2011-11-11T09:25:02-06:00 2010-12-31 ERNST & YOUNG US LLP 178 SOUTH RIO GRANDE ST SUITE 400 SALT LAKE CITY UT 84101 990 2010-01-01 870453633 PRIMARY CHILDREN'S MEDICAL CENTER FOUNDATION PRIM 8016626279 100 NORTH MARIO CAPECCHI DRIVE SALT LAKE CITY UT 84113 DOUGLAS E NIELSEN 2011-11-11 8013503300 2010 2016-03-07 17:11:31Z DOUGLAS E NIELSEN 100 NORTH MARIO CAPECCHI DRIVE SLC UT 84113 90947687 false X N/A X 1989 UT SOLICIT CHARITABLE SUPPORT FOR THE SUPPORT OF PRIMARY CHILDREN'S MEDICAL CENTER OF IHC HEALTH SERVICES, INC. IN THE AREAS OF CHARITY CARE, PEDIATRIC MEDICAL RESEARCH, CHILD ADVOCACY AND EDUCATION. 15 14 0 2780 0 0 13148536 17233287 0 0 -3680055 3072889 480011 486837 9948492 20793013 8824733 6944186 0 0 0 0 301561 0 237090 896111 1245060 10022405 8189246 -73913 12603767 62324225 81478238 1767233 2314809 60556992 79163429 SOLICIT CHARITABLE SUPPORT FOR THE SUPPORT OF PRIMARY CHILDREN'S MEDICAL CENTER OF IHC HEALTH SERVICES, INC. IN THE AREAS OF CHARITY CARE, PEDIATRIC MEDICAL RESEARCH, CHILD ADVOCACY AND EDUCATION. false false 7018726 6944186 0 SUPPORTED CHARITABLE ACTIVITIES OF IHC HEALTH SERVICES, INC., INCLUDING PROVISION OF CHARITY MEDICAL CARE, PEDIATRIC MEDICAL RESEARCH, CHILD ADVOCACY, AND EDUCATION. 7018726 true true false false false false false false true false false false false true true true false false false false true false false true false false true true true false false false false false false false false true false false false false true false false false false true 7 0 true 0 false false false false false true true false false false false false X 15 14 true false false false false false false true true false false true true true true true true false false false X JEREMIA RADANDT 8016626279 100 NORTH MARIO CAPECCHI DRIVE SLC UT 84113 X ARLEN B CROUCH 2.0 X 0 0 0 BRUCE T REESE 2.0 X 0 1170 0 DALE G JOHNSON MD 2.0 X 0 0 0 DOUGLAS E NIELSEN 40.0 X X 0 189310 83986 DWAN J YOUNG 2.0 X 0 0 0 EJ JAKE GARN 4.0 X X 0 0 0 EDWARD B CLARK MD 2.0 X 0 0 0 EDWARD B MORETON 4.0 X X 0 0 0 FRED W FAIRCLOUGH JR 2.0 X 0 0 0 KATHLEEN GARN 4.0 X X 0 0 0 KENNETH MACEY 2.0 X 0 0 0 MARK PURCELL 2.0 X 0 0 0 MELANIE BASTIAN 2.0 X 0 0 0 PATRICK CARTWRIGHT MD 2.0 X 0 0 0 SHERI DEW 2.0 X 0 0 0 SPENCER F ECCLES 4.0 X X 0 390 0 0 190870 83986 0 false true false WELLS FARGO 299 SOUTH MAIN 5TH FLOOR SALT LAKE CITY UT 84111 INVESTMENT MGT 274627 MERRICK FUNDRAISING 10 E PIER SAUSALITO CA 94965 CONSULTING 203361 2 1975768 792058 1614778 158091 12692592 991996 17233287 0 1233292 1233292 0 0 71327697 69488100 1839597 1839597 1839597 1153411 792058 666574 486837 486837 0 0 0 20793013 0 0 3559726 6885210 6885210 8976 8976 50000 50000 0 0 0 0 0 0 0 208345 208345 3799 3799 23984 23984 0 0 287576 287576 0 0 41200 41200 19721 19721 0 0 6899 6899 0 0 0 0 0 30000 30000 PURCHASED SERVICES 508712 307183 201529 BANK FEES 28717 28717 ADVOCACY COMM SAFETY ISSES 74540 74540 MISCELLANEOUS 11567 6006 5561 8189246 7018726 933430 237090 191339 1565978 4981662 5213182 4667048 5035883 128903 18844 49713911 66178787 2641362 3465564 62324225 81478238 675756 1255954 1091477 1058855 1767233 2314809 X 39782241 55380573 13282568 14791650 7492183 8991206 60556992 79163429 62324225 81478238 X 12603767 6002670 X false true false X false X X X false false false IHC HEALTH SERVICES INC DBA PRIMARY CHILDREN'S MED CENTER 942854057 03 true true true 4940162 1 4940162 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20774751 7358870 981162 5331927 23782856 20596934 5516541 1667705 7006429 20774751 25639343 4405269 -2299311 7148367 20596934 0.00000 0.37805 0.62195 false false 0 ANNUITIES PAYABLE 294575 DUE TO AFFILIATE 764280 1058855 20793013 8189246 12603767 5752902 249767 6002669 18606436 27984442 5752902 1007406 249767 7010075 20974367 -181354 -181354 20793013 9378006 1007406 181354 1188760 8189246 8189246 INTENDED USE OF ENDOWMENT FUNDS FORM 990, SCHEDULE D, PART V, LINE 4 THE ENDOWMENT FUNDS OF PRIMARY CHILDREN'S MEDICAL CENTER FOUNDATION INCLUDE BOTH TERM AND PERMANENT FUNDS. THE INTENDED USE OF THESE FUNDS INCLUDE RESEARCH, CHARITY CARE, PATIENT CARE AND OTHER PROJECTS TO BE DETERMINED BY THE BOARD OF TRUSTEES. FASB ASC TOPIC 740 (FIN 48) FORM 990, SCHEDULE D, PART X, LINE 2 OTHER CHANGES IN NET ASSETS FORM 990, SCHEDULE D, PART XI, LINE 8 $249,767 - NET CHANGE IN VALUATION OF CONTRIBUTIONS RECEIVABLE AND BENEFICIAL INTEREST IN PERPETUAL TRUSTS RECONCILIATION OF AUDITED REVENUE TO FORM 990 FORM 990, SCHEDULE D, PART XII, LINE 2D $249,767 - NET CHANGE IN VALUATION OF CONTRIBUTIONS RECEIVABLE AND BENEFICIAL INTEREST IN PERPETUAL TRUSTS REPORTED AS REVENUE IN AUDITED FINANCIAL STATEMENTS. RECONCILIATION OF AUDITED REVENUE TO FORM 990 FORM 990, SCHEDULE D, PART XII, LINE 4B $485,220 - SPECIAL EVENT REVENUE NETTED AGAINST EXPENSES ON AUDITED FINANCIAL STATEMENTS. $(666,574) - SPECIAL EVENT EXPENSES SHOWN AS EXPENSES ON AUDITED FINANCIAL STATEMENTS, AND SHOWN AS COMPONENT OF NET INCOME FROM FUNDRAISING EVENTS ON FORM 990. RECONCILIATION OF AUDITED EXPENSES TO FORM 990 FORM 990, SCHEDULE D. PART XIII, LINE 2D ($485,220) - SPECIAL EVENT REVENUE NETTED AGAINST EXPENSES ON AUDITED FINANCIAL STATEMENTS. $666,574 - SPECIAL EVENT EXPENSES SHOWN AS EXPENSES ON AUDITED FINANCIAL STATEMENTS, AND SHOWN AS COMPONENT OF INCOME FROM FUNDRAISING EVENTS ON FORM 990. true North America HYDROCEPHALUS RESEARCH 50000 CHECK 1 0 false false false false false false MONITORING USE OF GRANT FUNDS FORM 990, SCHEDULE F, PART I, LINE 2 THE FOUNDATION MAKES GRANTS FOR RESEARCH AND OTHER PURPOSES. RESEARCH GRANTS ARE REVIEWED BY A RESEARCH COMMITTEE OF THE BOARD, WHICH MAKES A RECOMMENDATION TO THE FULL BOARD, WHO GIVES FINAL APPROVAL. FOLLOW-UP REPORTS ARE REQUIRED, INCLUDING REGULAR PROGRESS REPORTS CONCERNING THE RESEARCH ACTIVITY. FESTIVAL TREES 1945469 792058 1153411 138144 528430 0 1945469 792058 1153411 138144 528430 666574 486837 true UNIVERSITY OF UTAH - DEPT OF PEDIATRICS PO BOX 581374 SALT LAKE CITY UT 84158 876000525 GOV 1818761 MEDICAL RESEARCH IHC HEALTH SERVICES - DBA PCMC 100 N MARIO CAPECCHI DR SLC UT 84 SALT LAKE CITY UT 84113 942854057 501(C)(3) 4914351 25811 FMV EQUIPMENT, THERAPY CHARITY CARE, EQUIPMENT ALABAMA CHILDREN'S HOSPITAL 1600 7TH AVE S BIRMINGHAM AL 35233 630879471 501(c)(3) 70000 HYDROCEPHALUS RESEARCH TEXAS CHILDREN'S HOSPITAL PO BOX 840982 DALLAS TX 75284 741100555 501(C)(3) 25000 HYDROCEPHALUS RESEARCH RESEARCH FOUNDATION OF SUNY STATE UNV OF NY New York City STONEY BROOK NY 11794 141368361 GOV 29219 HYDROCEPHALUS RESEARCH 5 0 MEDICAL FEES ASSISTANCE 40 8976 MONITORING USE OF GRANT FUNDS FORM 990, SCHEDULE I, PART I, LINE 2 THE FOUNDATION MAKES GRANTS FOR RESEARCH AND OTHER PURPOSES. RESEARCH GRANTS ARE REVIEWED BY A RESEARCH COMMITTEE OF THE BOARD, WHICH MAKES A RECOMMENDATION TO THE FULL BOARD, WHO GIVES FINAL APPROVAL. FOLLOW-UP REPORTS ARE REQUIRED, INCLUDING REGULAR PROGRESS REPORTS CONCERNING THE RESEARCH ACTIVITY. OTHER GRANT REQUESTS ARE REVIEWED BY FOUNDATION MANAGEMENT AND APPROVED BY EITHER THE EXECUTIVE DIRECTOR (UP TO $50,000) OR THE BOARD (GRANTS IN EXCESS OF $50,000). false true false false false false false false false DOUGLAS E NIELSEN 0 138381 0 33786 0 17143 0 69601 0 14385 0 273296 0 33786 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FORM 990, SCHEDULE J, PART I, LINE 4B IHC HEALTH SERVICES, INC., A RELATED ORGANIZATION, OFFERS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO MEMBERS OF ITS CENTRAL OPERATING GROUP. THE AMOUNTS IN THE PLAN ARE NOT VESTED, ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE, AND MAY OR MAY NOT BE PAID IN THE FUTURE. AMOUNTS DEFERRED DURING 2010 FOR THE INDIVIDUAL REPORTED ON PART VII OF THE FORM 990 HAVE BEEN INCLUDED IN THE SCHEDULE J, PART II, COLUMN (C) TOTAL. X 3 86775 FAIR MARKET VALUE X 1 420000 FAIR MARKET VALUE X AUCTION ITEMS 1328 485221 FMV 0 false true true NUMBER OF NON-CASH CONTRIBUTIONS FORM 990, SCHEDULE M, PART I, COLUMN (b) and LINE 32a NON-CASH CONTRIBUTIONS RECORDED ON LINE 9 (SECURITIES) REPRESENTS THE NUMBER OF INDIVIDUAL CONTRIBUTORS. SECURITIES WERE HELD AND SOLD BY INVESTMENT MANAGEMENT COMPANIES FOR THE FOUNDATION. Family Relationship Form 990, Part VI, Section A, Line 2 E.J. "Jake" Garn / Kathleen Garn - Family Relationship FORM 990 REVIEW BY BOARD MEMBERS FORM 990, PART VI, SECTION A, LINE 11 THE COMPLETE FORM 990 WAS REVIEWED IN DETAIL BY THE FINANCE COMMITTEE OF THE FOUNDATION'S GOVERNING BODY. THE COMPLETE FORM 990 WAS ALSO PROVIDED TO THE ENTIRE GOVERNING BODY FOR REVIEW IN THE REGULARLY SCHEDULED MEETING IN EARLY NOVEMBER PRIOR TO FILING. MONITORING AND ENFORCEMENT OF CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12 EACH OFFICER, DIRECTOR, TRUSTEE, AND KEY EMPLOYEE IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. THE COMPLETED QUESTIONNAIRES AER COLLECTED AND REVIEWED BY THE FOUNDATION'S EXECUTIVE DIRECTOR. ANY POTENTIAL CONFLICTS ARE REVIEWED WITH APPROPRIATE PERSONNEL, WHICH MAY INCLUDE COMPLIANCE AND LEGAL PERSONNEL OF IHC HEALTH SERVICES, INC. IF AN INDIVIDUAL DISCLOSES A SITUATION THAT POSES A CONFLICT OF INTEREST, THE PRESIDENT DETERMINES IF THE SITUATION CAN BE MANAGED (SUCH AS BY RECUSAL IN DECISION-MAKING SETTINGS) OR MUST BE ELIMINATED (SUCH AS THROUGH DIVESTITURE OF THE OUTSIDE INTEREST OR REQUIRING A CHOICE BETWEEN THE INDIVIDUAL'S ROLE WITH THE FOUNDATION OR THE OUTSIDE ENTITY). PUBLIC INSPECTION OF GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STMTS FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION ALLOWS PUBLIC INSPECTION OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS, ONLY UPON REQUEST. RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 5 $5,752,903 - NET UNREALIZED GAINS REPORTED ON FINANCIAL STATMENTS. $249,767 - NET CHANGE IN THE VALUATION OF CONTRIBUTIONS RECEIVABLE AND BENEFICIAL INTEREST IN PERPETUAL TRUSTS. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BRUCE T REESE TITLE:TRUSTEE HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SPENCER F ECCLES TITLE:TRUSTEE/TREASURER HOURS:5 IHC HEALTH SERVICES INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY UT 84111 942854057 HEALTHCARE UT 501(C)(3) LINE 3 NA false true true false false false false false false false false true false false true false false false