2023-10-20T18:17:55-05:00 2022-12-31 463330935 AVENSON HAMANN CPAS LLP 7421 BURNET ROAD 522 AUSTIN TX 78757 990 2022-01-01 200914085 THE PHYSICIANS FOUNDATION INC PHYS 6173990417 401 W 15TH STREET 100 AUSTIN TX 78701 JOHN DORMAN COO 6173990417 2023-10-20 1 JOHN DORMAN 999009999 0 CATHERINE AVENSON P01259734 5126939131 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JOHN DORMAN 401 W 15TH STREET 100 AUSTIN TX 78701 11575063 0 X WWW.PHYSICIANSFOUNDATION.ORG X 2003 FL THE FOUNDATION'S PURPOSE IS TO ADVANCE THE WORK OF PRACTICING PHYSICIANS AND TO IMPROVE THE QUALITY OF HEALTH CARE FOR ALL AMERICANS. 21 20 2 0 0 0 10000 0 0 0 7615645 2693883 0 2125 7625645 2696008 2155816 2041246 0 0 704126 750183 0 0 0 2986723 3199785 5846665 5991214 1778980 -3295206 135038479 110470672 2185768 2436355 132852711 108034317 X TO SUPPORT, BENEFIT OR CARRY OUT THE CHARITABLE PURPOSES OF PUBLICLY SUPPORTED ORGANIZATIONS WHOSE PURPOSES INCLUDE PROMOTING HIGH QUALITY MEDICAL CARE, INCLUDING, WITHOUT LIMITATION, ASSISTING PHYSICIANS AND THE PUBLIC TO IMPROVE THE QUALITY OF CARE RECEIVED BY PATIENTS IN THE EVOLVING HEALTHCARE ENVIRONMENT, IN A MANNER THAT CONSTITUTES CHARITABLE, SCIENTIFIC, OR EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. 0 0 2666399 675000 PHYSICIAN LEADERSHIP - GRANTS AND PROGRAMS TO EQUIP PHYSICIANS WITH THE CORE MANAGEMENT AND LEADERSHIP SKILLS NEEDED AS THEY INCREASINGLY FACE ADMINISTRATIVE AND REGULATORY BURDENS. 824340 374985 GENERAL HEALTH INITIATIVES - INCLUDE SOCIAL DETERMINANTS, DIRECT PRIMARY CARE EDUCATION, AND THE DEVELOPMENT OF TOOLS AND RESOURCES TO HELP PHYSICIAN PRACTICES IMPLEMENT TELEMEDICINE AND TECHNOLOGY. 1421145 991261 WELLNESS - GRANTS AND PROGRAMS TO SUPPORT SYSTEMIC CHANGE AND INNOVATIVE RESEARCH THAT REDUCES PHYSICIAN BURNOUT WHICH CAN HAVE DEVASTATING EFFECTS ON PHYSICIANS' QUALITY OF LIFE, AS WELL AS ON COST OF, ACCESS TO, AND QUALITY OF CARE. 4911884 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 29 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 X 21 20 1 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X JOHN DORMAN 6173990417 401 W 15TH STREET SUITE 100 AUSTIN TX 78701 GARY PRICE MD CHAIRMAN 20.00 X X 100000 0 0 SUBHI ALI MD TREASURER 5.00 X X 14000 0 0 SANDRA JOHNSON MEMBER 5.00 X 12000 0 0 RUSSELL LIBBY MD MEMBER 5.00 X 0 0 0 RIP HOLLISTER MD MEMBER 5.00 X 12000 0 0 RALPH NOBO MD MEMBER 5.00 X 12000 0 0 PHIL