INSTITUTE FOR CLINICAL SYSTEMS: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- INSTITUTE FOR CLINICAL SYSTEMS (EIN 41-1782168)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-13
- IRS object ID
- 201523179349303767
- Schema version
- 2014v5.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-13T11:04:17-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135665207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 WELLS FARGO CTR 90 S 7TH | AddressLine1Txt |
| Address Line2 | STREET | AddressLine2Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411782168 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INSTITUTE FOR CLINICAL SYSTEMS IMPROVEMENT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INST | BusinessNameControlTxt |
| Phone | 9528147077 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8009 34TH AVENUE SOUTH NO 1200 | AddressLine1Txt |
| City | BLOOMINGTON | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55425 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRAIG ACOMB | PersonNm |
| Person Title | CHIEF OPERATING OFFICER | PersonTitleTxt |
| Phone | 9528147077 | PhoneNum |
| Signature | 2015-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANN LAMOUREUX | PreparerPersonNm |
| PTIN | P00691316 | PTIN |
| Phone | 6123055000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CRAIG ACOMB | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8009 34TH AVENUE SOUTH NO 1200 | AddressLine1Txt |
| City | BLOOMINGTON | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55425 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,046,027 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ICSI.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | SEE SCH. O - THE ORGANIZATION'S MISSION, & SCH. O - EXEMPT PURPOSE AND ACHIEVEMENTS | ActivityOrMissionDesc |
| Voting Members Governing Body | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 450 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,544,270 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,325,426 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,783,195 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,720,804 | CYProgramServiceRevenueAmt |
| PY Investment Income | $132 | PYInvestmentIncomeAmt |
| CY Investment Income | -$203 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $12,327,597 | PYTotalRevenueAmt |
| CY Total Revenue | $9,046,027 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,491,026 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,967,855 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,656,618 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,046,548 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,845,792 | PYOtherExpensesAmt |
| CY Other Expenses | $1,426,944 | CYOtherExpensesAmt |
| PY Total Expenses | $11,993,436 | PYTotalExpensesAmt |
| CY Total Expenses | $9,441,347 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $334,161 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$395,320 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,965,249 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,780,849 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,660,241 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,871,161 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,305,008 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,909,688 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O - "THE ORGANIZATION'S MISSION" | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,011,750 | ExpenseAmt |
| Grant | $3,967,855 | GrantAmt |
| Revenue | $3,720,804 | RevenueAmt |
| Desc | SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS | Desc |
| Total Program Service Expenses | $9,011,750 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRAIG ACOMB CHIEF OPERATING OFFICER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9528147077 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8009 34TH AVENUE SOUTH | AddressLine1Txt |
| City | BLOOMINGTON | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55425 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| BETH AVERBECK MD | ||||||
| VICE CHAIR & DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| THOMAS BECKER | ||||||
| DIRECTOR | 0.10 | Yes (X) | $0 | $0 | $0 | |
| PETE BENNER | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| JIM CHASE | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| STEVEN CONNELLY | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| SHAWN FROST | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| CHARLES FAZIO | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| JULIE HALBERG | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| ROBERT KARASOVMD | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| SCOTT KETOVER MD | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| STEVE LAFFERTY | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| TIMOTHY LINEBERRY MD | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| JIM LYONS | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| SIDNA SCHEITEL | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| THOMAS O'CONNOR | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| BRIAN RANK MD | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| PAULA SANTRACH MD | ||||||
| CHAIR & DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| LARRY SCHULZ | ||||||
| SECRETARY & DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| LEIF SOLBERG | ||||||
| DIRECTOR | 0.10 | Yes (X) | $0 | $0 | $0 | |
| ROBERT STEVENS | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| ROBERT STROEBEL | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| DANIEL TRAJANO | ||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |
| MARK WERNER | ||||||
| DIRECTOR | 2.50 | Yes (X) | $0 | $0 | $0 | |
| CRAIG ACOMB | ||||||
| CFO & COO | 45.00 | Yes (X) | $0 | $167,435 | $49,231 | Yes (X) |
| SANNE MAGNAN | ||||||
| PRESIDENT & CEO | 45.00 | Yes (X) | $0 | $419,869 | $84,985 | Yes (X) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $587,304 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $134,216 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GROUP HEALTH PLAN INC | |||||
| 8170 33RD AVENUE SOUTH PO BOX 1309 | MINNEAPOLIS | MN | 554401309 | PAYROLL & EXPENSE PROCESSING | $4,468,249 |
| KAISER FOUNDATION RESEARCH INSTITUTE | |||||
| 1800 HARRISON ST 16TH FLOOR | OAKLAND | CA | 946123433 | GRANT PROGRAM PARTICIPATION | $1,180,103 |
| HEALTHPARTNERS RESEARCH & EDUCATION | |||||
| 8170 33RD AVENUE SOUTH PO BOX 1309 | MINNEAPOLIS | MN | 554401309 | GRANT PROGRAM PARTICIPATION | $689,482 |
| MICHIGAN CENTER FOR CLINICAL SYSTEMS IMP | |||||
| 233 E FULTON ST STE 20 | GRAND RAPIDS | MI | 49503 | GRANT PROGRAM PARTICIPATION | $391,472 |
| MAYO CLINIC | |||||
| 200 1ST ST SW | ROCHESTER | MN | 55905 | GRANT PROGRAM PARTICIPATION | $372,913 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,308,759 | GovernmentGrantsAmt |
| All Other Contributions | $16,667 | AllOtherContributionsAmt |
| Total Contributions | $5,325,426 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEMBERSHIP REVENUE | 900099 | $3,420,633 | $3,420,633 |
| COLLOQUIUM REVENUE | 900099 | $194,835 | $194,835 |
| CONSULTING REVENUE | 900099 | $105,336 | $105,336 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,720,804 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$203 | TotalRevenueColumnAmt |
| Exclusion | -$203 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,046,027 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,720,804 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$203 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,967,855 | TotalAmt |
| Program Services | $3,967,855 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $721,520 | TotalAmt |
| Program Services | $721,520 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,325,028 | TotalAmt |
| Program Services | $3,055,539 | ProgramServicesAmt |
| Management And General | $269,489 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,005 | TotalAmt |
| Program Services | $7,005 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,380 | TotalAmt |
| Program Services | $45,380 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $229,940 | TotalAmt |
| Program Services | $162,745 | ProgramServicesAmt |
| Management And General | $67,195 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,825 | TotalAmt |
| Program Services | $36,253 | ProgramServicesAmt |
| Management And General | $4,572 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,031 | TotalAmt |
| Program Services | $165,690 | ProgramServicesAmt |
| Management And General | $13,341 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,771 | TotalAmt |
| Program Services | $32,771 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $344,379 | TotalAmt |
| Program Services | $344,379 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,439 | TotalAmt |
| Program Services | $64,439 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,667 | TotalAmt |
| Program Services | $142,667 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,478 | TotalAmt |
| Program Services | $122,478 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,806 | TotalAmt |
| Program Services | $20,806 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $75,050 | $50 | $75,000 |
| BOARD EXPENSE | $38,309 | $38,309 | |
| MISCELLANEOUS FEES | $36,373 | $36,373 | |
| MEMBER COMMUNICATIONS | $29,215 | $29,215 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,276 | TotalAmt |
| Program Services | $18,276 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,441,347 | TotalAmt |
| Program Services | $9,011,750 | ProgramServicesAmt |
| Management And General | $429,597 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,838 | BOYAmt |
| EOY | $25,315 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,351,127 | BOYAmt |
| EOY | $2,926,469 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,351,439 | BOYAmt |
| EOY | $1,579,121 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,445 | BOYAmt |
| EOY | $30,373 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $696,848 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $477,277 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,400 | BOYAmt |
| EOY | $219,571 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,965,249 | BOYAmt |
| EOY | $4,780,849 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,528,845 | BOYAmt |
| EOY | $1,849,545 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,396 | BOYAmt |
| EOY | $21,616 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,660,241 | BOYAmt |
| EOY | $1,871,161 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,305,008 | BOYAmt |
| EOY | $2,909,688 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,305,008 | BOYAmt |
| EOY | $2,909,688 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,965,249 | BOYAmt |
| EOY | $4,780,849 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$395,320 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 5 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp (5 entries)
| EINEIN | Organization TypeOrganizationTypeDesc | Governing Document ListedGoverningDocumentListedInd | SupportSupportAmt | Other SupportOtherSupportAmt |
|---|---|---|---|---|
| HEALTHPARTNERS INC | ||||
| 411693838 | 501(C)(4) | Yes (1) | $0 | $0 |
| MEDICA HEALTH PLANS | ||||
| 411242261 | 501(C)(4) | Yes (1) | $0 | $0 |
| PARK NICOLLET INSTITUTE | ||||
| 410961862 | 4 | Yes (1) | $0 | $0 |
| MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH | ||||
| 411506440 | 9 | Yes (1) | $0 | $0 |
| GROUP HEALTH PLAN INC | ||||
| 410797853 | 3 | Yes (1) | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 5 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | Yes (1) | SupportedOrgSectionC456Ind |
| Supported Org Qualified | Yes (1) | SupportedOrgQualifiedInd |
| Suprt Exclusively Sec170c2 B | Yes (1) | SuprtExclusivelySec170c2BInd |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | Yes (1) | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (1) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (1) | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Test | Yes (X) | ActivitiesTestInd |
| Activities Further Exempt Prps | Yes (1) | ActivitiesFurtherExemptPrpsInd |
| Activities Engaged Org Invlmnt | Yes (1) | ActivitiesEngagedOrgInvlmntInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| I, 11G, COLUMNS (V) & (VI)- AMOUNT OF SUPPORT | NO DIRECT MONETARY SUPPORT IS INDICATED FROM INSTITUTE FOR CLINICAL SYSTEMS IMPROVEMENT (ICSI) TO ITS SUPPORTED ORGANIZATIONS: HOWEVER, THE MISSION OF ICSI IS TO CHAMPION THE CAUSE OF HEALTH CARE QUALITY AND TO ACCELERATE IMPROVEMENT IN THE VALUE OF THE HEALTH CARE ITS STAKEHOLDERS DELIVER TO THE POPULATIONS THEY SERVE. ACTIVITIES UNDERTAKEN TO ACCOMPLISH THIS MISSION ARE DESCRIBED IN SCHEDULE O: "FORM 990, PART III, LINE 4A, EXEMPT PURPOSE AND ACHIEVEMENTS." |
| IV, A, 6 - GRANTS TO OTHER THAN SUPPORTED ORGANIZATIONS | ICSI SUPPORTED NINE IMPLEMENTING PARTNERS TO SUPPORT ITS OBLIGATION THROUGH DIRECT FUNDING BY A FEDERAL GRANT. SEE SCHEDULE I FOR MORE DETAIL. |
| IV, D, 3 - SUPPORTED ORGANIZATION VOICE IN POLICIES | THE ICSI BOARD APPROVES THE ORGANIZATION'S ANNUAL AUDIT AND BUDGET. THE INVESTMENT POLICY AND QUARTERLY REPORTS ARE REVIEWED BY THE BOARD'S FINANCE AND AUDIT COMMITTEE WHICH HAS REPRESENTATIVES FROM SPONSOR AND MEMBER ORGANIZATIONS APPOINTED TO IT. |
| IV, E, 2A - FURTHERING EXEMPT PURPOSE OF SUPPORTED ORGS. | ALL ICSI ACTIVITIES SUPPORT ITS MISSION TOWARDS SUPPORTING THE TRIPLE AIM AND FOCUS ON QUALITY IMPROVEMENT, COST OF HEALTH CARE, OR POPULATION HEALTH. ALL OF ICSI'S SUPPORTING ORGANIZATIONS HAVE ADOPTED THE TRIPLE AIM AND EITHER BENEFIT DIRECTLY OR INDIRECTLY BY ICSI'S ACTIVITIES. |
| IV, E, 2B - REASON FOR ORGANIZATION'S POSITION | ALL ICSI ACTIVITIES SUPPORT ITS MISSION TOWARDS SUPPORTING THE TRIPLE AIM AND FOCUS ON QUALITY IMPROVEMENT, COST OF HEALTH CARE, OR POPULATION HEALTH. ALL OF ICSI'S SUPPORTING ORGANIZATIONS HAVE ADOPTED THE TRIPLE AIM AND EITHER BENEFIT DIRECTLY OR INDIRECTLY BY ICSI'S ACTIVITIES. |
| IV, A, 3B - 501(C)(4) SUPPORTED ORGANIZATIONS | ICSI SUPPORTED ORGANIZATIONS THAT ARE 501 (C) (4) ORGANIZATIONS ARE REQUIRED TO BE A NON-PROFIT CORPORATION UNDER MINNESOTA LAW. THE STATE OF MINNESOTA MONITORS THE PUBLIC BENEFIT OF THESE ORGANIZATIONS ANNUALLY TO ENSURE THAT THEY MEET STATE AND FEDERAL REQUIREMENTS. |
| IV, A, 3C - SUPPORTED ORGANIZATIONS | ICSI DOES NOT PROVIDE FINANCIAL SUPPORT TO ITS SUPPORED ORGANIZATIONS THAT ARE 501(C)(4) ORGANIZATIONS. THE MISSION OF ICSI IS TO CHAMPION THE CAUSE OF HEALTH CARE QUALITY AND TO ACCELERATE IMPROVEMENT IN THE VALUE OF THE HEALTH CARE ITS SUPPORTED ORGANIZATIONS DELIVER TO THE POPULATIONS THEY SERVE. ACTIVITIES UNDERTAKEN TO ACCOMPLISH THIS MISSION ARE DESCRIBED IN SCHEDULE O: "FORM 990, PART III, LINE 4A, EXEMPT PURPOSE AND ACHIEVEMENTS." |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $0 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE INSTITUTE FOR CLINICAL SYSTEMS IMPROVEMENT PAYS FOR CERTAIN CORPORATE AND EMPLOYEE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $144,614 | OtherCostOrOtherBasisAmt |
| Depreciation | $60,712 | DepreciationAmt |
| Book Value | $83,902 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $552,234 | OtherCostOrOtherBasisAmt |
| Depreciation | $416,565 | DepreciationAmt |
| Book Value | $135,669 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $219,571 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $9,046,027 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,046,027 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $9,046,027 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,441,347 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,441,347 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,441,347 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ICSI'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. ICSI RECORDED NO LIABILITIES AT DECEMBER 31, 2014 OR 2013 FOR UNRECOGNIZED TAX BENEFITS. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (8 entries)
| Address Line1USAddress/AddressLine1Txt | Address Line2USAddress/AddressLine2Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| PITTSBURGH REGIONAL HEALTH INITIATIVE | |||||||
| CTR CITY TOWER SUITE 2400640 | SMITHFIELD ST | PITTSBURGH | PA | 15222 | 010752319 | $591,059 | SUB-GRANT SERVICES |
| THE MICHIGAN CENTER FOR CLINICAL SYSTEMS IMPROVEMENT | |||||||
| 233 E FULTON ST STE 20 | GRAND RAPIDS | MI | 49503 | 274330555 | $391,472 | SUB-GRANT SERVICES | |
| HEALTHPARTNERS RESEARCH & EDUCATION | |||||||
| 8170 33RD AVE S PO BOX 1309 | MINNEAPOLIS | MN | 554401309 | 411670163 | $689,482 | SUB-GRANT SERVICES | |
| COMMUNITY HEALTH PLAN OF WASHINGTON | |||||||
| 720 OLIVE WAY STE 300 | SEATTLE | WA | 98101 | 911729710 | $407,932 | SUB-GRANT SERVICES | |
| KAISER FOUNDATION RESEARCH INSTITUTE | |||||||
| 1800 HARRISON STREET 16TH FLOOR | OAKLAND | CA | 94612 | 941105628 | $1,180,103 | SUB-GRANT SERVICES | |
| MOUNT AUBURN CAMBRIDGE INDEPENDENT PRACTICE ASSOCIATION | |||||||
| 1380 SOLDIERS FIELD ROAD FLOOR 2 | BRIGHTON | MA | 02135 | 042898888 | $135,929 | SUB-GRANT SERVICES | |
| MAYO CLINIC | |||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 416011702 | $372,913 | SUB-GRANT SERVICES | |
| UNIVERSITY OF WASHINGTON - AIMS CENTER | |||||||
| 1959 NE PACIFIC STREET BOX 356560 | SEATTLE | WA | 98195 | 916001537 | $198,964 | SUB-GRANT SERVICES | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 8 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | INSTITUTE FOR CLINICAL SYSTEMS IMPROVEMENT (ICSI) MANAGEMENT STAFF REVIEWS THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH ICSI'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO ICSI'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CRAIG ACOMB | ||||||||||||||
| CFO & COO | $0 | $161,435 | $0 | $6,000 | $0 | $0 | $0 | $13,093 | $0 | $36,138 | $0 | $216,666 | $0 | $0 |
| SANNE MAGNAN | ||||||||||||||
| PRESIDENT & CEO | $0 | $375,100 | $0 | $20,000 | $0 | $24,769 | $0 | $41,952 | $0 | $43,033 | $0 | $504,854 | $0 | $9,613 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II INCLUDES AMOUNTS FROM A NONQUALIFIED 457(F) PLAN FOR THE FOLLOWING OFFICER: SANNE MAGNAN $ 10,157 -------- TOTAL $ 10,157 |
| FORM 990, SCHEDULE J, PART II - PRIOR REPORTED COMPENSATION | COLUMN (F) INCLUDES AMOUNTS PAID TO PARTICIPANTS IN THE CURRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEARS' 990'S, AS RETIREMENT AND DEFERRED COMPENSATION, FOR THE FOLLOWING OFFICER: SANNE MAGNAN $ 9,613 ANY ANALYSIS OF EARNINGS FOR THE CURRENT YEAR, FOR THIS PARTICIPANT OF THE PLAN, SHOULD EXCLUDE THE AMOUNT IN COLUMN F AS PART OF THE ANALYSIS SINCE THOSE EARNINGS WERE ALREADY REPORTED IN COLUMN (C) OF PREVIOUS YEARS' 990'S. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 1 - THE ORGANIZATION'S MISSION | THE MISSION OF THE INSTITUTE FOR CLINICAL SYSTEMS IMPROVEMENT (ICSI) IS TO CHAMPION THE CAUSE OF HEALTH CARE QUALITY AND TO ACCELERATE IMPROVEMENT IN THE VALUE OF THE HEALTH CARE ITS STAKEHOLDERS DELIVER TO THE POPULATIONS THEY SERVE. ICSI'S VISION IS TO BE A COLLABORATION THAT IS DEEMED ESSENTIAL BY ITS MEMBERS FOR THEIR IMPROVEMENT OF HEALTH CARE AND DEEMED ESSENTIAL BY THE COMMUNITY AS A TRUSTED VOICE FOR QUALITY IN HEALTH CARE. |
| FORM 990, PART III, LINE 4A - EXEMPT PURPOSE AND ACHIEVEMENTS | I. ORGANIZATION AND GOVERNANCE ICSI IS A NONPROFIT MINNESOTA CORPORATION EXEMPT FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC") AND IS NOT A PRIVATE FOUNDATION AS DEFINED BY SECTION 509(A) OF THE IRC. ICSI IS GOVERNED BY A BOARD OF DIRECTORS. THE MISSION OF ICSI IS TO CHAMPION THE CAUSE OF HEALTH CARE QUALITY AND TO ACCELERATE IMPROVEMENT IN THE VALUE OF THE HEALTH CARE ITS STAKEHOLDERS DELIVER TO THE POPULATIONS THEY SERVE. ICSI'S VISION IS TO BE A COLLABORATION THAT IS DEEMED ESSENTIAL BY ITS MEMBERS FOR THEIR IMPROVEMENT OF HEALTH CARE AND DEEMED ESSENTIAL BY THE COMMUNITY AS A TRUSTED VOICE FOR THE IMPROVED HEALTH OF THE POPULATION, EXPERIENCE OF THE PATIENT AND AFFORDABILITY OF HEALTH CARE. ICSI HAS ABOUT 50 MEMBERS AND IS FUNDED BY FIVE MINNESOTA AND WISCONSIN HEALTH PLANS. THE COMBINED MEDICAL GROUPS, HOSPITALS, AND INTEGRATED SYSTEMS REPRESENT APPROXIMATELY 8,000 PHYSICIANS. AS PART OF ITS COMMITMENT TO SUPPORT QUALITY IMPROVEMENT, ICSI HAS ACCOMPLISHED THE FOLLOWING IN 2014. II. ICSI'S ACTIVITIES IMPROVE AFFORDABILITY - ICSI EXPANDED THE RARE (REDUCING AVOIDABLE HOSPITAL READMISSIONS) WORK TO EXPLICITLY PREVENTING MENTAL HEALTH READMISSIONS (RARE MH) AND INITIATED EXPLORATION OF PREVENTABLE EVENTS (E.G., ADMISSIONS, ED USE). - ICSI'S HIGH-TECH DIAGNOSTIC IMAGING INITIATIVE SAVED AN ESTIMATED $234 MILLION (FROM 2007 TO 2012), AND INFLUENCED THE PASSAGE OF A BILL IN 2014 THAT REQUIRES PROVIDERS TO USE CLINICAL DECISION SUPPORT TOOLS WHEN ORDERING DIAGNOSTIC TESTS FOR MEDICARE AND MEDICAID PATIENTS NATIONALLY STARTING JANUARY 1, 2017. - THE ABIM FOUNDATION GRANTS TO ICSI / MINNESOTA HEALTH ACTION GROUP AND MINNESOTA MEDICAL ASSOCIATION TO LAUNCH THE CHOOSING WISELY CAMPAIGN IN MINNESOTA RESULTED IN AN 11 PERCENT INCREASE IN AWARENESS OF THE CHOOSING WISELY CAMPAIGN OVER THE PAST YEAR. A SURVEY CONDUCTED 15 MONTHS AFTER LAUNCHING THE CAMPAIGN INDICATED THAT MORE THAN 50% OF THOSE SAID THE CAMPAIGN INFLUENCED THEIR RECOMMENDATIONS FOR PROCEDURES AND MORE PROVIDERS ARE CONSIDERING COSTS BEFORE ORDERING OR RECOMMENDING A TEST. - ICSI CONTINUED TO MAKE ADDRESSING "AFFORDABILITY" AS LEGITIMATE AN ISSUE AS IMPROVING QUALITY BY INTEGRATING THIS TRIPLE AIM GOAL INTO ALL ICSI PROJECTS, ICSI GUIDELINES AND BY PROVIDING A SERIES OF WEBINARS HIGHLIGHTING STRATEGIES FOR APPROPRIATE USE OF HEALTH CARE RESOURCES. IMPROVE THE EXPERIENCE OF CARE, INCLUDING QUALITY - IN THE COMPASS PROGRAM, PRELIMINARY RESULTS SHOW THAT OF THE 3,660 ENROLLED (AS OF NOVEMBER, 2014) 60% OF THOSE ENROLLED FOR MORE THAN FOUR MONTHS HAVE SEEN THEIR DEPRESSIVE SYMPTOMS IMPROVE COMPARED TO THE INITIATIVE'S GOAL OF 40%; 14% OF DIABETES PATIENTS HAD THEIR HBA1C IMPROVE, COMPARED TO THE INITIATIVE'S GOAL OF 20%; AND PATIENTS IDENTIFIED WITH UNCONTROLLED BLOOD PRESSURE AT BASELINE SAW AN IMPROVEMENT OF 53% COMPARED TO THE INITIATIVE'S GOAL OF 20%. - ICSI CONTINUED THE REDESIGN OF ITS GUIDELINE PROGRAM TO CREATE ALIGNMENT WITH THE INSTITUTE OF MEDICINE STANDARDS. ICSI WAS ASKED BY AHRQ TO SUBMIT A WHITE PAPER ON THIS PROCESS FOR THEIR EXPERT COMMENTARY SERIES. ICSI'S DIABETES GUIDELINE WAS OUR FIRST TO MEET THE NEW NATIONAL GUIDELINE CLEARINGHOUSE INCLUSION CRITERIA. THIS NEW APPROACH ALLOWS ICSI TO INCLUDE EXPANDED, EVIDENCE-BASED, IMPLEMENTATION COMPONENTS, SUCH AS: SHARED DECISION-MAKING, DECISION SUPPORT, IMPLEMENTATION STRATEGIES, INTERSECTIONS WITH CHOOSING WISELY RECOMMENDATIONS, HEALTH CARE VALUE/COST IMPACT, AND DEFINABLE TRIPLE AIM PROCESS AND OUTCOMES MEASURES. - ICSI CURRENTLY HAS 39 GUIDELINES AVAILABLE ON ITS WEBSITE. ICSI REVISED 8 OF THEM IN 2014. - ICSI PUBLISHED A WHITE PAPER SUMMARY OF THE GLOBAL HEALTH MEASURES DISCUSSION GROUP THAT IDENTIFIED AREAS FOR ALIGNMENT OF MEANINGFUL MEASUREMENT OF HEALTH IN CLINICAL AND NON-CLINICAL SETTINGS. - THROUGH A GRANT FROM THE AHRQ, ICSI IS PARTNERING WITH MAYO CLINIC TO SUPPORT THE USE OF SHARED DECISION-MAKING (SDM) TOOLS AS STANDARD PRACTICE IN SIX SITES. - IN CONJUNCTION WITH THE MINNESOTA DEPARTMENT OF HEALTH AND THE AMERICAN CANCER SOCIETY, ICSI COMPLETED A LEARNING COLLABORATIVE TO HELP MEDICAL GROUPS INCREASE APPROPRIATE SCREENING FOR BREAST, CERVICAL AND COLORECTAL CANCERS. - ICSI DEVELOPED SYMPHONY AND SYNERGY, A WORKSHOP THAT COMBINES MOTIVATIONAL INTERVIEWING, SHARED DECISION-MAKING AND HEALTH COACHING TO IMPROVE CARE TEAM AND PATIENT COMMUNICATION. THIS WAS OFFERED TWICE IN 2014 AND WAS VERY WELL RECEIVED. - ICSI ESTABLISHED A DECISION SUPPORT ADVISORY COUNCIL THAT DEFINED CATEGORIES OF DECISION SUPPORT TOOLS. USING THESE CATEGORIES, ICSI LAUNCHED A DECISION SUPPORT REPOSITORY, ON THE ICSI WEBSITE, FOR MEMBER USE. ICSI MEMBERS CAN CONTRIBUTE TO THIS REPOSITORY. - ICSI WAS CONTRACTED TO EVALUATE THE SBIRT (SCREENING, BRIEF INTERVENTION AND REFERRAL TO TREATMENT) INITIATIVE CENTRACARE IS IMPLEMENTING THROUGH A STATE OF MINNESOTA (DEPARTMENT OF HUMAN SERVICES) GRANT. - DR. GLYN ELWYN SPOKE AT THE ANNUAL REINERTSEN LECTURE IN OCTOBER, 2014. A SUBSEQUENT, HALF-DAY WORKSHOP WAS HOSTED WITH OVER 50 ATTENDEES. THESE EVENTS, IN PART, HELPED SATISFY A LEGISLATIVELY MANDATED REQUIREMENT FOR THE MN NON-PROFIT HEALTH PLANS ON SHARED DECISION-MAKING. IMPROVE POPULATION HEALTH - THROUGH FUNDING FROM RWJF, ICSI IS PRODUCING A SERIES OF COMMUNICATION UNDER THE BANNER OF "GOING BEYOND CLINICAL WALLS" TO HELP CLINICIANS, THEIR STAFF AND ADMINISTRATORS CONNECT WITH PUBLIC HEALTH AND OTHER COMMUNITY RESOURCES TO COLLABORATIVELY SOLVE PROBLEMS AND IMPROVE HEALTH. THE FIRST INSTALLMENT IN THIS SERIES RECEIVED 1,100 WEBSITE VISITS IN TWO MONTHS, HIGHER THAN ANY OTHER ICSI INITIATIVE IN THAT TIME PERIOD. - ICSI'S ANNUAL COLLOQUIUM HAD 387 ATTENDEES AND SUPPORTS ALL ELEMENTS OF THE TRIPLE AIM. |
| FORM 990, PART VI, SECTION A, LINE 6 | ICSI'S CURRENT MEMBERS ARE HEALTHPARTNERS, INC., BCBSM, INC., AND MEDICA. PER ARTICLE I, SECTION 1 OF ICSI'S BYLAWS, THE VOTING MEMBERS, WHICH ARE REFERRED TO AS PRINCIPAL SPONSORS IN THE BYLAWS, SHALL BE HEALTHPARTNERS, INC., BCBSM, INC., MEDICA, AND THOSE OTHER ENTITIES (A) WITH WHOM THIS CORPORATION HAS ENTERED INTO A PRINCIPAL SPONSOR AGREEMENT; (B) WHO ARE NOT IN DEFAULT UNDER SUCH AGREEMENT; (C) WHO AGREE TO USE STATEMENTS OF BEST HEALTH CARE PRACTICE DEVELOPED BY THIS CORPORATION ONLY FOR COLLABORATIVE, SYSTEMATIC QUALITY IMPROVEMENT AND NOT FOR PUNISHMENT, COERCION OR ASSIGNMENT OF PENALTY; AND (D) WHO HAVE BEEN ACCEPTED AS PRINCIPAL SPONSORS BY ALL OF THE THEN-EXISTING PRINCIPAL SPONSORS AND BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7A | PER ARTICLE III, SECTION 2 OF ICSI'S BYLAWS, THERE SHALL BE SIX INSTITUTIONAL DIRECTORS, WHO SHALL BE APPOINTED AS FOLLOWS: (I) TWO INSTITUTIONAL DIRECTORS SHALL BE APPOINTED BY MAYO FOUNDATION, A MINNESOTA NONPROFIT CORPORATION; (II) TWO INSTITUTIONAL DIRECTORS SHALL BE APPOINTED BY GROUP HEALTH PLAN, INC., D/B/A HEALTHPARTNERS MEDICAL GROUP ("HPMG"), A MINNESOTA NONPROFIT CORPORATION; AND (III) TWO INSTITUTIONAL DIRECTORS SHALL BE APPOINTED BY PARK NICOLLET HEALTH SERVICES, A MINNESOTA NONPROFIT CORPORATION. THERE SHALL BE THREE PRINCIPAL SPONSOR DIRECTORS, WHO SHALL BE APPOINTED AS FOLLOWS: (I) HEALTHPARTNERS, INC., A MINNESOTA NONPROFIT CORPORATION, SHALL APPOINT ONE PRINCIPAL SPONSOR DIRECTOR, WHO SHALL BE A MEDICAL DIRECTOR OF HEALTHPARTNERS, INC.; (II) BCBSM, INC., A MINNESOTA NONPROFIT CORPORATION D/B/A BLUE CROSS AND BLUE SHIELD OF MINNESOTA, SHALL APPOINT ONE PRINCIPAL SPONSOR DIRECTOR, WHO SHALL BE A MEDICAL DIRECTOR OF BCBSM, INC.; AND (III) MEDICA, A MINNESOTA NONPROFIT CORPORATION, SHALL APPOINT ONE PRINCIPAL SPONSOR DIRECTOR, WHO SHALL BE A MEDICAL DIRECTOR OF MEDICA. |
| FORM 990, PART VI, SECTION A, LINE 7B | PER ARTICLE IV, SECTION 9 OF ICSI'S BYLAWS, THE FOLLOWING ACTIONS SHALL NOT BE EFFECTIVE WITHOUT THE APPROVAL OF THE PRINCIPAL SPONSORS: (A) ADOPTION OF ANNUAL OPERATING AND CAPITAL BUDGETS; (B) AMENDMENTS TO APPROVED OPERATING AND CAPITAL BUDGETS; (C) PAYMENT OF UNBUDGETED EXPENDITURES IN EXCESS OF $100,000; (D) ADOPTION OR AMENDMENT OF ANY STRATEGIC OR ANNUAL PLAN; OR (E) SUBSTANTIAL CHANGES IN THE PROGRAMMATIC OR STRATEGIC DIRECTION OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11 | ICSI'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF ICSI. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GHI, THE MANAGEMENT TEAM OF ICSI, ICSI'S OUTSIDE LEGAL COUNSEL AND ICSI'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF ICSI. ONCE THAT REVIEW PROCESS HAS BEEN COMPLETED, IT IS THE POLICY OF ICSI TO MAKE AVAILABLE TO THE FINANCE AND AUDIT COMMITTEE OF ITS BOARD OF DIRECTORS AND TO ITS BOARD OF DIRECTORS, A COPY OF THE 990 PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY WILL BE PROVIDED IN THE BOARD PACKET OF BOTH THE FINANCE AND AUDIT COMMITTEE MEETING AND THE BOARD OF DIRECTORS MEETING PRIOR TO THE FILING OF THE 990 AND WILL BE AN AGENDA ITEM AT BOTH MEETINGS. THE BOARD OF DIRECTORS HAS GIVEN THE RESPONSIBILITY OF THE 990 REVIEW PROCESS TO THE FINANCE AND AUDIT COMMITTEE. IT WILL BE THE RESPONSIBILITY OF THE FINANCE AND AUDIT COMMITTEE TO ADDRESS THAT REVIEW WITH THE BOARD OF DIRECTORS. THIS PROCESS WILL BE NOTED AND DOCUMENTED TO THE MEETING MINUTES OF BOTH MEETINGS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ICSI'S BOARD OF DIRECTORS MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND REQUESTED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. A REPORT OF THESE POTENTIAL CONFLICTS IS SHARED WITH THE BOARD OF DIRECTORS, INCLUDING THE PRESIDENT. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | ICSI HAS NO EMPLOYEES. THE PRESIDENT AND OTHER OFFICERS ARE PAID BY GHI, A SUPPORTED ORGANIZATION, WHICH HAS AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF ICSI'S PRESIDENT AND ITS OTHER OFFICERS. EVERY THREE YEARS, UNDER THE DIRECTION OF THE GHI BOARD OF DIRECTORS' COMPENSATION COMMITTEE (COMPENSATION COMMITTEE), A TOTAL COMPENSATION MARKET REVIEW IS COMPLETED. THE REVIEW INCLUDES ALL COMPONENTS OF COMPENSATION; BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE INDEPENDENT COMPENSATION COMMITTEE. IN INTERIM YEARS, GHI'S HUMAN RESOURCES STAFF, UNDER THE DIRECTION OF THE COMPENSATION COMMITTEE, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION COMMITTEE. FOR THE PRESIDENT AND CERTAIN OTHER POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED. IN ALL CASES, COMMITTEE MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMPENSATION COMMITTEE MEMBERS' INDEPENDENCE, STAFF IS NOT IN ROOM DURING DELIBERATIONS OR VOTE INCLUDING EXECUTIVE SESSIONS, AND CONTEMPORANEOUS MINUTES ARE KEPT. THE BOARD OF DIRECTORS HAS DELEGATED TO THE COMPENSATION COMMITTEE THE ACCOUNTABILITY TO CONDUCT AN ANNUAL PERFORMANCE EVALUATION AND TO DETERMINE THE COMPENSATION OF THE PRESIDENT BASED ON THE PERFORMANCE REVIEW AND THE MARKET COMPARABILITY DATA, APPROVED BY THE COMPENSATION COMMITTEE. THE BOARD HAD DELEGATED TO THE PRESIDENT (WITH AUTHORITY TO FURTHER DELEGATE) THE ACCOUNTABILITY TO CONDUCT ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL OTHER OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMPENSATION COMMITTEE. ANY EXCEPTIONS NEED TO BE APPROVED BY THE COMPENSATION COMMITTEE. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND W2 STATEMENTS. |
| FORM 990, PART VI, SECTION C, LINE 19 | ICSI'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM ICSI. ICSI'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE MINNESOTA SECRETARY OF STATE'S OFFICE. |
| FORM 990, PART VII, SECT A, LINE 1A, COL (B) - AVERAGE HRS - RELATED ORG | ALL EMPLOYEES OF ICSI ARE EMPLOYED AND COMPENSATED BY GHI. ICSI REIMBURSES GHI 100% OF SALARIES AND BENEFITS. ALL HOURS WORKED BY ICSI EMPLOYEES ARE TO SUPPORT ICSI'S OPERATIONS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS INC | ||||||||||
| 8170 33RD AVENUE SOUTH PO BOX 1309 | MINNEAPOLIS | MN | 554401309 | 411693838 | HYBRID STAFF MODEL/NETWORK MODEL HMO | MN | 501(C)(4) | N/A | 0 | |
| MEDICA HEALTH PLANS | ||||||||||
| 401 CARLSON PARKWAY | MINNETONKA | MN | 55305 | 411242261 | HEALTH INSURANCE | MN | 501(C)(4) | N/A | 0 | |
| PARK NICOLLET INSTITUTE | ||||||||||
| 6500 EXCELSIOR BOULEVARD | ST LOUIS PARK | MN | 55426 | 237346465 | HEALTH CARE ADMINISTRATION | MN | 501(C)(3) | N/A | 0 | 170(B)(1) (A)(III) |
| MAYO FOUNDATION | ||||||||||
| 200 1ST STREET SW | ROCHESTER | MN | 55905 | 411506440 | SUPPORT MEDICINE/HEALTHCARE ORGANIZATION | MN | 501(C)(3) | N/A | 0 | 509(A)(2) |
| GROUP HEALTH PLAN INC | ||||||||||
| 8170 33RD AVENUE SOUTH PO BOX 1309 | MINNEAPOLIS | MN | 554401309 | 410797853 | STAFF MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(3) | N/A | 0 | 170(B)(1) (A)(III) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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