GRAND ITASCA CLINIC AND HOSPITAL: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- GRAND ITASCA CLINIC AND HOSPITAL (EIN 41-1865874)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-13
- IRS object ID
- 201121339349303872
- Schema version
- 2009v1.7
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-13T14:28:45-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM McGladrey Inc | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 801 Nicollet Mall Suite 1100 | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411865874 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAND ITASCA CLINIC AND HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GRAN | NameControl |
| Phone | 2183265000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 GOLF COURSE ROAD | AddressLine1 |
| City | GRAND RAPIDS | City |
| State | MN | State |
| ZIP Code | 55744 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SARAH GUSTAFSON | Name |
| Title | director of finance | Title |
| Phone | 2183265000 | Phone |
| Date Signed | 2011-05-05 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Collin F Buzzell | Name |
| Phone | 6125738750 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MICHAEL YOUSO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 GOLF COURSE ROAD | AddressLine1 |
| City | GRAND RAPIDS | City |
| State | MN | State |
| ZIP Code | 55744 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 67698240 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.GRANDITASCA.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1997 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE HEALTH CARE SERVICES INCLUDING A HOSPITAL, HOME HEALTH, AND CLINIC TO THE SURROUNDING COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 656 | TotalNbrEmployees |
| Total Nbr Volunteers | 125 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 66743849 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 66307969 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 714556 | InvestmentIncomePriorYear |
| Investment Income Current Year | 734244 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 872501 | OtherRevenuePriorYear |
| Other Revenue Current Year | 656027 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 68330906 | TotalRevenuePriorYear |
| Total Revenue Current Year | 67698240 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 40394037 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 41392849 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 70455 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 28868098 | OtherExpensePriorYear |
| Other Expenses Current Year | 28365713 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 69262135 | TotalExpensesPriorYear |
| Total Expenses Current Year | 69758562 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -931229 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2060322 | RevenuesLessExpensesCY |
| Total Assets BOY | 92024559 | TotalAssetsBOY |
| Total Assets EOY | 88104369 | TotalAssetsEOY |
| Total Liabilities BOY | 55497617 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 53584148 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 36526942 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 34520221 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDE HEALTH SERVICES INCLUDING A HOSPITAL, HOME HEALTH, AND CLINIC TO THE SURROUNDING COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 58398381 | Expense |
| Revenue | 66963996 | Revenue |
| Description | Grand Itasca Clinic and Hospital is an integrated multi-specialty clinic and acute/surgical hospital. The facility is licensed for 64 beds which are comprised of 14 acute rehab beds, 34 medical beds, 10 intesnive care beds and 6 OB beds. In addition to providing traditional hospital services, the facility has four surgery suites, 24-hour emergency department, outpatient mental health services, outpatient rehabilitation services, and outpatient clinic services. The facility employs approximately 600 people including 41 healthcare providers.The facility served approximately 2600 inpatients and approximately 143,000 outpatient encounters including clinic, emergency room, outpatient imaging and outpatient surgical procedure. Grand Itasca serves the patient regardless of the person's ability to pay. During the year the facility provided $851,556 of charity care, $478,227 discount to the uninsured and absorbed $1,923,378 of unpaid Medicare and Medicaid costs. Grand Itasca Clinic and Hospital also provides other support to the community through cash and in-kind donations that totaled $51,439 iN FY10. In addition, Grand Itasca provided healthcare support services of $45,465 including Ask-A-Nurse and patient transportation. Grand Itasca also paid $1,194,101 in payments for Minnesota Care tax and Medicaid surcharges, which were used to fund care for the indigent and underinsured. | Description |
