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        <BusinessName>
          <BusinessNameLine1Txt>Brianne Wagner</BusinessNameLine1Txt>
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        <TitleTxt>Foundation Director</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>124078</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>8248</BonusRelatedOrganizationsAmt>
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        <OtherCompensationRltdOrgsAmt>679</OtherCompensationRltdOrgsAmt>
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        <DeferredCompRltdOrgsAmt>8490</DeferredCompRltdOrgsAmt>
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        <TotalCompensationRltdOrgsAmt>172829</TotalCompensationRltdOrgsAmt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD, JEAN MACDONELL, DUE TO A VESTING EVENT, THE FOLLOWING INDIVIDUALS HAD INCOME IN PART VII AND SCHEDULE J RELATED TO A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD $2,049,355</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 7 Non-fixed payments</FormAndLineReferenceDesc>
        <ExplanationTxt>Fairview Health Services provides lump sum financial awards based on system-wide, business unit and/or departments financial and quality measures. Annual goals, specifically tied to productivity and quality indicators, are set for the year and an incentive paid out annually if key goals and measures are achieved.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3 Related Org to establish compensation</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION IS PART OF THE FAIRVIEW HEALTH SERVICES SYSTEM AND FAIRVIEW HEALTH SERVICES HUMAN RESOURCES USES COMPARABLES TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR ACCORDING TO MARKET STANDARDS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part V, Line 1a Part V, Line 1a</FormAndLineReferenceDesc>
        <ExplanationTxt>All cash disbursements are centralized through a related organization, Fairview Health Services a 501(c)3 non-profit tax-exempt organization. Therefore, the related organization, Fairview Health Services, makes the payment and files the related Form 1099's and Form 1096 instead of this organization.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part V, Line 2a</FormAndLineReferenceDesc>
        <ExplanationTxt>Grand Itasca Foundation leases employees from a related organization, Grand Itasca Clinic and Hospital, a 501(c)(3) tax-exempt, non-profit organization. Therefore, Grand Itasca Clinic and Hospital files the appropriate W-3 and related W-2 tax forms for these individuals instead of Grand Itasca Foundation. The leased employee compensation on the Grand Itasca Foundation Form 990 Part VII and Schedule J is reported as compensation paid by related organization, Grand Itasca Clinic and Hospital.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>Grand Itasca Clinic &amp; Hospital, a Minnesota nonprofit corporation, is the sole member of Grand Itasca Foundation.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>Grand Itasca Clinic &amp; Hospital, as the only voting member of Grand Itasca Foundation, has the authority to elect and remove the directors of Grand Itasca Foundation with or without cause, at any time.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>Various powers, as stated in Section 4.4 of Grand Itasca Foundation's bylaws, are reserved for Grand Itasca Clinic &amp; Hospital, the one voting member of Grand Itasca Foundation</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 990 is reviewed by the Board of Directors and the Foundation director prior to filing with the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>Conflict of Interest policies are reviewed annually. Conflict of Interest forms are signed annually by all board members.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>Financial statements, conflict of interest policy and governing documents are available upon request for the same period of disclosure as set forth in Section 6104(D).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VII, Section B, Line 1 Additional Information</FormAndLineReferenceDesc>
        <ExplanationTxt>Form 1099's were filed by a related organization Fairview Health Services, a 501(c)(3) non-profit, tax-exempt organizations. Fairview Health Services reports the five highest compensated independent contractors for the system.</ExplanationTxt>
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          <BusinessNameLine1Txt>Grand Itasca Clinic and Hospital</BusinessNameLine1Txt>
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          <AddressLine1Txt>1601 Golf Course Road</AddressLine1Txt>
          <CityNm>Grand Rapids</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
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          <CityNm>Minneapolis</CityNm>
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      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
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      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
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