PINE REST FOUNDATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
PINE REST FOUNDATION (EIN 38-1676540)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-03-20
IRS object ID
201200889349300970
Schema version
2010v3.4
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-03-20T09:30:58-07:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN381676540EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PINE REST FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPINENameControl
Phone6164555000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 165AddressLine1
CityGrand RapidsCity
StateMIState
ZIP Code495010165ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePaul KarstenName
TitleChief Financial OfficerTitle
Phone6164555000Phone
Date Signed2012-03-20DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1Pine Rest FoundationBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO Box 165AddressLine1
CityGrand RapidsCity
StateMIState
ZIP Code495010165ZIPCode
FieldValueIRS element (for citing)
Gross Receipts13943483GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.pinerest.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1960YearFormation
State Legal DomicileMIStateLegalDomicile
Activity Or Mission DescriptionThe Pine Rest Foundation was organized to raise funds by means of memberships and gifts, to manage investment assets in an effort to increase available funds, and to provide grants that support the services and mission of Pine Rest Christian Mental Health Services which is to express the healing ministry of Jesus Christ by providing behavioral health care with professional excellence, Christian integrity and compassion.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year514749ContributionsGrantsPriorYear
Contributions Grants Current Year646186ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year1465848InvestmentIncomePriorYear
Investment Income Current Year3717903InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year1980597TotalRevenuePriorYear
Total Revenue Current Year4364089TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year914466GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY899417GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year282542OtherExpensePriorYear
Other Expenses Current Year144658OtherExpensesCurrentYear
Total Expenses Prior Year1197008TotalExpensesPriorYear
Total Expenses Current Year1044075TotalExpensesCurrentYear
Revenues Less Expenses Prior Year783589RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3320014RevenuesLessExpensesCY
Total Assets BOY17096753TotalAssetsBOY
Total Assets EOY20385375TotalAssetsEOY
Total Liabilities BOY78561TotalLiabilitiesBOY
Total Liabilities EOY47169TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY17018192NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY20338206NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe Pine Rest Foundation was organized to raise funds by means of memberships and gifts, to manage investment assets in an effort to increase available funds, and to provide grants that support the services and mission of Pine Rest Christian Mental Health Services which is to express the healing ministry of Jesus Christ by providing behavioral health care with professional excellence, Christian integrity and compassion.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense872223Expense
Grants872223Grants
Revenue0Revenue
DescriptionEach year, following a specific formula, the Pine Rest Foundation awards grants to the Pine Rest Christian Mental Health Services to fund various aspects of behavioral health care and counseling programs. An award of $454,353 was made to provide funds for financial assistance for patients with the inability to pay for services. An additional $417,870 was made available for education, prevention and support programs throughout the Hospital. A Job Support and Career Exploration Program was funded for emotionally disturbed adolescents in the residential parogram. Funding was provided for additional therapeutic resources available to implement scientifically proven higher outcome based treatment for children ages 12 and under. Funding was also provided for the initial hiring, training and support of research personnel that will be necessary to expand the number of self-sustaining clinical research projects at Pine Rest. A number of research, development and training programs were also funded.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense27194Expense
Grants0Grants
Revenue99698Revenue
DescriptionAnnual Golf Classic Fund Raiser: The net proceeds from the Annual Golf Classic is put into a Foundation Endowment that builds each year. Then every 3-years, a three-year rolling average is taken to provide support to the Patient Assistance Fund, a program which provides financial assistance for patients with the inability to pay for services, or invested in order to provide additional support to Pine Rest.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense899417TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMIStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Paul H KarstenBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6164555000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1300 68th Street SEAddressLine1
CityGrand RapidsCity
StateMIState
ZIP Code495486927ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
Randall Johnson
Executive Director20X010069911639
Mark Eastburg
Board Member2X024405618254
Rick Treur
Board Member1X000
Jim Schipper
Board Member1X000
John Van Fossen
Board Member1X000
Jeff Yonker
Board Member1X000
Thomas Nobel
Board Member1X000
Charles Burt
Board Member1X000
Lou Anne Gaydou
Board Member1X000
Jon Marcus
Board Member1X000
Steve Wert
Board Member1X000
David Bellamy
Board Member1X000
Kirk Lambers
Board Member1X000
Carol Van Andel
President4000X
John Lichtenberg
Vice President4000X
Cindy Varney
Secretary4000X
Ray Reitsma
Treasurer4000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs344755TotalReportableCompFrmRltdOrgs
Total Other Compensation29893TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues19046MembershipDues
Fundraising Events99698FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions527442AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions646186TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column425421TotalRevenueColumn
Related Or Exempt Function Income425421RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities12871876Securities
Other0Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities9579394Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3292482Securities
Other0Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3292482TotalRevenueColumn
Related Or Exempt Function Income3292482RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events99698CntrbtnsRprtdFundraisingEvents
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4364089TotalRevenueColumn
Related Or Exempt Function Income3717903RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total899417Total
Program Services899417ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total4270Total
Program Services0ProgramServices
Management And General4270ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total298Total
Program Services0ProgramServices
Management And General298ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total12400Total
Program Services0ProgramServices
Management And General12400ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total110022Total
Program Services0ProgramServices
Management And General110022ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1390Total
Program Services0ProgramServices
Management And General1390ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total16278Total
Program Services0ProgramServices
Management And General16278ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1044075Total
Program Services899417ProgramServices
Management And General144658ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY906043BOY
EOY767239EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY12760BOY
EOY12287EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY16177950BOY
EOY19605849EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY17096753BOY
EOY20385375EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY78561BOY
EOY47169EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY78561BOY
EOY47169EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY13312319BOY
EOY16632333EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3705873BOY
EOY3705873EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY17018192BOY
EOY20338206EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY17096753BOY
EOY20385375EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses3320014ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1PINE REST CHRISTIAN MENTAL HEALTH SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
EIN381368360EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$872,223Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts872223SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3705873BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses0InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance3705873EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3705873BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses0InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance3705873EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3705873BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses0InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance3705873EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0BoardDesignatedEOYBalance
Permanent Endowment EOY Balance1PermanentEndowmentEOYBalance
Term Endowment EOY Balance0TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSchD_P05_S00_L04Identifier
Return ReferenceSchedule D, Part V, Line 4ReturnReference
ExplanationThe permanent endowment funds will be held in perpetuity and the income generated by the corpus of these funds will be used to fulfill the mission of the Foundation.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Annual Golf ClassicNameOfEvent1
Gross Receipts Event199698GrossReceiptsEvent1
Charitable Contributions Event10CharitableContributionsEvent1
Gross Revenue Event199698GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Non Cash Prizes Event10NonCashPrizesEvent1
Rent Facility Costs Event10RentFacilityCostsEvent1
Food And Beverage Event10FoodAndBeverageEvent1
Entertainment Event10EntertainmentEvent1
Other Direct Expenses Event127194OtherDirectExpensesEvent1
Food And Beverage Other Events0FoodAndBeverageOtherEvents
Entertainment Other Events0EntertainmentOtherEvents
Gross Receipts Total99698GrossReceiptsTotal
Charitable Contributions Total0CharitableContributionsTotal
Gross Revenue Total Events99698GrossRevenueTotalEvents
Cash Prizes Total Events0CashPrizesTotalEvents
Non Cash Prizes Total Events0NonCashPrizesTotalEvents
Rent Facility Costs Total Events0RentFacilityCostsTotalEvents
Food And Beverage Total Events0FoodAndBeverageTotalEvents
Entertainment Total Events0EntertainmentTotalEvents
Other Direct Expenses Total Events27194OtherDirectExpensesTotalEvents
Direct Expense Summary Events27194DirectExpenseSummaryEvents
Net Income Summary72504NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Pine Rest Christian Mental Health ServicesBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 165AddressLine1
CityGrand RapidsCity
StateMIState
ZIP Code495010165ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient381368360EINOfRecipient
IRC Section501(c)(3)IRCSection
Amount Of Cash Grant944727AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Method Of ValuationCash ValueMethodOfValuation
Purpose Of GrantThe purpose of the grants was to support the programs, services and mission of Pine Rest Christian Mental Health Services, its sole member.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSchI_P01_S00_L02Identifier
Return ReferenceSchedule I, Part I, Line 2ReturnReference
ExplanationAll grants are reviewed by the Foundation Board of Governors on a regular basis. Each specific service or program is monitored periodically by an assigned governor. This involves regular contact between the Board of Governors and the managers responsible for utilizing the grant funds for their intended purpose.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonMark EastburgNamePerson
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs244056CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs5696DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs12558NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs262310TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchJ_P01_S00_L01aSchedule J, Part I, Line 1aFees were paid for membership at the University Club in Grand Rapids, Michigan for the purpose of holding Board and Committee meetings downtown. The downtown location is the closest location to most of the Board and Committee members and results in higher attendance and participation. The University Club also offers a convenient location to have meetings with donors and potential donors. Receipts and documentation for each charge are required before payment is made to the University Club.
SchJ_P01_S00_L03Schedule J, Part I, Line 3The organization did not pay any compensation to any officer, director, etc... Compensation disclosed was paid by the organization's sole member, Pine Rest Christian Mental Health Services, a nonprofit corporation.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Mark Eastburg
Key Employee of related organization262310President and CEO, Dr. Mark Eastburg0
Randall Johnson
Key employee of related organization112338Executive Director, Randall Johnson0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P03_S00_L04aForm 990, Part III, Line 4aDuring the summer of 2008, the Foundation amended its Articles of Incorporation to be organized on a membership basis with the corporation's sole member being Pine Rest Christian Mental Health Services, a 501 (c) 3 non profit. As a result, the Foundation also amended its by-laws to change the accounting period from a December fiscal year end to a June fiscal year end. This change would correspond to the fiscal year end date of the sole member - Pine Rest Christian Mental Health Services. Due to this change, the Foundation has determined that the reporting of Foundation grants awarded during the fiscal year covered on the 990 needed to be synched up with the fiscal year end June 30, 2011. In order to do this, the Foundation has repeated the Foundation award grants of $872,223 originally reported June 30, 2010 on the June 30, 2011 990.
F990_P06_S0A_L02Form 990, Part VI, Section A, Line 2Conflict of Interest Disclosures: John Lichtenberg - The sole member is a client of a law firm for which John Lichtenberg is greater than a 5% owner. Cindy Varney - The branch manager where the Foundation performs banking activities and has a family member who is a patient of Pine Rest Christian Mental Health Services in the Adrian home receiving Patient Assistance Funds. Kirk Lambers - On the Contributions Committee for Royal Technologies, whom has given contributions to the Pine Rest Foundation in the past few years. Carri Kendall - John and Carri Kendall own 100% of DK Security, whom is a vendor of Pine Rest Christian Mental Health Services.
F990_P06_S0A_L06Form 990, Part VI, Section A, Line 6The Foundation is a corporation organized on a membership basis. The corporation's sole member is Pine Rest Christian Mental Health Services, a nonprofit corporation.
F990_P06_S0A_L07bForm 990, Part VI, Section A, Line 7bThe Foundation is a corporation organized on a membership basis. The corporation's sole member is Pine Rest Christian Mental Health Services, a nonprofit corporation. Decisions of the governing board are subject to approval by the sole member.
F990_P06_S0B_L11aForm 990, Part VI, Section B, Line 11aThe organization made the decision to have the Pine Rest Foundation Board Members review the Form 990 for the full year: July 1, 2010 to June 30, 2011 at the first Pine Rest Foundation Board meeting to take place subsequent to completion and prior to filing. This meeting took place on Monday, March 19, 2012 and fulfilled the required procedures for the review and approval of the Form 990.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cThe organization made the decision to have the Pine Rest Foundation Board Members review the Form 990 for the full year: July 1, 2010 to June 30, 2011 at the first Pine Rest Foundation Board meeting to take place subsequent to completion and prior to filing. This meeting took place on Monday, March 19, 2012 and fulfilled the required procedures for the review of the Form 990. The organization also had each of its Board Members complete a specific Conflict of Interest questionairre, which adheres to the corporate policy of Conflict of Interest Disclosures.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19All documents are available to the public upon request.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Pine Rest Christian Mental Health ServicesBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 165AddressLine1
CityGrand RapidsCity
StateMIState
ZIP Code495010165ZIPCode
FieldValueIRS element (for citing)
EIN381368360EIN
Primary ActivitiesProvides behavioral health services in inpatient, outpatient, and residential settings.PrimaryActivities
Legal Domicile StateMILegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status3PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationIRS announced a two month suspension of due dates to allow for the modernization of the e-file operations for 990 filers. According to the IRS announcement, organizations with approved extensions between January 1, 2012 and February 29, 2012 will be considered timely if filed by March 31, 2012. Pine Rest Foundation received approval for Form 8868 extending the due date to February 15, 2012.Explanation

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