| Total Program Service Expense | 58398381 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 68 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 656 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SARAH GUSTAFSON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2183265000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 GOLF COURSE ROAD | AddressLine1 |
| City | GRAND RAPIDS | City |
| State | MN | State |
| ZIP Code | 55744 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| Barbara McDonald | |||||||
| Chair | 1.00 | X | X | 0 | 0 | 0 | |
| Peter McDermott | |||||||
| Vice Chair | 1.00 | X | X | 0 | 0 | 0 | |
| Mary Kosak | |||||||
| Secretary | 1.00 | X | X | 0 | 0 | 0 | |
| Shelly Sterre | |||||||
| Treasurer | 1.00 | X | X | 0 | 0 | 0 | |
| Frank Allen | |||||||
| Board of Directors | 1.00 | X | 0 | 0 | 0 | ||
| Mike Ives | |||||||
| BOard of Directors | 1.00 | X | 0 | 0 | 0 | ||
| Darlene Freeman | |||||||
| Board of Directors | 1.00 | X | 0 | 0 | 0 | ||
| Marva Jean Hutchens | |||||||
| Board of Directors | 1.00 | X | 0 | 0 | 0 | ||
| Ron Iannelli | |||||||
| Board of Directors | 1.00 | X | 0 | 0 | 0 | ||
| Colleen Nardone | |||||||
| Board of Directors | 1.00 | X | 0 | 0 | 0 | ||
| Terri Radovich | |||||||
| BOARD of Directors/ER MD | 40.00 | X | 240131 | 0 | 27723 | ||
| Barb Sanderson | |||||||
| Board of Directors | 1.00 | X | 0 | 0 | 0 | ||
| Richard Helvig | |||||||
| BOARD OF DIRECTORS/Fam Practice MD | 40.00 | X | 196178 | 0 | 28438 | ||
| Elizabeth Miskovich | |||||||
| Board of Directors | 1.00 | X | 634 | 0 | 28 | ||
| Charles Kampen | |||||||
| Board of Directors | 1.00 | X | 0 | 0 | 0 | ||
| Jack Carlisle | |||||||
| Chief Medical Officer | 40.00 | X | 222938 | 0 | 29860 | ||
| Steve Feltman | |||||||
| CFO | 40.00 | X | 176984 | 0 | 27347 | ||
| Mike Youso | |||||||
| CEO | 40.00 | X | 0 | 0 | 0 | ||
| Daniel Lister | |||||||
| Orthopedic Surgeon | 40.00 | 680174 | 0 | 31779 | X | ||
| Steven Haugen | |||||||
| Radiologist | 40.00 | 417669 | 0 | 32191 | X | ||
| Tim Gold | |||||||
| Radiologist | 40.00 | 410868 | 0 | 24806 | X | ||
| Roberta Zimmerman | |||||||
| Pathology | 40.00 | 355470 | 0 | 32165 | X | ||
| Dennis Scherer | |||||||
| Family Practice MD | 40.00 | 333906 | 0 | 31806 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3034952 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 266143 | TotalOtherCompensation |
| Number Individuals GT100 K | 54 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| QUEST DIAGNOSTICS | |||||
| PO Box 12989 | CHICAGO | IL | 60693 | Laboratory Services | 422702 |
| NORTHERN COUNTIES SECRETARIAL | |||||
| 6139 157th Lane NW | RAMSEY | MN | 55303 | Coding Services | 353260 |
| SHEILA INGRAM | |||||
| 317 Indian Woods Trail | CYNTHIANA | KY | 41031 | Interim Director Pharmacy | 241151 |
| ALEXANDRIA UROLOGY PA | |||||
| 14589 Oak Hill Road North | SCANDIA | MN | 55073 | Urology Services | 222000 |
| LAKE SUPERIOR LAUNDRY | |||||
| PO Box 488 | SUPERIOR | WI | 54880 | Laundry Services | 204023 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT AND RESIDENT S | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 66307969 | TotalRevenueColumn |
| Related Or Exempt Function Income | 66307969 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 66307969 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 734244 | TotalRevenueColumn |
| Exclusion | $734,244 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | miscellaneous operatin | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 656027 | TotalRevenueColumn |
| Related Or Exempt Function Income | 656027 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 656027 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 67698240 | TotalRevenueColumn |
| Related Or Exempt Function Income | 66963996 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $734,244 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 950260 | Total |
| Program Services | 795510 | ProgramServices |
| Management And General | 153790 | ManagementAndGeneral |
| Fundraising | 960 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32894453 | Total |
| Program Services | 27537592 | ProgramServices |
| Management And General | 5323638 | ManagementAndGeneral |
| Fundraising | 33223 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2304992 | Total |
| Program Services | 1929624 | ProgramServices |
