2021-11-15T11:18:55-06:00 2020-12-31 346565596 ERNST & YOUNG US LLP 560 MISSION ST 1600 SAN FRANCISCO CA 94105 990 2020-01-01 800225150 INTERMOUNTAIN HEALTHCARE FOUNDATION INC INTE 8014422000 36 SOUTH STATE STREET SUITE 2200 SALT LAKE CITY UT 84111 PRESIDENT CDO PRESIDENT 8014423491 2021-11-15 0 PRESIDENT CDO XXX-XX-XXXX EVA NITTA P01286320 4158948000 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z DAVID L FLOOD 36 S STATE STREET STE 2200 SLC UT 84111 138780803 0 X N/A X 2009 UT PROVIDE STRATEGIC AND FIDUCIARY LEADERSHIP FOR PHILANTHROPIC ENDEAVORS OF IHC HEALTH SERVICES, INC. 9 5 0 6 3355857 1000131 100465092 75840891 0 0 8019134 10671120 -961193 -1109541 107523033 85402470 32643305 37704655 0 0 0 0 545512 424207 1398716 2629169 1906815 35817986 40035677 71705047 45366793 553069901 641106172 182501797 213297012 370568104 427809160 PROVIDE STRATEGIC AND FIDUCIARY LEADERSHIP FOR THE PHILANTHROPIC ENDEAVORS OF IHC HEALTH SERVICES, INC. 0 0 37704655 37704655 82977 INTERMOUNTAIN HEALTHCARE FOUNDATION, INC. ("FOUNDATION") SUPPORTED THE HEALTHCARE ACTIVITIES OF IHC HEALTH SERVICES, INC. ("HEALTH SERVICES") BY ENHANCING AND STRENGTHENING THE RELATIONSHIP BETWEEN THE FOUNDATION AND COMMUNITY LEADERS AND BY DEVELOPING FINANCIAL AND CHARITABLE SUPPORT. 37704655 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 1 1 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 X 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 0 0 0 X 9 5 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 UT X BRYAN HAYMOND 8014423491 36 SOUTH STATE STREET SUITE 2200 SALT LAKE CITY UT 84111 A MARC HARRISON MD TRUSTEE / VICE PRESIDENT 3.00 63.00 X X 0 3747833 2214464 ALBERT R ZIMMERLI TRUSTEE / SECRETARY 1.00 64.00 X X 0 2357401 1242239 DAVID L FLOOD TRUSTEE / PRESIDENT 50.00 10.00 X X 0 974163 736267 A SCOTT ANDERSON TRUSTEE / CHAIR 3.00 2.00 X X 0 0 0 THOMAS D DEE III TRUSTEE 1.00 0.00 X 0 0 0 SPENCER F ECCLES TRUSTEE 1.00 2.00 X 0 0 0 CYNDI WOODBURY GILBERT TRUSTEE 1.00 0.00 X 0 0 0 JAMES D LAUB TRUSTEE / VICE CHAIR 3.00 0.00 X X 0 0 0 TODD R PEDERSEN TRUSTEE 1.00 0.00 X 0 0 0 CHARLES W SORENSON JR MD FORMER OFFICER 0.00 50.00 X 0 315206 68857 0 7394603 4261827 0 1 1 0 GHIORSI & SORRENTI INC 255 MADISON AVENUE WYCKOFF NJ 07481 FUNDRAISING CONSULTANT 378387 SILCHESTER INTERNATIONAL INVESTORS INC 780 3RD AVE 42ND FL NEW YORK NY 10017 INVESTMENT MANAGEMENT 205194 2 57332 1408135 5048509 69326915 3499502 75840891 4401670 -621957 5023627 57850839 352527 51933916 0 5916923 352527 6269450 3977814 2291636 251899 1408135 1444417 -1192518 -1192518 OTHER REVENUE 900099 82977 82977 82977 85402470 82977 3355857 6122745 37674655 37674655 30000 30000 36803 36803 424207 424207 353615 353615 406338 138880 267458 25485 5161 20324 432277 106597 325680 190934 190127 807 9114 1522 7592 28671 5270 23401 3449 2450 999 28696 2595 26101 MEMBERSHIPS, LICENSES 340476 59242 281234 SUPPLIES 41405 21802 19603 OTHER EXPENSES 7179 7179 0 RECRUITMENT 2373 1063 1310 40035677 37704655 932306 1398716 86240051 85350481 97313625 98741701 307693231 419905639 58142813 31485972 3680181 5622379 553069901 641106172 82531 0 3333087 2955373 179086179 210341639 182501797 213297012 X 70722127 91621253 299845977 336187907 370568104 427809160 553069901 641106172 X 45366793 13072768 -1198505 X 0 1 X 0 0 X 54841594 58818312 41006328 100465092 75840891 330972217 54841594 58818312 41006328 100465092 75840891 330972217 88042676 242929541 3468532 4266731 5057884 5472524 4401670 22667341 82977 82977 353722535 8756800 0.68680 0.70960 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2020 AMOUNT: $ 82,977. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 299845977 69601347 4702583 37962000 336187907 233226280 95736228 5098476 34215007 299845977 237048460 37992070 -2237839 39576411 233226280 202259102 56147635 3976657 25334934 237048460 170865649 53298045 2372720 24277312 202259102 0.00000 0.13050 0.86950 0 0 0 SECURITIES HELD FOR AFFILIATES 210116602 INVESTMENT PURCHASES PAYABLE 14668 CHARITABLE ANNUITY 210369 210341639 FORM 990, SCHEDULE D, PART V, LINE 4: THE FOUNDATION'S TEMPORARY ENDOWMENT AND EARNINGS FROM THE PERMANENT ENDOWMENT FUND HEALTH SERVICES' ACTIVITIES SUCH AS PATIENT PROGRAMS (INCLUDING CHARITY CARE), MEDICAL RESEARCH, AND CAPITAL/TECHNOLOGY NEEDS. 1 NORTH AMERICA - CANADA AND MEXICO, BUT NOT THE UNITED STATES 0 0 GRANTS 30000 0 0 0 0 0 0 30000 0 30000 NORTH AMERICA - CANADA AND MEXICO, BUT NOT THE UNITED STATES HYDROCEPHALUS RESEARCH 30000 CHECK 1 0 0 0 0 0 0 0 PART III ACCOUNTING METHOD: SCHEDULE F, PART I, LINE 2: GRANT REQUESTS ARE MADE THROUGH AN APPLICATION PROCESS AND ARE GENERALLY LIMITED TO ORGANIZATIONS EXEMPT UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). GRANTEES ARE REQUIRED TO REPORT HOW THE FUNDS WERE USED TO THE FOUNDATION. X X X X X X 1 GHIORSI & SORRENTI INC 255 MADISON AVE WYCKOFF NJ 07481 FUNDRAISING STRATEGY CONSULTING 0 0 378387 0 GOBEL GROUP 200 OLD FORGE LN STE 202 KENNETT SQUARE PA 19348 FUNDRAISING STRATEGY CONSULTING 0 0 45820 0 424207 UT FESTIVAL OF TREES 1191836 994770 197066 0 0 164743 23081 0 1061072 JUBILEE OF TREES 468198 413365 54833 0 0 13500 44776 2400 134845 1660034 1408135 251899 178243 67857 2400 1195917 1444417 -1192518 1 IHC HEALTH SERVICES INC 36 S STATE STREET STE 2200 SALT LAKE CITY UT 84111 942854057 501(C)(3) 36346172 HOSPITAL SUPPORT UNIVERSITY OF UTAH 201 PRESIDENTS CIRCLE RM 411 SALT LAKE CITY UT 84112 876000525 GOV 1228318 RESEARCH AND EDUCATION ALABAMA CHILDREN'S HOSPITAL FOUNDATION 1600 7TH AVENUE SOUTH BIRMINGHAM AL 35233 630879471 501(C)(3) 50000 HCRN CLINSITE RESEARCH RONALD MCDONALD HOUSE CHARITIES OF THE INTERMOUNTAIN AREA INC 935 E SOUTH TEMPLE SALT LAKE CITY UT 84102 742386043 501(C)(3) 34565 SUPPORT COMMUNITY HEALTH SALT LAKE COMMUNITY COLLEGE 4600 S REDWOOD RD SALT LAKE CITY UT 84123 876000448 GOV 6400 EDUCATION WEBER STATE UNIVERSITY 3850 DIXON PARKWAY DEPT 1021 OGDEN UT 84408 876000535 GOV 6000 EDUCATION 6 0 PART I, LINE 2: GRANT REQUESTS ARE MADE THROUGH AN APPLICATION PROCESS AND ARE GENERALLY LIMITED TO ORGANIZATIONS EXEMPT UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). GRANTEES ARE REQUIRED TO REPORT HOW THE FUNDS WERE USED TO THE FOUNDATION. 0 1 0 0 0 0 0 0 0 A MARC HARRISON MD TRUSTEE / VICE PRESIDENT 0 1804499 0 1774349 0 168985 0 2171820 0 42644 0 5962297 0 1494941 ALBERT R ZIMMERLI TRUSTEE / SECRETARY 0 1108442 0 832570 0 416389 0 1203683 0 38556 0 3599640 0 700803 DAVID L FLOOD TRUSTEE / PRESIDENT 0 532139 0 382857 0 59167 0 703192 0 33075 0 1710430 0 310118 CHARLES W SORENSON JR MD FORMER OFFICER 0 313459 0 450 0 1297 0 43468 0 25389 0 384063 0 0 PART I, LINE 4B IHC HEALTH SERVICES, INC., A RELATED TAX-EXEMPT ORGANIZATION, OFFERS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. PARTICIPATION IN THE PLAN IS LIMITED TO EMPLOYEES DESIGNATED BY THE BOARD. 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 2020 FOR THE INDIVIDUALS REPORTED ON PART VII OF THE FORM 990 HAVE BEEN INCLUDED IN THE SCHEDULE J, PART II, COLUMN (C) TOTAL. THE FOLLOWING INDIVIDUAL RECEIVED A SUPPLEMENTAL EMPLOYER RETIREMENT PAYMENT FROM IHC HEALTH SERVICES, INC. IN 2020: - ALBERT R. ZIMMERLI $289,425 THE 2020 SUPPLEMENTAL EMPLOYER RETIREMENT PAYMENT REPORTED ABOVE IS INCLUDED IN THE PART II, COLUMN (B)(III) TOTALS. X 8300 FMV X 45930 FMV X 53 1077776 FMV X 20 660157 FMV X MISC. ITEMS 0 1707339 FMV 1 0 0 0 PART I, COLUMN (B): THE NONCASH CONTRIBUTIONS RECORDED ON LINE 9 REPRESENTS THE NUMBER OF CONTRIBUTIONS. THE NONCASH CONTRIBUTIONS RECORDED ON LINE 20 REPRESENTS THE NUMBER OF CONTRIBUTIONS. THE NUMBER OF NONCASH CONTRIBUTIONS OR ITEMS CONTRIBUTED RECORDED ON LINE 25 IS NOT REASONABLY DETERMINABLE. FORM 990, PART V, LINE 1A: ALL OF THE FORM 1099'S FOR INTERMOUNTAIN HEALTHCARE FOUNDATION, INC. ARE ISSUED BY A RELATED NONPROFIT ORGANIZATION, IHC HEALTH SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 2 DAVID L. FLOOD / A. MARC HARRISON, MD / ALBERT R. ZIMMERLI - BUSINESS RELATIONSHIP (EMPLOYER/EMPLOYEE RELATIONSHIP IN IHC HEALTH SERVICES, INC., A RELATED UTAH NONPROFIT CORPORATION) A. MARC HARRISON, MD / ALBERT R. ZIMMERLI - BUSINESS RELATIONSHIP (BOARD MEMBERS OF SELECTHEALTH BENEFIT ASSURANCE COMPANY, INC., A TAXABLE CORPORATION THAT IS WHOLLY OWNED BY AN AFFILIATE OF THE FILING ORGANIZATION) FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF INTERMOUNTAIN HEALTHCARE FOUNDATION, INC. IS IHC HEALTH SERVICES, INC., A RELATED UTAH NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO THE APPROVED BYLAWS, THE FILING ORGANIZATION'S TRUSTEES ARE ELECTED BY THE SOLE MEMBER AT AN ANNUAL MEMBERSHIP MEETING. FORM 990, PART VI, SECTION A, LINE 7B PURSUANT TO THE ARTICLES OF INCORPORATION, THE SOLE MEMBER EXERCISES ALL PROPERTY, VOTING, AND OTHER RIGHTS, INTERESTS AND POWERS CONFERRED UNDER LOCAL STATUTE, INCLUDING THE ELECTION OF INTERMOUNTAIN HEALTHCARE FOUNDATION, INC. TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B THE COMPLETE FORM 990 AND ALL REQUIRED SCHEDULES WERE MADE AVAILABLE TO THE ENTIRE GOVERNING BODY FOR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH OFFICER, DIRECTOR, TRUSTEE, AND KEY EMPLOYEE IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AT LEAST ANNUALLY. THESE INDIVIDUALS HAVE ALSO BEEN INSTRUCTED TO UPDATE THEIR QUESTIONNAIRE INFORMATION IF THEY BECOME AWARE OF A NEW POTENTIAL CONFLICT, OR IF ANY OF THE PREVIOUSLY REPORTED INFORMATION CHANGES. ADDITIONALLY, BOARD MEMBERS ARE ASKED AT THE BEGINNING OF EACH BOARD OR COMMITTEE MEETING IF THEY ARE AWARE OF ANY NEW CONFLICTS. ACCORDING TO POLICY, THE QUESTIONNAIRES ARE COLLECTED AND REVIEWED BY IHC HEALTH SERVICES, INC.'S VICE PRESIDENT OF BUSINESS ETHICS AND COMPLIANCE. POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED WITH APPROPRIATE PERSONNEL, WHICH MAY INCLUDE (BUT IS NOT LIMITED TO) THE AUDIT AND COMPLIANCE COMMITTEE CHAIR, SENIOR MANAGEMENT, AND THE LEGAL DEPARTMENT OF IHC HEALTH SERVICES, INC. IF AN INDIVIDUAL DISCLOSES A SITUATION THAT POSES A CONFLICT OF INTEREST, THEN A DETERMINATION IS MADE WHETHER 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 INTERMOUNTAIN HEALTHCARE FOUNDATION, INC. OR THE OUTSIDE ENTITY). FORM 990, PART VI, SECTION B, LINE 15 INTERMOUNTAIN HEALTHCARE FOUNDATION, INC. DID NOT COMPENSATE ANY OFFICER, DIRECTOR, TRUSTEE OR KEY EMPLOYEE. COMPENSATION AMOUNTS LISTED ON PART VII WERE PAID BY A RELATED ORGANIZATION AND WERE DETERMINED IN ACCORDANCE WITH IRS GUIDELINES, INCLUDING REVIEWS AND APPROVALS BY INDEPENDENT PERSONS, USE OF COMPARABLE DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF DELIBERATIONS AND DECISIONS. FORM 990, PART VI, SECTION C, LINE 19 INTERMOUNTAIN HEALTHCARE FOUNDATION, INC. DOES NOT CURRENTLY ALLOW PUBLIC INSPECTION OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS. FORM 990, PART XI, LINE 9: NET CHANGE IN THE VALUATION OF TRUSTS RECEIVABLE 43,486. PROVISION FOR UNCOLLECTIBLE ACCOUNTS -1,241,991. INTERMOUNTAIN HEALTH CARE INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY UT 84111 870269232 HOLDING COMPANY UT 501(C)(3) LINE 12B, II N/A 0 IHC HEALTH SERVICES INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY UT 84111 942854057 HEALTHCARE UT 501(C)(3) LINE 3 INTERMOUNTAIN HEALTH CARE INC 0 INTERMOUNTAIN COMMUNITY CARE FOUNDATION INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY UT 84111 942853320 COMMUNITY HEALTH UT 501(C)(3) LINE 12B, II INTERMOUNTAIN HEALTH CARE INC 1 INTERMOUNTAIN HEALTH CARE RETIREE VEBA 36 SOUTH STATE SUITE 2200 SALT LAKE CITY UT 84111 742675605 RETIREMENT BENEFITS UT 501(C)(9) N/A INTERMOUNTAIN HEALTH CARE INC 1 SELECTHEALTH INC 5381 GREEN STREET MURRAY UT 84123 870409820 DELIVERY OF HEALTH BENEFITS UT 501(C)(4) N/A INTERMOUNTAIN HEALTH CARE INC 1 HEART & LUNG RESEARCH FOUNDATION 5121 S COTTONWOOD DRIVE MURRAY UT 84157 870617606 COMMUNITY HEALTH UT 501(C)(3) LINE 7 INTERMOUNTAIN HEALTHCARE FOUNDATION INC 1 MCKAY DEE SURGICAL CENTER LLC 3895 HARRISON BLVD OGDEN UT 84403 260286308 OUTPATIENT SURGERY UT N/A N/A 0 0 HEART LUNG INSTITUTE LLC 5121 SOUTH COTTONWOOD DRIVE MURRAY UT 84157 RESEARCH AND DEVELOPMENT UT N/A N/A 0 0 GRANDEUR PEAK INTERNATIONAL STALWARTS LP 136 S MAIN STREET STE 720 SALT LAKE CITY UT 84101 475468723 INVESTMENTS DE N/A N/A 0 0 INNOVATION FUND HOLDINGS COMPANY LLC 1000 W FULTON STREET CHICAGO IL 60607 471525723 INNOVATION DE N/A N/A 0 0 HEALTHBOX SALT LAKE CITY I LLC 1000 W FULTON MARKET STE 213 CHICAGO IL 60607 465338772 INNOVATION DE N/A N/A 0 0 HOMESPIRE LLC 36 S STATE STREET STE 2200 SALT LAKE CITY UT 84111 823121436 HOMECARE ASSISTANCE UT N/A N/A 0 0 INTERMOUNTAIN VENTURES FUND LLC 36 S STATE STREET STE 2200 SALT LAKE CITY UT 84111 844037085 INVESTMENTS DE N/A N/A 0 0 PELION OPPORTUNITY FUND III LLC 2750 E COTTONWOOD PARKWAY STE 600 SALT LAKE CITY UT 84121 842757193 INVESTMENTS DE N/A N/A 0 0 AACP KOREA BUYOUT INVESTORS II LP ONE EMBARCADERO 16TH FLOOR SAN FRANCISCO CA 94111 824971663 INVESTMENTS CJ N/A N/A 0 0 AACP SPECIAL SITUATIONS II LP ONE EMBARCADERO 16TH FLOOR SAN FRANCISCO CA 94111 832883726 INVESTMENTS CJ N/A N/A 0 0 BVA SM GROUP LLC 901 PIER VIEW DRIVE SUITE 201 IDAHO FALLS ID 83402 834516988 HOLDING COMPANY ID N/A N/A 0 0 AACP KOREA BUYOUT INVESTORS IV LP ONE EMBARCADERO 16TH FLOOR SAN FRANCISCO CA 94111 981549044 INVESTMENTS CJ N/A N/A 0 0 HEALTHCARE CAPTIVE INSURANCE COMPANY 36 SOUTH STATE SUITE 2200 SALT LAKE CITY UT 84111 201937561 INSURANCE AZ N/A C 1 SELECTHEALTH BENEFIT ASSURANCE COMPANY INC 5381 GREEN STREET MURRAY UT 84123 870497579 DELIVERY OF HEALTH BENEFITS UT N/A C 1 INTERMOUNTAIN SUPPLY SERVICES INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY UT 84111 474576955 HOLDING COMPANY DE N/A C 1 INTALERE INC TWO CITY PLACE DRIVE SUITE 400 ST LOUIS MO 63141 431415071 GROUP PURCHASING DE N/A C 1 NAVICAN GENOMICS INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY UT 84111 814153832 CANCER TREATMENT DE N/A C 1 EMPIRIC HEALTH INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY UT 84111 384026200 HEALTH SERVICES TECHNOLOGY DE N/A C 1 ALLUCEO INC 36 SOUTH STATE SUITE 2200 SALT LAKE CITY UT 84111 824614934 MENTAL HEALTH INTEGRATION SERVICES DE N/A C 1 INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INC 770 EAST WARM SPRINGS ROAD LAS VEGAS NV 89110 200160881 HOLDING COMPANY DE N/A C 1 HEALTHCARE PARTNERS MEDICAL GROUP (COATS) LTD 770 EAST WARM SPRINGS ROAD LAS VEGAS NV 89110 880213519 HEALTHCARE NV N/A C 1 SALTZER MEDICAL GROUP INC 215 EAST HAWAII AVENUE NAMPA ID 83686 820299231 MEDICAL SERVICES ID N/A C 1 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 IHC HEALTH SERVICES INC B 36346172 COST IHC HEALTH SERVICES INC C 5035104 COST IHC HEALTH SERVICES INC P 1328483 COST INTERMOUNTAIN COMMUNITY CARE FOUNDATION INC Q 196152 COST