2022-11-15T10:28:49-06:00 2021-12-31 450250958 EIDE BAILLY LLP 666 WALNUT ST STE 1900 DES MOINES IA 503093912 990PF 2021-01-01 426521745 THE JOHN R AND ZELDA Z GRUBB CHARITABLE FOUNDATION JOHN 5152599293 4454 128TH ST URBANDALE IA 503231728 JOHN W GRUBB PRESIDENT 5152599293 2022-11-15 1 JOHN GRUBB XXX-XX-XXXX ALEXANDER RADIG CPA P01937466 5152440266 2022-11-15 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z X 12390632 X 530172 1266 1266 222973 222973 -2132571 4901833 21027 4535912 29471 3157752 274737 0 0 0 1057874 0 1057874 115751 0 115751 24062 0 24062 89811 0 89811 264363 0 264363 2244 2244 0 231971 0 224345 132845 0 8401 0 8401 1445803 57602 1388201 3373125 59846 3172808 439650 439650 3812775 59846 3612458 -655023 214891 920492 1002831 1002831 1751893 1223721 445073 1223721 1223721 16540 329327 0 0 136200 0 0 246019 148219 152476 7545529 10058757 9979563 2646261 0 0 46880 32041 32041 14084214 12465569 12390632 393675 23 546001 1612 939676 1635 X 13144538 12463934 13144538 12463934 14084214 12465569 13144538 -655023 60264 12549779 85845 12463934 SALE OF PUBLICLY TRADED SECURITIES P 1178155 1225571 -47416 -47416 SALE OF PUBLICLY TRADED SECURITIES P 1603050 1689996 -86946 -86946 CAPITAL GAINS DIVIDENDS P 155389 155389 155389 21027 2987 0 2987 0 2987 3180 0 25000 0 28180 0 25193 25193 0 0 0 0 0 0 0 0 0 0 0 1 1 IA 1 0 0 0 0 1 N/A JOHN W GRUBB 5152599293 4454 128TH ST URBANDALE IA 503231728 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 JOHN W GRUBB 4454 128TH ST URBANDALE IA 503231728 PRESIDENT, SECRETARY 1.00 0 0 0 KATLYN POOTS 1400 W MAIN ST MCGREGOR IA 52157 RN 40.00 58523 1757 0 GAYLE MOORE 116 REIMER ST ELKADER IA 52043 RN 40.00 52482 1678 0 LORA GLENN 116 REIMER ST ELKADER IA 52043 RN 40.00 51519 0 0 LISA BOLSINGER 116 REIMER ST ELKADER IA 52043 RN 40.00 44048 7258 0 0 HEALTHCARE OF IOWA 5925 DRY CREEK LN NE CEDAR RAPIDS IA 52402 ACCOUNTING FEES/CONSULTING FEES 350171 MILLENNIUM REHAB & CONSULTING 4725 MERLE HAY RD DES MOINES IA 50322 THERAPIES 245393 MARTIN BROS PO BOX 69 CEDAR FALLS IA 50613 FOOD 177707 DIVERSACARE 5925 DRY CREEK LN NE CEDAR RAPIDS IA 52402 CONSULTING 129766 UHC PREMIUM BILLING PO BOX 94017 PALATINE IL 60094 INSURANCE PREMIUMS 55809 0 OPERATES TWO NURSING HOMES FOR THE ELDERLY WITH APPROXIMATELY 124 BEDS. THE NURSING HOMES WERE SOLD IN 2021. 0 0 8705208 0 0 8705208 0 0 8705208 130578 8574630 428732 428732 2987 2987 425745 0 425745 0 425745 3612458 0 3612458 425745 0 0 0 3612458 0 0 0 425745 3186713 0 0 3186713 0 0 0 0 0 0 0 3186713 3186713 X AMERICAN HEART ASSOCIATION 5000 WESTOWN PKWY STE 340 WEST DES MOINES IA 50266 PC DONATION OF FUNDS FOR GENERAL OPERATING OF HEART AND CIRCULATORY SYSTEM DISEASES, DISORDERS 1000 ASU FOUNDATION 1201 SOUTH FOREST AVENUE TEMPE AZ 85282 PC ASU - CHARTER FUND THAT SUPPORTS STUDENT INITIATIVES 3000 BARRETT BOESEN FOUNDATION 475 ALICES ROAD WAUKEE IA 50263 PC DONATION TO GENERAL FUND 10000 BLANK CHILDREN'S HOSPITAL 1200 PLEASANT STREET DES MOINES IA 50309 PC ROBERT PULVER MEMORIAL AND FESTIVAL OF TREES & LIGHTS 35000 C4 FOUNDATION PO BOX 181679 CORONADO CA 92178 PC DONATION TO GENERAL FUND & POLAR BEAR GALA 5000 CHRYSALIS FOUNDATION 1248 8TH STREET SUITE 101 WEST DES MOINES IA 50265 PC DONATION TO GENERAL FUND 5000 FOOD BANK OF IOWA 2221 E 17TH STREET DES MOINES IA 503162115 PC FOOD BANKS/PANTRIES - SUPPLY GOODS, FOOD, AND OTHER SERVICES TO POOR 10000 HOPE MINISTRIES PO BOX 862 DES MOINES IA 503040862 PC DONATION TO GENERAL FUND TO PROVIDE BASIC HUMAN SERVICES TO THOSE IN NEED 5000 HOYT SHERMAN PLACE 1501 WOODLAND AVE DES MOINES IA 50309 PC 2021 CAPITAL CAMPAIGN 10000 IOWA HEALTH CARE ASSOCIATION FOUNDATION 1776 - 90TH STREET WEST DES MOINES IA 502661564 PC DONATION TO GENERAL FUND FOR HEALTH CARE SCHOLARSHIPS 30000 MOUNT MERCY UNIVERSITY 1330 ELMHURST DR NE CEDAR RAPIDS IA 52402 PC DONATION TO GENERAL FUND 2500 NORTH HIGH SCHOOL 501 HOLCOMB AVE DES MOINES IA 50313 PC DONATION TO GENERAL FUND 15000 ST BONIFACE CATHOLIC CHURCH 1200 WARRIOR LN WAUKEE IA 50263 PC DONATION TO GENERAL FUND 2500 STRANDS OF STRENGTH 1311 TULIP TREE LANE WEST DES MOINES IA 50267 PC REDUCE THE STIGMA EVENT 2400 VARIETY CLUB 506 - 5TH AVENUE SUITE 310 DES MOINES IA 503092323 PC DONATION TO GENERAL FUND TO PROVIDE AID/SERVICES TO THE HANDICAP 303250 439650 0 NURSING HOMES 3842946 ASSISTED LIVING 496256 14 1266 14 222973 14 29471 18 21027 -2153598 OTHER 167239 0 274737 2352843 2627580 1A THE FOUNDATION OPERATES TWO NURSING HOMES FOR THE ELDERLY WITH 1A APPROXIMATELY 124 BEDS. 1B THE FOUNDATION OPERATES AN ASSISTED LIVING FACILITY FOR THE ELDERLY. 11A OTHER MISCELLANEOUS INCOME 0 0 0 0 0 0 0 0 0 0 X X 1 DEPARTMENT OF HEALTH AND HUMAN SERVICES 200 INDEPENDENCE AVE SW WASHINGTON DC 20201 35560 X 2 US SMALL BUSINESS ADMINISTRATION 409 3RD ST SW WASHINGTON DC 20416 494612 X ACCOUNTING FEES 81486 0 81486 TAX PREPARATION 8325 0 8325 SALE OF NURSING HOMES PURCHASED 1965239 8266377 COST 0 -2153598 4147540 BANK OF AMER COP B/E 73969 77438 MORGAN STANLEY B/E 74250 75038 AVISTA ONSHORE FEEDER FUND, LP AT COST 154309 154309 COLUMBIA STRATEGIC INCOME FUND CLASS INSTITUTIONAL AT COST 718172 724394 DOUBLELINE LOW DURATION BOND FUND I AT COST 834870 820133 FEDERATED