| Management And General | 373040 | ManagementAndGeneral |
| Fundraising | 2328 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2583392 | Total |
| Program Services | 2162687 | ProgramServices |
| Management And General | 418096 | ManagementAndGeneral |
| Fundraising | 2609 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2659752 | Total |
| Program Services | 2226612 | ProgramServices |
| Management And General | 430454 | ManagementAndGeneral |
| Fundraising | 2686 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68287 | Total |
| Program Services | 57166 | ProgramServices |
| Management And General | 11052 | ManagementAndGeneral |
| Fundraising | 69 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 96056 | Total |
| Program Services | 80413 | ProgramServices |
| Management And General | 15546 | ManagementAndGeneral |
| Fundraising | 97 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 429103 | Total |
| Program Services | 359224 | ProgramServices |
| Management And General | 69446 | ManagementAndGeneral |
| Fundraising | 433 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8358001 | Total |
| Program Services | 6996900 | ProgramServices |
| Management And General | 1352659 | ManagementAndGeneral |
| Fundraising | 8442 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 934372 | Total |
| Program Services | 782209 | ProgramServices |
| Management And General | 151219 | ManagementAndGeneral |
| Fundraising | 944 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2023705 | Total |
| Program Services | 1694144 | ProgramServices |
| Management And General | 327517 | ManagementAndGeneral |
| Fundraising | 2044 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 94936 | Total |
| Program Services | 79476 | ProgramServices |
| Management And General | 15364 | ManagementAndGeneral |
| Fundraising | 96 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2205302 | Total |
| Program Services | 1846169 | ProgramServices |
| Management And General | 356906 | ManagementAndGeneral |
| Fundraising | 2227 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4929413 | Total |
| Program Services | 4126658 | ProgramServices |
| Management And General | 797776 | ManagementAndGeneral |
| Fundraising | 4979 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 278739 | Total |
| Program Services | 233346 | ProgramServices |
| Management And General | 45111 | ManagementAndGeneral |
| Fundraising | 282 | Fundraising |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| non phy fee | 2974680 | 2490254 | 481422 | 3004 |
| bad debt | 2642870 | 2212479 | 427722 | 2669 |
| EMPLOYEE RECRUITMENT/ED | 451506 | 377978 | 73072 | 456 |
| LICENSES | 228417 | 191219 | 36967 | 231 |
| FREIGHT | 184910 | 154797 | 29926 | 187 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2465416 | Total |
| Program Services | 2063924 | ProgramServices |
| Management And General | 399003 | ManagementAndGeneral |
| Fundraising | 2489 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69758562 | Total |
| Program Services | 58398381 | ProgramServices |
| Management And General | 11289726 | ManagementAndGeneral |
| Fundraising | 70455 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6666904 | BOY |
| EOY | 2786274 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 73884 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10231327 | BOY |
| EOY | 13148388 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1154633 | BOY |
| EOY | 1052571 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 787294 | BOY |
| EOY | 927846 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 74136847 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 23953010 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53669722 | BOY |
| EOY | 50183837 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19514679 | BOY |
| EOY | 19931569 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 92024559 | BOY |
| EOY | 88104369 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6814565 | BOY |
| EOY | 6217014 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38978165 | BOY |
| EOY | 37412432 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9704887 | BOY |
| EOY | 9954702 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55497617 | BOY |
| EOY | 53584148 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36118931 | BOY |
| EOY | 34212210 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 408011 | BOY |
| EOY | 308011 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36526942 | BOY |
| EOY | 34520221 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 92024559 | BOY |
| EOY | 88104369 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 607331 | OtherCostOrOtherBasis |
| Book Value | 607331 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 44503749 | OtherCostOrOtherBasis |
| Depreciation | 9202838 | Depreciation |
| Book Value | 35300911 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 29025767 | OtherCostOrOtherBasis |
| Depreciation | 14750172 | Depreciation |
| Book Value | 14275595 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 50183837 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DEFERRED FINANCING COSTS | 1301987 |
| ASSETS LIMITED TO USE | 18421571 |
| CHARITABLE REMAINDER TRUST | 208011 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 19931569 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| OTHER ACCRUALS | $385,000 |
| POST RETIREMENT BENEFIT | $7,201,715 |
| SELF INSURED WORKER'S COMP | $445,648 |
| CAPITAL LEASE OBLIGATION | $356,605 |
| CURRENT PORTION OF LONG TERM DEBT | $1,565,734 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 9954702 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part X: | Identifier |
| Return Reference | Description of Uncertain Tax Positions Under FIN 48: | ReturnReference |
| Explanation | EFFECTIVE JULY 1, 2009, THE ORGANIZATION ADOPTED THE PROVISIONS OF ASC 740, INCOME TAXES, RELATED TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES (FIN48). THE ADOPTION OF THE ASC 740 PROVISIONS HAD NO IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 0 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 913443 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 913443 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01360 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4922688 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3477081 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1445607 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02150 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5836131 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3477081 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2359050 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03510 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 82984 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 82984 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2000 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11270 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11270 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 96254 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 96254 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5932385 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3477081 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2455304 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03650 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 45465 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 45465 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 51439 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 51439 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 96904 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 96904 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,236,802 | BadDebtExpenseAmount |
| Amount Attributable To | 309200 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 22834187 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 26396997 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3562810 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAND ITASCA CLINIC AND HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 GOLF COURSE ROAD | AddressLine1 |
| City | GRAND RAPIDS | City |
| State | MN | State |
| ZIP Code | 55744 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Footnote | Part III, Line 4: PATIENT ACCOUNTS RECEIVABLE DUE DIRECTLY FROM THE PATIENT ARE CARRIED AS THE ORIGINAL CHARGE FOR THE SERVICES PROVIDED LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF OUTSTANDING AMOUNTS ON A MONTHLY BASIS. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS, BY USING HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS, AND BY CONSIDERING THE PATIENT'S FINANCIAL HISTORY AND CREDIT HISTORY AND CURRENT ECONOMIC CONDITIONS. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED.The costing method used is to utilize the cost report to capture the cost to charge ratio. We then cost out total bad debt reported as charges to the cost of providing those services. From review of the number of applications denied for insufficient information we estimate 25% of bad debt is related to individuals who would qualify for charity care. | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: The shortfall is the cost of services provided to the medicare population in the community for which we do not recoup any payments from the patients. The costing methodology is to utlize the cost to charge ratio as determined by the cost report for that period. | ShortfallAsCommunityBenefit |
| Needs Assessment | Part VI, Line 2: The healthcare needs of the community are assessed by market analysis, referral tracking and feedback from patients. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: The organization contacts individuals that are self-pay to assist in determining eligibility for federal, state and local governments, as well as under the organizations charity care policy. We also identify patients through conversations during the collection process. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: The community is a diverse community that has a large geographic area. The community has experienced high unemployment rates in the past year. The community has a large population of skilled workers which has been volatile in the recent economic downturn. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: The organization promotes the health of the community by offering various programs focusing on wellness. We also align with larger organizations to offer such programs such as cardiac education. These include classes such as a cooking class from our head chef, smoking cessation classes and various other offerings. We also offer pediatric programs to focus on reading and child development. These are just a few examples of the community activities we offer. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: We support many organizations that focus on promoting the health of the community. | OtherInformation |
| Reports Filed With States | MN | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Terri Radovich | |||||||||||||
| 214636 | 0 | 0 | 0 | 25495 | 0 | 10923 | 0 | 16800 | 0 | 267854 | 0 | 0 | 0 |
| Richard Helvig | |||||||||||||
| 186961 | 0 | 0 | 0 | 9217 | 0 | 9057 | 0 | 19381 | 0 | 224616 | 0 | 0 | 0 |
| Jack Carlisle | |||||||||||||
| 200528 | 0 | 0 | 0 | 22410 | 0 | 10241 | 0 | 19619 | 0 | 252798 | 0 | 0 | 0 |
| Steve Feltman | |||||||||||||
| 164968 | 0 | 0 | 0 | 12016 | 0 | 8195 | 0 | 19152 | 0 | 204331 | 0 | 0 | 0 |
| Daniel Lister | |||||||||||||
| 496242 | 0 | 0 | 0 | 183932 | 0 | 11830 | 0 | 19949 | 0 | 711953 | 0 | 0 | 0 |
| Steven Haugen | |||||||||||||
| 404473 | 0 | 0 | 0 | 13196 | 0 | 11830 | 0 | 20361 | 0 | 449860 | 0 | 0 | 0 |
| Tim Gold | |||||||||||||
| 397672 | 0 | 0 | 0 | 13196 | 0 | 11830 | 0 | 12976 | 0 | 435674 | 0 | 0 | 0 |
| Roberta Zimmerman | |||||||||||||
| 342274 | 0 | 0 | 0 | 13196 | 0 | 11830 | 0 | 20335 | 0 | 387635 | 0 | 0 | 0 |
| Dennis Scherer | |||||||||||||
| 317884 | 0 | 0 | 0 | 16022 | 0 | 11654 | 0 | 20152 | 0 | 365712 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAND RAPIDS STATE BANK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | SHELLY STEERE, TREASURER, IS VP OF THE BANK, WHICH IS GICH'S PRIMARY BANK | Relationship |
| Amount Of Transaction | 270839 | AmountOfTransaction |
| Description Of Transaction | INTEREST PAID FROM CD'S AND CHECKING/SAVINGS ACCOUNTS AT GRAND RAPIDS STATE BANK | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section B, line 11 | FORM 990 IS COMPARED TO LAST YEARS RETURN AND THE CURRENT YEAR AUDIT. FORM 990 IS REVIEWED BY THE CONTROLLER PRIOR TO FILING. A COPY OF FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. |
| Form 990, Part VI, Section B, line 12c | BOARD MEMBERS SIGN THE CONFLICT OF INTEREST POLICY ANNUALLY. |
| Form 990, Part VI, Section B, line 15 | COMPENSATION IS DETERMINED BY ASSESSING THE MARKET THROUGH THE USE OF SURVEYS AND STUDIES AND DETERMINING PAY RATES AND RANGES FROM THE RESULTS OF THE ASSESSMENT. THE CEO COMPENSATION PACKAGE IS SUMMARIZED IN AN EMPLOYMENT AGREEMENT THAT IS APPROVED BY THE BOARD. THE COMPENSATION PACKAGE IS BASED UPON MARKET FOR THE POSITION. |
| Form 990, Part VI, Section C, line 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST. AN ANNUAL REPORT IS ALSO ISSUED AND MAILED TO THE PATIENTS IN THE COMMUNITY. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAND ITASCA FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1601 GOLF COURSE ROAD | AddressLine1 |
| City | GRAND RAPIDS | City |
| State | MN | State |
| ZIP Code | 55744 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411560554 | EIN |
| Primary Activities | FINANCIAL SUPPORT OF GRAND ITASCA CLINIC & HOSPITAL | PrimaryActivities |
| Legal Domicile State | MN | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11(F) | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |