2017-11-15T16:13:26-06:00 2016-12-31 420714325 RSM US LLP 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990 2016-01-01 411560554 GRAND ITASCA FOUNDATION GRAN 2183267763 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 JOE CARGILL CHAIR 2183267763 2017-11-14 1 TODD A JACKSON P00092672 6123324300 108.171.131.187 2017-11-14 13:54:25 CS P 01563F10D6676BDC9B96404AA3206AA292B808E6 5AB5DFEC54AF030231DDAA57F2AFD57D98013E0B 2016 2017-02-10 21:41:12Z JOE CARGILL 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 745609 0 X N/A X 1986 MN TO BUILD PHILANTHROPIC PARTNERSHIPS TO SUPPORT THE MISSION OF GRAND ITASCA CLINIC & HOSPITAL. 16 14 0 102 0 0 132035 680623 0 0 10151 5665 -2989 12431 139197 698719 95004 174387 0 0 0 0 0 0 945 11720 48379 106724 222766 32473 475953 478599 943038 21988 22164 456611 920874 TO BUILD PHILANTHROPIC PARTNERSHIPS TO SUPPORT THE MISSION OF GRAND ITASCA CLINIC & HOSPITAL. 0 0 174387 174387 GRAND ITASCA FOUNDATION ENHANCES AND HELPS TO GUARANTEE THE DELIVERY OF QUALITY MEDICAL SERVICES THROUGH EDUCATION, MANAGEMENT OR CHARITABLE CONTRIBUTIONS AND PROVIDES FINANCIAL SUPPORT TO GRAND ITASCA CLINIC & HOSPITAL. IN 2016 GRAND ITASCA FOUNDATION AWARDED $174,387 IN GRANT FUNDING TO ORGANIZATIONS AND INDIVIDUALS. THIS INCLUDES $108,700 TO GRAND ITASCA CLINIC AND HOSPITAL FOR PATIENT FOCUSED PROJECTS, SIX INDIVIDUAL SCHOLARSHIP AWARDS TOTALING $15,500, AND CARE TO SHARE GRANTS TO 13 RECIPEINTS FOR A TOTAL OF $6,500. 174387 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 16 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X TODD CHRISTENSEN 2189991702 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 JOE CARGILL CHAIR 1.00 X X 0 0 0 STEVE WRIGHT SECRETARY 1.00 X X 0 0 0 ANDY SHERMOEN TREASURER 1.00 X X 0 0 0 PATRICIA CARLIN-JANSSEN MD DIRECTOR 1.00 40.00 X 0 274252 40239 CHARITY BRANSTAD RN DIRECTOR 1.00 40.00 X 0 80088 4789 AMBER BURGGRAF DIRECTOR 1.00 X 0 0 0 CRICKET GUYER DIRECTOR 1.00 X 0 0 0 CORY JACKSON DIRECTOR 1.00 X 0 0 0 RON JOHNSON DIRECTOR 1.00 X 0 0 0 DONNA KELLY DIRECTOR 1.00 X 0 0 0 TARA MAKINEN DIRECTOR 1.00 0.00 X 0 0 0 SUE MATTSON DIRECTOR 1.00 X 0 0 0 ISAAC MEYER DIRECTOR 1.00 X 0 0 0 DIANE WEBER DIRECTOR 1.00 X 0 0 0 MARY KOSAK DIRECTOR 1.00 X 0 0 0 AMANDA OKECH DIRECTOR 1.00 X 0 0 0 KELLY KIRWIN FOUNDATION DIRECTOR 40.00 X 0 80205 5273 0 434545 50301 0 0 1 0 0 52719 627904 680623 5665 5665 59321 52719 46890 12431 12431 698719 0 0 18096 X 152387 152387 22000 22000 33807 33807 1260 1260 8965 8965 ADMIN FEES 2030 2030 DONOR WALL 1372 1372 FUNDRAISING PROJECTS 945 945 222766 174387 47434 945 259679 156983 210236 777370 8684 8685 478599 943038 21988 22164 21988 22164 X 254995 152123 179644 746779 21972 21972 456611 920874 478599 943038 X 475953 -11690 X 0 1 X 1 0 X X 1 GRAND ITASCA CLINIC AND HOSPITAL 411865874 3 1 108700 0 1 108700 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 X PART X, LINE 2: THE CORPORATION AND THE FOUNDATION HAVE REVIEWED THEIR TAX POSITIONS FOR ALL OPEN YEARS AND HAVE CONCLUDED THAT NO MATERIAL LIABILITIES EXIST AS OF DECEMBER 31, 2016 AND 2015. GENERALLY, THE CORPORATION AND THE FOUNDATION ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS PRIOR TO THE FISCAL YEAR ENDED DECEMBER 31, 2013. CARING FOR KIDS GOLF TOURNAMENT 72077 41254 30823 0 9099 7475 2043 GIFO GOLF TOURNAMENT 39963 11465 28498 21883 3890 2500 112040 52719 59321 21883 12989 9975 2043 46890 12431 1 GRAND ITASCA CLINIC & HOSPITAL 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 411865874 501(C)3 108700 PROGRAM SUPPORT GRAND RAPIDS AREA COMMUNITY FOUNDATION 350 NW 1ST AVENUE SUITE E GRAND RAPIDS MN 55744 411761590 501(C)3 10000 PROGRAM SUPPORT 2 SCHOLARSHIPS 7 15500 CARE TO SHARE 13 6500 PART I, LINE 2: 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. 0 0 0 0 0 0 0 0 0 PATRICIA CARLIN-JANSSEN MD DIRECTOR 0 274252 0 0 0 0 0 15829 0 26385 0 316466 0 0 PART I, LINE 3 ALL COMPENSATION IS PAID BY GRAND ITASCA CLINIC & HOSPITAL (GICH), A RELATED ORGANIZATION. GICH USES THE FOLLWOING METHOD TO ESTABLISH COMPENSATION: - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL OF THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 6 GRAND ITASCA CLINIC & HOSPITAL, A MINNESOTA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF GRAND ITASCA FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A GRAND 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, SECTION A, LINE 7B VARIOUS 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, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS AND THE FOUNDATION DIRECTOR PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICIES ARE REVIEWED ANNUALLY. CONFLICT OF INTEREST FORMS ARE SIGNED ANNUALLY BY ALL BOARD MEMBERS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL 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 BANK FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 129. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 129. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 33,678. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,678. FORM 990, PART XI, LINE 9: NET GOLF EVENT INCOME NOT INCLUDED IN FINANCIALS -11,690. FORM 990, PART VI, SECTION B, LINE 15: CURRENTLY THE FOUNDATION DOES NOT DIRECTLY EMPLOY ANYONE. ALL COMPENSATION IS PAID BY GRAND ITASCA CLINIC AND HOSPITAL, A RELATED ORGANIZATION. GRAND ITASCA CLINIC AND HOSPITAL 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 411865874 HOSPITAL MN 501(C)(3) LINE 3 N/A 0 CDI GRAND RAPIDS LLC 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 453783014 PROVIDE IN-HOUSE MRI AND DTI SERVICES MN GRAND ITASCA CLINIC & HOSPITAL RELATED 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0