2019-09-24T12:22:33-05:00 2018-12-31 810348775 JUNKERMIERCLARKCAMPANELLASTEVENS PC PO BOX 16237 MISSOULA MT 59808 990 2018-01-01 474110464 GREAT FALLS CLINIC LEGACY FOUNDATION GREA 4067713107 1400 29TH STREET SOUTH GREAT FALLS MT 59405 ED VENETZ PRESIDENT 4067713107 2019-09-16 1 DREW RIEKER CPA P01372762 4065494148 208.123.198.253 2019-09-16 13:45:23 MD P 4BD95361F921005AF6C55537EB1E454493ED4A95 DA62A4CBC2F988934D5EDD4926F531E31B1456EF 2018 2019-02-21 02:37:17Z ED VENETZ 1400 29TH STREET SOUTH GREAT FALLS MT 59405 375790 0 X WWW.GFCLEGACY.ORG X 2015 MT PROVIDE CARE AND COMFORT FOR PATIENTS AND FAMILIES AT A PATIENT HOUSING FACILITY. 11 11 0 15 0 0 1477916 342087 0 0 8 0 0 27806 1477924 369893 8447 7465 0 0 0 5634 0 15000 44485 19878 38761 28325 66860 1449599 303033 1504032 1821684 0 0 1504032 1821684 THE GREAT FALLS CLINIC LEGACY FOUNDATION BRINGS HOPE AND HEALING TO GREAT FALLS AND SURROUNDING COMMUNITIES. 0 0 8160 7465 THE GREAT FALLS CLINIC LEGACY FOUNDATION IS DEDICATED TO HELPING PATIENTS AND FAMILIES FROM AROUND MONTANA SEEKING TREATMENT AT THE GREAT FALLS CLINIC. FOR MANY YEARS, THERE HAS BEEN A GREAT NEED IN THE COMMUNITY FOR PATIENT HOUSING WHILE RECEIVING OUTPATIENT TREATMENT. THE FOUNDATION AND THE GENEROUS COMMUNITY WILL PROVIDE A NEW LEVEL OF SERVICE IN THE AREA OF HEALTHCARE. CARE AND COMFORT FOR PATIENTS AND FAMILIES ARE OF THE UTMOST IMPORTANCE AND THE PATIENT HOUSING FACILITY HAS BECOME THE TOP PRIORITY. WE ARE CURRENTLY WORKING ON A CAPITAL CAMPAIGN TO RAISE SUPPORT FOR THE CONSTRUCTION OF TWELVE (12) GUEST ROOMS FOR PATIENTS. 8160 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 X GREAT FALLS CLINIC 4067713107 1400 29TH STREET SOUTH GREAT FALLS MT 59405 ED VENETZ PRESIDENT 1.00 X X 0 0 0 TIM PETERSON VICE PRESIDENT 1.00 X X 0 0 0 AMY PENNINGTON TREASURER 1.00 X X 0 0 0 ROBERT HENDERSON BOARD MEMBER 1.00 X 0 0 0 KARL GUTER BOARD MEMBER 1.00 X 0 0 0 THOMAS WARR BOARD MEMBER 1.00 X 0 0 0 WYMAN TAYLOR BOARD MEMBER 1.00 X 0 0 0 GREGORY SCHWANDT BOARD MEMBER 1.00 X 0 0 0 VICKI NEWMILLER BOARD MEMBER 1.00 X 0 0 0 BRAD LIVINGSTON BOARD MEMBER 1.00 X 0 0 0 REED BASSETT BOARD MEMBER 1.00 X 0 0 0 SUZANNE PORTER BOARD MEMBER (FORMER) 1.00 X 0 0 0 DIANE STEFFENS BOARD MEMBER (FORMER) 1.00 X 0 0 0 SAMANTHA SHINABERGER SECRETARY/EXECUTIVE DIRECTOR 5.00 X 5634 0 0 5634 0 0 0 0 0 1 0 2656 339431 30765 342087 22820 2656 5157 17663 17663 10883 740 10143 10143 369893 0 0 27806 7465 7465 5634 5634 3250 3250 15000 15000 245 245 16238 16238 990 495 495 400 200 200 2311 1155 1156 645 323 322 IN-KINDS EXPENSED 10829 10829 PROPERTY TAXES 2003 2003 SUPPLIES 921 921 BANK FEES 746 746 183 183 66860 8160 14215 44485 143779 387624 69 399429 0 360245 399429 1000008 1034562 1504032 1821684 0 0 X 1504032 1821684 1504032 1821684 1504032 1821684 303033 14619 0 X 0 0 0 X 19534 37831 477916 342087 877368 19534 37831 477916 342087 877368 363891 513477 33073 33073 910441 X SCHEDULE A, PART II, LINE 1 THE AMOUNTS PREVIOUSLY REPORTED FOR SCHEDULE A, PART II, LINE 1 HAVE BEEN RESTATED TO CONFORM TO THE CURRENT YEAR PRESENTATION. 2016 AMOUNTS PREVIOUSLY REPORTED ON SCHEDULE A, PART II, LINE 1 INCLUDED FUNDRAISING EVENT INCOME AS CONTRIBUTION INCOME. SCHEDULE A, PART II, LINE 10 GROSS FUNDRAISING EVENT INCOME OF $33,073 IS REPORTED AS OTHER INCOME ON SCHEDULE A, PART II, LINE 10. 340000 340000 59429 59429 399429 TOUR MONTANA SUMMER OF 2018 22082 2656 19426 817 1610 2000 711 OTHER FUNDRAISING EVENTS 3394 3394 19 25476 2656 22820 817 1610 2000 730 5157 17663 1 ASSISTANCE WITH MEDICAL, HOTEL, AND TRAVEL EXPENSES. 41 7465 PART I, LINE 2: CURRENTLY ONLY GRANTS FOR PEDIATRIC PATIENTS ARE AWARDED. THERE IS A MAXIMUM OF $1,000 AWARDED TO EACH PATIENT PER APPLICATION. IF A REQUEST IS SUBMITTED OUTSIDE OF THE PARAMETERS OF THE GRANT APPLICATION IT IS TAKEN TO THE BOARD FOR REVIEW AND CONSIDERATION. 0 0 0 0 0 0 0 0 0 SAMANTHA SHINABERGER SECRETARY/EXECUTIVE DIRECTOR 5634 0 0 0 0 0 0 0 0 0 5634 0 0 0 SCHEDULE J, UNRELATED COMPENSATION GREAT FALLS CLINIC, LLP EMPLOYS THE EXECUTIVE DIRECTOR, SAMANTHA SHINABERGER, FOR THE FOUNDATION FULL-TIME AND COMPENSATION IS DETERMINED BY GREAT FALLS CLINIC'S HR MODEL. THE GREAT FALLS CLINIC LEGACY FOUNDATION REIMBURSES GREAT FALLS CLINIC, LLP FOR THE EXECUTIVE DIRECTORS WAGES. THE AMOUNT REIMBURSED DURING THE CURRENT YEAR WAS $5,634. X 1 19936 QUOTED MARKET VALUE X FUNDRAISING EVENT SILENT AUCTION ITEMS 32 10839 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION A, LINE 8B GREAT FALLS CLINIC LEGACY FOUNDATION HAS AN INFORMAL EXECUTIVE COMMITEE THAT IS COMPRISED OF FOUR BOARD MEMBERS. THIS COMMITTEE CURRENTLY MEETS WITH THE FULL BOARD AT MEETINGS AND WOULD ONLY MEET SEPARATELY IF A SPECIAL ISSUE WAS TO ARISE. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS IS SENT A DRAFT FORM 990 FOR REVIEW AND APPROVAL PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE GREAT FALLS CLINIC LEGACY FOUNDATION REQUIRES INITIAL DISCLOSURE AT THE TIME OF COMMITMENT AND APPROVAL TO THE BOARD. THE BOARD MEMBERS ARE REQUESTED TO PROVIDE WRITTEN OR ORAL INSTRUCTION OF ANY CHANGES TO THE CONFLICT OF INTEREST POLICY. WE RELY ON INSIDERS AND OTHER INTERESTED PERSONS TO REPORT CONFLICTS OF INTEREST AND THEN THEY ARE ADDRESSED BY THE BOARD. TYPICALLY THE BOARD MEMBER WOULD NOTIFY OF THE CONFLICT AND EXCUSE THEMSELVES FROM THE VOTE OR REMOVE THEMSELVES FROM THE MEETING. FORM 990, PART VI, SECTION C, LINE 19 THE GREAT FALLS CLINIC LEGACY FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.