HERMES KAUFMAN SMALL CAP FUND IS AT COST 557232 532813 JOHN HANCOCK INTL GROWTH FUND CL I AT COST 95822 115234 MATTHEW ASIA DIVIDEND AT COST 359473 342250 MORGAN STANLEY MONEY MARKET MUTUAL FUNDS AT COST 1987 1987 PE PREMIER BLACKSTONE ENERGY PARTNERS II OFFSHORE AT COST 399577 399577 PIMCO BRAVO FUND II OFFSHORE FEEDER AIV I, LP AT COST 137549 137549 PIMCO BRAVO FUND II SPECIAL ONSHORE FEEDER (TE), LP AT COST 108978 108978 PIMCO INCOME FUND CLASS 12 AT COST 2282997 2276516 PIMCO MORTGAGE OPPORTUNITIES AND BOND FUND 1-2 AT COST 598501 586605 PRINCIPAL MIDCAP FUND CLASS I AT COST 566407 601278 T. ROWE PRICE GLOBAL STK FD AT COST 238204 226653 EATON VANCE FLOATING RATE ADVANTAGE CL I AT COST 1016130 1014819 BLACKROCK SCIENCE & TECHNOLOGY TRUST II AT COST 198650 194700 BLACKROCK HEALTH SCIENCES TR II AT COST 270260 253600 ISHARES CORE S&P SMALL-CAP ETF AT COST 155753 148863 NEUBERGER BERMAN LARGE CAP VALUE FUND INSTITUTIONAL AT COST 326503 331945 PIMCO DYNAMIC INCOME FD AT COST 528886 508976 COLUMBIA MORTGAGE OPPORTUNITIES FUND CLASS INSTITUTIONAL AT COST 508497 498384 LEGAL FEES 24062 0 24062 CSV LIFE INSURANCE 46880 32041 32041 ADDITIONAL BOOK DEPRECIATION IN EXCESS OF TAX DEPRECIATION 24450 NON-DEDUCTIBLE DUES 1615 BOOK TAX DIFFERENCE PE PREMIER BLACKSTONE ENERGY PARTNERS II OFFSHORE K-1 24366 BOOK TAX DIFFERENCE UBS FINANCIAL SERVICES INC. 1099 35414 ADVERTISING 18610 0 18610 BUSINESS EXPENSE 3347 0 3347 DIETARY 179116 0 179116 DUES & LICENSES 12864 0 12864 EMPLOYEE RECRUITMENT 16358 0 16358 INCONTINENT CARE 612 0 612 INSURANCE 62400 0 62400 INVESTMENT FEES 30834 30834 0 PROPERTY 184716 0 184716 LIFE INSURANCE 28497 0 28497 MANAGEMENT FEE 53536 26768 26768 OFFICE EXPENSE 67154 0 67154 PURCHASED SERVICES 31585 0 31585 REPAIRS & MAINTENANCE 86500 0 86500 SNF SUPPLIES & THERAPIES 310370 0 310370 STAFF EDUCATION 7877 0 7877 SUPPLIES 139060 0 139060 TELEPHONE 10558 0 10558 UTILITIES 156520 0 156520 WORKMENS COMPENSATION 45289 0 45289 NET INVESTMENT INCOME FROM K-1 ACTIVITIES 29471 29471 29471 NURSING HOMES 3842946 3842946 ASSISTED LIVING 496256 496256 OTHER 167239 167239 BOOK TAX DIFFERENCE AVISTA ONSHORE FEEDER FUND, LP K-1 4919 BOOK TAX DIFFERENCE PIMCO BRAVO FUND II OFFSHORE FEEDER AIV I, LP K-1 12992 BOOK TAX DIFFERENCE PIMCO BRAVO FUND II SPECIAL ONSHORE FEEDER (TE), LP K-1 17355 PRIOR PERIOD ADJUSTMENT 3188 BOOK TAX DIFFERENCE ON SALE OF NURSING HOME 21810 DEPOSITS 52940 0 INCOME TAX PAYABLE 2761 1612 PPP LOAN 490300 0 NURSING HOME MANAGEMENT & OTHER 264363 0 264363 EXCISE TAX ON INVESTMENT 7626 0 0 PAYROLL 143858 0 143858 PROPERTY 80487 0 80487