2016-11-15T15:44:36-06:00 2015-12-31 420714325 RSM US LLP 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990 2015-01-01 411560554 GRAND ITASCA FOUNDATION GRAN 2183267763 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 DALE ADAMS CHAIR 2183267763 2016-11-03 1 TODD A JACKSON P00092672 6123324300 2015 2017-02-10 21:41:12Z DALE ADAMS 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 190491 0 X N/A X 1986 MN TO BUILD PHILANTHROPIC PARTNERSHIPS TO SUPPORT THE MISSION OF GRAND ITASCA CLINIC & HOSPITAL. 17 15 0 97 0 0 53708 132035 0 0 64616 10151 0 -2989 118324 139197 87393 95004 0 0 0 0 0 0 556 7895 11720 95288 106724 23036 32473 487762 478599 23813 21988 463949 456611 TO BUILD PHILANTHROPIC PARTNERSHIPS TO SUPPORT THE MISSION OF GRAND ITASCA CLINIC & HOSPITAL. 0 0 95467 95004 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 2015 GRAND ITASCA FOUNDATION AWARDED $95,000 IN GRANT FUNDING TO ORGANIZATIONS AND INDIVIDUALS. THIS INCLUDES $51,434 TO GRAND ITASCA CLINIC AND HOSPITAL FOR PATIENT FOCUSED PROJECTS, SIX INDIVIDUAL SCHOLARSHIP AWARDS TOTALING $15,000, AND $5,000 TO SCHOLARSHIP FUND. 95467 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 17 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X COREY SMITH 2189991702 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 DALE ADAMS CHAIR 1.00 X X 0 0 0 JOE CARGILL VICE 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 284252 49300 CHARITY BRANSTAD DIRECTOR 1.00 40.00 X 0 81651 4823 AMBER BURGGRAF DIRECTOR 1.00 X 0 0 0 CHRIS DEADRICK DIRECTOR 1.00 X 0 0 0 MANDY DICK 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 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 KELLY KIRWIN FOUNDATION DIRECTOR 40.00 X 0 81214 5328 0 447117 59451 0 0 1 0 0 42101 89934 132035 12234 12234 5000 7083 -2083 -2083 -2083 41222 42101 44211 -2989 -2989 139197 0 0 7162 75004 75004 20000 20000 9329 9329 336 336 463 463 26 26 SUPPLIES 1010 1010 FUNDRAISING PROJECTS 556 556 106724 95467 10701 556 306429 259679 172595 210236 8738 8684 487762 478599 23813 21988 23813 21988 X 204823 254995 237154 179644 21972 21972 463949 456611 487762 478599 X 32473 95654 -135465 X 0 1 X 1 0 X X 1 GRAND ITASCA CLINIC AND HOSPITAL 411865874 3 1 51434 0 1 51434 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, 2015 AND 2014. 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, 2012. GIFO GOLF TOURNAMENT 44565 13983 30582 23497 4190 2675 1394 CARING FOR KIDS GOLF TOURNAMENT 38758 28118 10640 3982 6325 2148 83323 42101 41222 23497 8172 9000 3542 44211 -2989 1 GRAND ITASCA CLINIC & HOSPITAL 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 411865874 501(C)3 51434 PROGRAM SUPPORT 1 SCHOLARSHIPS 6 15000 CARE TO SHARE 10 5000 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 284252 0 0 0 0 0 15847 0 34952 0 335051 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 AND HOSPITAL, A MINNESOTA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF GRAND ITASCA FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A GRAND ITASCA CLINIC AND 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 OF GRAND ITASCA CLINIC AND HOSPITAL, THE ONE VOTING MEMBER OF GRAND ITASCA FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11 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 XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS USED FOR PROPERTY AND EQUIPMENT -122,656. NET GOLF EVENT INCOME NOT INCLUDED IN FINANCIALS -12,809. 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