SCHUH MEMBER 5.00 40.00 X 9000 0 0 PAUL HARRINGTON MEMBER 5.00 X 12000 0 0 PALMER JONES MEMBER 5.00 X 12000 0 0 JOSEPH VALENTI MD MEMBER 5.00 X 12000 0 0 JENNIFER HANSCOM MEMBER 5.00 40.00 X 12000 347587 21601 DUSTIN CORCORAN MEMBER 5.00 40.00 X 12000 1062000 109630 DON ALEXANDER MEMBER 5.00 X 12000 0 0 ALEX MALTER MD MEMBER 5.00 X 12000 0 0 LARRY DOWNS SECRETARY 5.00 40.00 X X 14000 249804 0 LAWRENCE BRAUD MD VICE PRESIDENT 5.00 X X 14000 0 0 MARCH SEABROOK MEMBER 5.00 5.00 X 12000 0 0 HURSHELL BAGGETT MEMBER 5.00 40.00 X 9000 300841 50567 JERRY VAN METER MEMBER 5.00 X 12000 0 0 JOY MAXEY MEMBER 5.00 X 0 0 0 MICHAEL DARROUZET MEMBER 5.00 40.00 X 0 629216 42547 JOHN DORMAN COO 5.00 40.00 X 110000 471874 73067 ROBERT SELIGSON CEO 40.00 15.00 X 312500 0 0 726500 3061322 297412 2 0 1 0 WEIL MEDICAL COLLEGE OF CORNELL UNIVERSI 575 LEXINGTON AVE 9TH FLOOR NEW YORK NY 10022 ACADEMIC RESEARCH 450000 JPA HEALTH COMMUNICATIONS 111 CONNECTICUT AVE SUITE 600 WASHINGTON DC 20036 COMMUNICATIONS 405526 GMA FOUNDATIONS 2 LIBERTY SQUARE SUITE 500 BOSTON MA 02109 GRANT MANAGEMENT 381069 PROJECT HOPE - HEALTH AFFAIRS 7500 OLD GEORGETOWN RD STE 600 CHICAGO IL 60693 PRACTICE OF MEDICINE SERIES 220000 THE HEALTH INITIATIVE 255 FRANKLIN ST SUITE 350 BOSTON MA 02110 IMPACT RESEARCH 203542 5 2286885 2286885 9286053 8879055 406998 406998 406998 OTHER INCOME 900099 2125 2125 2125 2696008 0 0 2696008 X 2041246 2041246 726500 472225 254275 23683 15394 8289 67874 67874 112500 112500 224506 224506 791073 569590 221483 2622 2622 88985 60510 28475 314034 235024 79010 175797 123058 52739 22716 22716 PROFESSIONAL CONSULTING 1464364 1464364 SPONSORSHIPS 55000 55000 MISCELLANEOUS -119686 -124527 4841 5991214 4911884 1079330 0 924870 319333 4414894 1585339 10906 436201 453852 69223769 55804124 60027839 52308024 135038479 110470672 18666 344966 2167102 2091389 2185768 2436355 X 132852711 108034317 132852711 108034317 135038479 110470672 -3295206 -21523188 0 X 0 1 X 1 0 X X X 68 ALASKA STATE MEDICAL ASSOCIATION 926002176 10 1 0 0 CALIFORNIA MEDICAL ASSOCIATION 940359340 10 1 0 0 CONNECTICUT STATE MEDICAL SOCIETY 060665164 10 1 0 0 DENTON COUNTY MEDICAL SOCIETY 751676014 10 1 0 0 EL PASO COUNTY MEDICAL SOCIETY 741238007 10 1 0 0 FLORIDA MEDICAL ASSOCIATION 590559672 10 1 0 0 LOUISIANA STATE MEDICAL SOCIETY 720386637 10 1 0 0 ACCMA COMMUNITY HEALTH FOUNDATION 461703508 7 0 0 0 MEDICAL ASSOCIATION OF GEORGIA 580605267 10 1 0 0 MEDICAL SOCIETY OF NEW YORK 131030760 10 1 0 0 MEDICAL SOCIETY OF NORTHERN VIRGINA 540739279 10 1 0 0 NEBRASKA MEDICAL ASSOCIATION 470372108 10 1 0 0 NEW HAMPSHIRE MEDICAL SOCIETY 020223176 10 1 0 0 NORTH CAROLINA MEDICAL ASSOCIATION 560320130 10 1 0 0 SOUTH CAROLINA MEDICAL ASSOCIATION 570248750 10 1 0 0 TENNESSEE MEDICAL ASSOCIATION 620382010 10 1 0 0 MEDICAL SOCIETY OF NEW JERSEY 210601684 10 1 0 0 AMERICAN ACADEMY OF PEDIATRICS 362275597 10 0 0 0 BOARD OF TRUSTEES OF THE LELAND STANFORD JR UNIVERSITY 941156365 2 0 0 0 CENTER FOR A HEALTHY MARYLAND 521110642 7 0 75000 0 COMMUNITY SERVICE EDUCATION AND RESEARCH FUND 237003581 7 0 0 0 CONNECTICUT STATE MEDICAL SOCIETY PHYSICIAN HEALTH & EDUCATION FUND 061425205 7 0 0 0 DANIEL HANLEY CENTER FOR HEALTH LEADERSHIP 204271488 7 0 0 0 FOUNDATION OF THE AMERICAN ASSOCIATION OF MEDICAL SOCIETY EXECUTIVES 362915937 10 0 0 0 INDIANA MEDICAL FOUNDATION 237001672 7 0 75000 0 TEXAS MEDICAL ASSOCIATION 741078510 10 1 0 0 WASHINGTON STATE MEDICAL ASSOCIATION 910462170 10 1 0 0 MEDICAL SOCIETY OF VIRGINIA FOUNDATION 521394768 7 0 125000 0 MEDICAL EDUCATION AND SCIENTIFIC FOUNDATION OF NY 112780360 7 0 0 0 MEDICAL ASSOCIATION OF GEORGIA FOUNDATION 586066431 7 0 0 0 ASSOCIATION OF WOMEN SURGEONS FOUNDATION 364029232 10 0 0 0 PALM BEACH COUNTY MEDICAL SOCIETY SERVICES 651048299 7 0 0 0 TRAVIS COUNTY MEDICAL SOCIETY FOUNDATION 741720086 7 0 125000 0 OHIO MEDICAL EDUCATION FOUNDATION 310907287 10 0 0 0 SOUTH CAROLINA MEDICAL ASSOCIATION FOUNDATION 570168534 10 0 0 0 PHYSICIANS FOR A HEALTHY CALIFORNIA 946062822 7 0 0 0 FOUNDATION FOR HEALTHY FLORIDIANS 462259497 7 0 0 0 TWIN CITIES MEDICAL SOCIETY FOUNDATION 510178010 10 0 0 0 AMERICAN MEDICAL ASSOCIATION 360727175 10 0 0 0 NORTH CAROLINA MEDICAL SOCIETY FOUNDATION 566088142 7 0 0 0 INSTITUTE OF MEDICINE AND PUBLIC OF NEW JERSEY 200678012 7 0 0 0 TEXAS MEDICAL ASSOCIATION SPECIAL FUNDS FOUNDATION 742749879 7 0 0 0 WYOMING MEDICAL SOCIETY SCHOLARSHIP FUND 836004846 7 0 0 0 MONTANA MEDICAL ASSOCIATION FOUNDATION 463696068 10 0 150000 0 NEBRASKA MEDICAL FOUNDATION 476036827 7 0 0 0 WSMA FOUNDATION FOR HEALTH CARE IMPROVEMENT 916074463 7 0 150000 0 DOCS FOR PATIENT CARE FOUNDATION 464752703 10 0 0 0 PAGNY HEALTH AND RESEARCH FOUNDATION INC 811318522 7 0 0 0 MAINE MEDICAL EDUCATION TRUST 010443926 7 0 75000 0 BROWN UNIVERSITY OF PROVIDENCE 050258809 2 0 25000 0 ACADEMY OF MEDICINE EDUCATION FOUNDATION 320006201 7 0 0 0 DR LORNA BREEN HEROES' FOUNDATION 851509081 7 0 0 0 IOWA MEDICAL SOCIETY FOUNDATION 426078626 7 0 0 0 MASSACHUSETTS MEDICAL SOCIETY AND ALLIANCE CHARITABLE FOUNDATION 223199624 7 0 75000 0 MISSISSIPPI STATE MEDICAL ASSOCIATION FOUNDATION 570906060 10 0 0 0 THE RESEARCH INSTITUTE AT NATIONWIDE CHILDREN'S HOSPITAL 316056230 7 0 0 0 FUTURE ALASKA MEDICAL LEADERS 831874375 7 0 150000 0 LOUISIANA STATE MEDICAL SOCIETY EDUCATION AND RESEARCH FOUNDATION 237029259 10 0 0 0 VERMONT MEDICAL SOCIETY 030164911 10 1 0 0 HAWAII MEDICAL ASSOCIATION 990067306 10 1 0 0 ARIZONA MEDICAL ASSOCIATION FOUNDATION 237036794 10 0 75000 0 DUVAL COUNTY MEDICAL SOCIETY FOUNDATION 590880039 7 0 150000 0 FOUNDATION OF THE PENNSYLVANIA MEDICAL SOCIIETY 371732501 10 0 74985 0 MINNESOTA MEDICAL ASSOCIATION FOUNDATION 416031551 10 0 117175 0 PHYSICIANS BENEVOLENT FUND 746050660 7 0 150000 0 TENNESSEE FOUNDATION FOR QUALITY PATIENT HEALTHCARE 204232591 10 0 150000 0 THE REGENTS OF THE UNIVERSITY OF COLORADO 846000555 10 0 149086 0 VERMONT MEDICAL SOCIETY EDU & RESEARCH FOUNDATION 200183445 7 0 150000 0 68 2041246 0 0 1 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 PART IV, SECTION A, LINE 1: SUPPORTED ORGANIZATIONS ARE DESIGNATED IN THE GOVERNING DOCUMENTS BY CLASS OR PURPOSE: "TO SUPPORT, BENEFIT OR CARRY OUT THE CHARITABLE PURPOSES OF PUBLICLY SUPPORTED ORGANIZATIONS WHOSE PURPOSES INCLUDE PROMOTING HIGH QUALITY MEDICAL CARE, INCLUDING, WITHOUT LIMITATION, ASSISTING PHYSICIANS AND THE PUBLIC TO IMPROVE THE QUALITY OF CARE RECEIVED BY PATIENTS IN THE EVOLVING HEALTHCARE ENVIRONMENT, IN A MANNER THAT CONSTITUTES CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE CODE." PART IV, SECTION A, LINE 2: THE FOUNDATION CONFIRMS ANNUALLY THAT EACH OF ITS SUPPORTED ORGANIZATIONS QUALIFY AS PUBLICLY SUPPORTED ORGANIZATIONS. ALL 501(C)(6) SUPPORTED ORGANIZATIONS ARE DEEMED TO BE DESCRIBED IN SECTION 509(A)(2) BECAUSE MEMBERSHIP DUES CONSTITUTED MORE THAN ONE THIRD OF THEIR SUPPORT, AND NO MORE THAN ONE THIRD OF THEIR SUPPORT CAME FROM GROSS INVESTMENT INCOME AND NET UNRELATED BUSINESS TAXABLE INCOME. PART IV, SECTION A, LINE 3B: THE FOUNDATION MAINTAINS A COPY OF THE DETERMINATION LETTER FOR EACH SUPPORTED ORGANIZATION THAT QUALIFIES UNDER SECTION 501(C)(6) ALONG WITH AN ANNUALLY-UPDATED SCHEDULE DEMONSTRATING THE ORGANIZATION'S COMPLIANCE WITH THE SECTION 509(A)(2) PUBLIC SUPPORT TEST. PART IV, SECTION A, LINE 3C: TO ENSURE THAT ITS ASSETS ARE USED FOR CHARITABLE PURPOSES, THE FOUNDATION MAKES GRANTS ONLY TO 501(C)(3) ORGANIZATIONS OR 501(C)(6) ORGANIZATIONS THAT ARE DEEMED TO BE DESCRIBED IN SECTION 509(A)(2). FUNDED PROJECTS ARE APPROVED AFTER A RIGOROUS APPLICATION PROCESS. GRANTS ARE MADE SUBJECT TO A WRITTEN AGREEMENT REQUIRING PERIODIC AND FINAL FINANCIAL AND NARRATIVE REPORTS AND PROVIDING THAT THE FOUNDATION MAY WITHHOLD FUTURE PAYMENTS AND DEMAND CORRECTION OF MISUSE OF FUNDS SHOULD THE FOUNDATION DETERMINE FUNDS HAVE NOT BEEN USED FOR APPROVED PURPOSES. PART IV, SECTION A, LINE 5A: AS DESCRIBED IN PART IV, NUMBER 3C, THE FOUNDATION MAKES GRANTS TO 501(C)(3) ORGANIZATIONS AND 501(C)(6) ORGANIZATIONS THAT ARE DEEMED TO BE DESCRIBED IN SECTION 509(A)(2) THAT ARE INCLUDED IN THE CLASS OF ORGANIZATIONS DESIGNATED IN THE GOVERNING DOCUMENTS BY CLASS OR PURPOSE. IN 2022 THE FOUNDATION MADE NEW GRANTS TO 8 ORGANIZATIONS THAT WERE NOT LISTED ON THE 2021 FORM 990: ARIZONA MEDICAL ASSOCIATION FOUNDATION, DUVAL COUNTY MEDICAL SOCIETY FOUNDATION, FOUNDATION OF THE PENNSYLVANIA MEDICAL SOCIETY, MINNESOTA MEDICAL ASSOCIATION FOUNDATION, PHYSICIANS BENEVOLENT FUND, TENNESSEE FOUNDATION FOR QUALITY PATIENT HEALTHCARE, THE REGENTS OF THE UNVIVERSITY OF COLORADO, AND VERMONT MEDICAL SOCIETY EDUCATION AND RESEARCH FOUNDATION. SOME OF THE SUPPORTED ORGANIZATIONS DID NOT RECEIVE SUPPORT DURING 2022, BUT THEY ARE ALL LISTED ON SCHEDULE A, PART VI OF THE 2022 FORM 990. 4 ORGANIZATIONS THAT WERE LISTED AS SUPPORTED ORGANIZATIONS ON THE 2021 FORM 990, SCHEDULE A ARE NO LONGER SUPPORTED ORGANIZATIONS AND WERE REMOVED FROM THE 2022 LIST. PART IV, SECTION B, LINE 2: IN ADDITION TO MAKING GRANTS TO 501(C)(3) ORGANIZATIONS OPERATED, SUPERVISED OR CONTROLLED BY SUPPORTED ORGANIZATIONS NAMED IN THE ORGANIZING DOCUMENTS, THE FOUNDATION ALSO GIVES GRANTS TO 501(C)(6) ORGANIZATIONS TO CARRY OUT THE FOUNDATION'S CHARITABLE PURPOSES. SEE REV. RUL. 76-401, 1976-C.B. 175, WHICH PROVIDES THAT THE GENERAL REQUIREMENTS OF SECTIONS 1.509(A)-4(C), (D) AND (E) OF THE REGULATIONS ARE INAPPLICABLE TO SUPPORTED SECTION 501(C)(6) ORGANIZATIONS FOR PURPOSES OF SATISFYING BOTH THE ORGANIZATIONAL AND OPERATIONAL TESTS OF SECTION 509(A)(3)(A) OF THE INTERNAL REVENUE CODE. THE FOUNDATION MAKES GRANTS TO PUBLICLY SUPPORTED ORGANIZATIONS THAT DO NOT CONTROL THE FOUNDATION, BUT BY BENEFITTING THEM, THE FOUNDATION CARRIES OUT THE PURPOSE OF THE CONTROLLING SIGNATORY ENTITIES, AS PERMITTED UNDER SECTION 1.509(A)-4(G)(1)(II) OF THE REGULATIONS. 