related Org to establish compensationTHE ORGANIZATION IS PART OF THE FAIRVIEW HEALTH SERVICES SYSTEM AND FAIRVIEW HEALTH SERVICES HUMAN RESOURCES USES COMPARABLES TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR ACCORDING TO MARKET STANDARDS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 6 Classes of members or stockholdersGrand Itasca Clinic & Hospital, a Minnesota nonprofit corporation, is the sole member of Grand Itasca Foundation.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyGrand Itasca Clinic & Hospital, as the only voting member of Grand Itasca Foundation, has the authority to elect and remove the directors of Grand Itasca Foundation with or without cause, at any time.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersVarious powers, as stated in Section 4.4 of Grand Itasca Foundation's bylaws, are reserved for Grand Itasca Clinic & Hospital, the one voting member of Grand Itasca Foundation
Form 990, Part VI, Line 11b Review of form 990 by governing bodyForm 990 is reviewed by the Board of Directors and the Foundation director prior to filing with the IRS.
Form 990, Part VI, Line 12c Conflict of interest policyConflict of Interest policies are reviewed annually. Conflict of Interest forms are signed annually by all board members.
Form 990, Part VI, Line 19 Required documents available to the publicFinancial statements, conflict of interest policy and governing documents are available upon request for the same period of disclosure as set forth in Section 6104(D).
Form 990, Part IX, Line 11g Other FeesConsulting Services - Total Expense: 21106, Program Service Expense: 21106, Management and General Expenses: , Fundraising Expenses: ; Software Subscription Services - Total Expense: 12575, Program Service Expense: 12575, Management and General Expenses: , Fundraising Expenses: ; Standard Services - External Vendors - Total Expense: 26, Program Service Expense: 26, Management and General Expenses: , Fundraising Expenses: ;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Grand Itasca Clinic and Hospital
1601 Golf Course RoadGrand RapidsMN55744411865874HospitalMN501(c)(3)3Fairview Health Servicesfalse
Fairview Health Services
2450 Riverside AvenueMinneapolisMN55454410991680HospitalMN501(c)(3)3NAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CDI Grand Rapids LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11601 Golf Course RoadAddressLine1Txt
CityGrand RapidsCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55744ZIPCd
FieldValueIRS element (for citing)
EIN453783014EIN
Primary ActivitiesMRI-DTIPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Grand Itasca Clinic and HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeTypeTxt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd