2014-11-12T11:09:25-06:00 2013-12-31 346565596 Ernst & Young US LLP 178 S Rio Grande St STE 400 Salt Lake city UT 84101 990 2013-01-01 800225150 Intermountain Healthcare Foundation Inc INTE 8014422000 36 South State Street No 2200 Salt Lake City UT 84111 President President 8014422000 2014-11-05 0 Shannon DeForest P00712229 8013503300 2013 2015-11-30 17:44:51Z Albert R Zimmerli 36 South State Street No 2200 Salt Lake City UT 84111 82371061 0 X N/A X 2009 UT Provide strategic and fiduciary leadership for philanthropic endeavors of IHC Health Services, Inc. 13 8 0 14 -483342 -483342 144787789 26629839 0 0 1195238 4218390 710979 61001 146694006 30909230 674780 15273009 0 0 0 0 0 0 506268 905762 1801037 1580542 17074046 145113464 13835184 225010055 265532742 78515987 91507325 146494068 174025417 Provide strategic and fiduciary leadership for the philanthropic endeavors of IHC Health Services, Inc. 0 0 15273009 15273009 0 Intermountain Healthcare Foundation, Inc. supported the healthcare activities of IHC Health Services, Inc. by enhancing and strengthening the relationship between the Foundation and community leaders and by developing financial and charitable support. 15273009 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 5 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 13 8 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 X Colin Quincy 8014423491 36 S State Street Suite 2300 Salt Lake City UT 84111 A Scott Anderson Trustee/Vice Chair 3.00 13.00 X X 0 289 0 Edward Clark MD Trustee 1.00 0.00 X 0 0 0 Thomas D Dee III Trustee 1.00 0.00 X 0 25527 2009 Spencer F Eccles Trustee 1.00 2.00 X 0 579 0 Kem C Gardner Trustee/Chair 3.00 9.00 X X 0 1002 0 M Elizabeth Hammond MD Trustee 1.00 0.00 X 0 631 0 Christena Huntsman Durham Trustee 1.00 0.00 X 0 0 0 Jim Laub Trustee 1.00 0.00 X 0 0 0 Todd Pedersen Trustee 1.00 0.00 X 0 0 0 Charles W Sorenson Jr MD Trustee/Secretary 3.00 63.00 X X 0 6428819 969904 Diane Stewart Trustee 1.00 0.00 X 0 0 0 Cyndi Woodbury Gilbert Trustee 1.00 0.00 X 0 0 0 Albert R Zimmerli Trustee/President 1.00 64.00 X X 0 1405568 1057538 David Flood Vice President / CDO 50.00 0.00 X 0 251388 56516 0 8113803 2085967 0 0 1 0 0 310712 2670745 2247479 21400903 2543258 26629839 2806704 -751246 3557950 50469448 49057762 1411686 1411686 267904 1143782 1954631 2670745 2050249 -95618 -95618 510439 353820 156619 156619 30909230 0 -483342 4762733 15271193 15271193 1816 1816 409986 144790 265196 5000 4000 1000 551351 551351 105746 44720 61026 330456 250017 80439 36618 36618 6320 5581 739 64167 43571 20596 102751 76125 26626 300 300 6579 6523 56 181763 131173 50590 17074046 15273009 1294769 506268 480 9174633 22468619 8065537 6355842 51529 54153 4327 4976 545458 25066 539191 520392 200608945 228467728 1025916 1109302 5539977 6551250 225010055 265532742 1048169 2946346 2787347 1591862 74680471 86969117 78515987 91507325 X 414355 17076844 127835368 130007643 18244345 26940930 146494068 174025417 225010055 265532742 X 13835184 13721146 -24981 X 0 1 X 0 0 X 386982 193079 144787789 26629839 171997689 386982 193079 144787789 26629839 171997689 4004511 167993178 855895 2806704 3662599 175660288 4539142 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 146079713 23706675 3107693 15945508 156948573 329665 146530976 2187943 2968871 146079713 304306 273174 247815 329665 471256 166950 304306 0.00000 0.11610 0.88390 0 0 383440 383440 126778 16904 109874 23116 3214 19902 12124 4948 7176 520392 Securities held for affiliates 86039679 Investment purchases payable 906292 Other Liabilities 23146 86969117 Form 990, Schedule D, Part V, Line 4 The Intermountain Healthcare Foundation's temporary and permanent endowments have been set aside to fund physical and mental health programs for the medically needy, including necessary buildings and equipment. Festival of Trees 1930434 973922 956512 110601 17947 705673 Jubilee of Trees 1016014 705218 310796 14506 42692 32800 359944 22 1678928 991605 687323 4450 34066 62802 168670 53286 442812 4625376 2670745 1954631 4450 34066 187909 229309 86086 1508429 2050249 -95618 1 IHC Health Services Inc 36 S State Street Suite 2200 Salt Lake City UT 84111 942854057 501(c)(3) 11596305 Hospital Support Alabama Children's Hospital 1600 7th Ave So Birmingham AL 35233 630879471 501(c)(3) 35000 HCRN ClinSite research Texas Children's Hospital 1919 S Braeswood Ste 5214 Houston TX 77030 741100555 501(c)(3) 22000 HCRN ClinSite research University of Utah Dept of Pediatrics PO Box 581374 Salt Lake City UT 84158 876000525 Gov 3541579 Research Midtown Clinic 2240 Adams Ave Ogden UT 84401 870540039 501(c)(3) 41500 Health Connection American Cancer Society 941 E 3300 S Salt Lake City UT 84106 131788491 501(c)(3) 31135 Patient Navigator Program 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 back to the Foundation how the funds were used. 0 1 0 0 0 0 0 0 0 Charles W Sorenson Jr MD Trustee/Secretary 0 941185 0 703560 0 4784074 0 930113 0 39791 0 7398723 0 5281544 Albert R Zimmerli Trustee/President 0 802579 0 569617 0 33372 0 1025850 0 31688 0 2463106 0 441156 David Flood Vice President / CDO 0 162523 0 50000 0 38865 0 46875 0 9641 0 307904 0 0 Part I, Line 4b IHC Health Services, Inc., a related organization, offers a supplemental nonqualified retirement plan to select members of its Advisory Council. 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 2013 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 in 2013 from IHC Health Services, Inc., a related tax exempt organization: - Charles W Sorenson Jr MD $4,738,970 X 1 1000000 FMV X Misc. Auction 2780 1543258 FMV 0 0 0 Part I, Column (b): The noncash contributions recorded on line 25 represent the number of individual contributors. Form 990, Part VI, Section A, line 2 Albert R Zimmerli / Charles W Sorenson Jr MD - Business Relationship (Board members of SelectHealth Benefit Assurance Company, a wholly owned taxable subsidiary of an affiliate of the filing organization.) Charles W Sorenson Jr MD / Albert R Zimmerli / A Scott Anderson / Kem C Gardner - Business Relationship (Board members and/or officers of IHC Affiliated Services, Inc., a taxable corporation with minimal activity that is wholly owned by an affiliate of the filing organization.) Charles W Sorenson Jr MD / Albert R Zimmerli / Thomas D Dee - Business Relationship. Form 990, Part VI, Section A, line 6 The sole member of Intermountain Healthcare Foundation, Inc. is IHC Health Services, Inc., a 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 member exercises all property, voting, and other rights, interests and powers conferred under local statute, including the election of Intermountain Healthcare Foundation Trustees. Form 990, Part VI, Section B, line 11 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. The questionnaires are collected and reviewed, per policy, 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, IHC Health Services 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 Intermountain Healthcare Foundation, Inc. or the outside entity). 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 contributions recievable -24,981. Intermountain Health Care Inc 36 South State Suite 2200 Salt Lake City UT 84111 870269232 Holding Company UT 501(C)(3) Line 11a, I 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 IHC Management Inc 36 South State Suite 2200 Salt Lake City UT 84111 942860622 Community Health UT 501(C)(3) Line 11b, II 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 11a, I Intermountain Health Care Inc 0 Intermountain Health Care Retiree VEBA 36 South State Suite 2200 Salt Lake City UT 84111 742675605 Retirement Benefits UT 501(C)(9) Intermountain Health Care Inc 0 IHC Professional Services Inc 36 South State Suite 2200 Salt Lake City UT 84111 942886596 Community Health UT 501(C)(3) Line 11a, I Intermountain Health Care Inc 0 SelectHealth Inc 5381 Green Street Murray UT 84123 870409820 Delivery of Health Benefits UT 501(C)(4) Intermountain Health Care Inc 0 Heart & Lung Research Foundation 36 South State Suite 2200 salt Lake City UT 84111 870617606 Community Health UT 501(C)(3) Line 7 Intermountain Healthcare Foundation Inc 0 McKay Dee Surgical Center LLC 4401 Harrison Blvd Ogden UT 84403 260286308 Outpatient Surgery UT 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 0 SelectHealth Benefit Insurance Company Inc 5381 Green Street Murray UT 84123 870497579 Insurance UT N/A C 0 IHC Affiliated Services Inc 36 South State Suite 2200 Salt Lake City UT 84111 870405996 Hospital Services UT N/A C 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0