2012-03-20T09:30:58-07:00 2011-06-30 990 2010-07-01 381676540 PINE REST FOUNDATION PINE 6164555000 PO Box 165 Grand Rapids MI 495010165 Paul Karsten 6164555000 2012-03-20 2010 2016-02-24 21:20:13Z Pine Rest Foundation PO Box 165 Grand Rapids MI 495010165 13943483 0 X www.pinerest.org X 1960 MI The 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. 17 15 0 0 0 0 514749 646186 0 0 1465848 3717903 0 0 1980597 4364089 914466 899417 0 0 0 0 0 0 0 282542 144658 1197008 1044075 783589 3320014 17096753 20385375 78561 47169 17018192 20338206 X The 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. 0 0 872223 872223 0 Each 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. 27194 0 99698 Annual 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. 0 0 0 899417 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 X 17 15 1 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MI X X Paul H Karsten 6164555000 300 68th Street SE Grand Rapids MI 495486927 Randall Johnson 20 X 0 100699 11639 Mark Eastburg 2 X 0 244056 18254 Rick Treur 1 X 0 0 0 Jim Schipper 1 X 0 0 0 John Van Fossen 1 X 0 0 0 Jeff Yonker 1 X 0 0 0 Thomas Nobel 1 X 0 0 0 Charles Burt 1 X 0 0 0 Lou Anne Gaydou 1 X 0 0 0 Jon Marcus 1 X 0 0 0 Steve Wert 1 X 0 0 0 David Bellamy 1 X 0 0 0 Kirk Lambers 1 X 0 0 0 Carol Van Andel 4 X 0 0 0 John Lichtenberg 4 X 0 0 0 Cindy Varney 4 X 0 0 0 Ray Reitsma 4 X 0 0 0 0 344755 29893 0 0 1 0 0 0 19046 99698 0 0 527442 0 646186 0 425421 425421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12871876 0 9579394 0 3292482 0 3292482 3292482 0 0 99698 0 4364089 3717903 0 0 899417 899417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4270 0 4270 0 298 0 298 0 12400 0 12400 0 0 0 0 0 0 0 110022 0 110022 0 0 0 0 0 0 0 0 0 1390 0 1390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16278 0 16278 1044075 899417 144658 0 906043 767239 0 0 12760 12287 0 0 0 0 0 0 0 0 0 0 0 0 16177950 19605849 0 0 0 0 17096753 20385375 78561 47169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78561 47169 X 13312319 16632333 0 0 3705873 3705873 17018192 20338206 17096753 20385375 3320014 X 0 1 1 X 0 X X X 0 0 0 PINE REST CHRISTIAN MENTAL HEALTH SERVICES 381368360 3 1 1 1 872223 1 872223 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3705873 0 0 0 0 0 3705873 3705873 0 0 0 0 0 3705873 3705873 0 0 0 0 0 3705873 0 1 0 0 0 SchD_P05_S00_L04 Schedule D, Part V, Line 4 The 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. Annual Golf Classic 99698 0 99698 0 0 0 0 0 27194 0 0 99698 0 99698 0 0 0 0 0 27194 27194 72504 1 Pine Rest Christian Mental Health Services PO Box 165 Grand Rapids MI 495010165 381368360 501(c)(3) 944727 0 Cash Value The purpose of the grants was to support the programs, services and mission of Pine Rest Christian Mental Health Services, its sole member. 1 0 SchI_P01_S00_L02 Schedule I, Part I, Line 2 All 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. X 1 1 0 0 0 0 0 0 0 0 0 Mark Eastburg 0 244056 0 0 0 0 0 5696 0 12558 0 262310 0 SchJ_P01_S00_L01a Schedule J, Part I, Line 1a Fees 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_L03 Schedule J, Part I, Line 3 The 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. Mark Eastburg Key Employee of related organization 262310 President and CEO, Dr. Mark Eastburg 0 Randall Johnson Key employee of related organization 112338 Executive Director, Randall Johnson 0 F990_P03_S00_L04a Form 990, Part III, Line 4a During 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_L02 Form 990, Part VI, Section A, Line 2 Conflict 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_L06 Form 990, Part VI, Section A, Line 6 The 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_L07b Form 990, Part VI, Section A, Line 7b The 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_L11a Form 990, Part VI, Section B, Line 11a The 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_L12c Form 990, Part VI, Section B, Line 12c The 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_L19 Form 990, Part VI, Section C, Line 19 All documents are available to the public upon request. Pine Rest Christian Mental Health Services PO Box 165 Grand Rapids MI 495010165 381368360 Provides behavioral health services in inpatient, outpatient, and residential settings. MI 501(c)(3) 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 IRS 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.