0 ISHARES CORE S&P SMALL CAP E 9781328 F ISHARES CORE S&P 500 ETF 16848377 F ISHARES S&P MIDCAP 400 INDEX 8689414 F ISHARES TR RUS 1000 GRW ETF 5647366 F ISHARES RUSSELL 1000 VALUE ETF 5799854 F ISHARES TRUST ISHARES ESG AW 5541685 F 52308024 X -19051686 -21523188 -21523188 2471502 224506 224506 2696008 5766708 0 5766708 224506 224506 5991214 PART X, LINE 2: THE FOUNDATION ACCOUNTS FOR UNCERTAINTY OF INCOME TAXES BASED ON A "MORE-LIKELY-THAN-NOT" THRESHOLD FOR THE RECOGNITION AND DE-RECOGNITION OF TAX POSITIONS, WHICH INCLUDES THE ACCOUNTING FOR INTEREST AND PENALTIES. AT DECEMBER 31, 2022 AND 2021, THE FOUNDATION DOES NOT HAVE ANY UNRECOGNIZED TAX BENEFITS RESULTING FROM ITS TAX POSITIONS. 1 MEDICAL SOCIETY OF VIRGINIA FOUNDATION 2924 EMERYWOOD PKWY SUITE 300 RICHMOND VA 23294 521394768 501(C)(3) 125000 0 TO EXPAND AND ENHANCE THE PHYSICIAN LEADERSHIP INSTITUTE MAINE MEDICAL EDUCATION TRUST PO BOX 190 MANCHESTER ME 04351 010443926 501(C)(3) 75000 0 SUPPORT INTEGRATION OF SOCIAL DRIVERS OF HEALTH SCREENING/TOOLS INTO PHYSICIAN PRACTICE BROWN UNIVERSITY OF PROVIDENCE CONTROLLERS OFFICE BOX 3 PROVIDENCE RI 02912 050258809 501(C)(3) 25000 0 TO SUPPORT THE IMPLEMENTATION OF THE SECOND PATIENT PRACTITIONER AND COMPUTER CONFERENCE INDIANA MEDICAL FOUNDATION 23 CANAL WALK INDIANAPOLIS IN 46202 237001672 501(C)(3) 75000 0 TO SUPPORT THE LAUNCH OF A PHYSICIAN LEADERSHIP PROGRAM MASSACHUSETTS MEDICAL SOCIETY AND ALLIANCE CHARITABLE FOUNDATION 860 WINTER STREET WALTHAM MA 02451 223199624 501(C)(3) 75000 0 TO SUPPORT TELEHEALTH MONTANA MEDICAL ASSOCIATION FOUNDATION 2021 11TH AVENUE STE 1 HELENA MT 59601 463696068 501(C)(3) 150000 0 TO SUPPORT A PHYSICIAN LEADERSHIP PROGRAM ARIZONA MEDICAL ASSOCIATION FOUNDATION 2401 W PEORIA AVE STE 130 PHOENIX AZ 85029 237036794 501(C)(3) 75000 0 TO SUPPORT DRIVERS OF HEALTH IN ARIZONA CENTER FOR A HEALTHY MARYLAND 1211 CATHEDRAL ST BALTIMORE MD 21201 521110642 501(C)(3) 75000 0 SUPPORT INTEGRATION OF SOCIAL DRIVERS OF HEALTH SCREENING/TOOLS INTO PHYSICIAN PRACTICE DUVAL COUNTY MEDICAL SOCIETY FOUNDATION PO BOX 551538 JACKSONVILLE FL 32255 590880039 501(C)(3) 150000 0 TO SUPPORT DUVAL COUNTY MEDICAL SOCIETY LIFEBRIDGE NAVY MEDICAL CORPS EXPANSION VERMONT MEDICAL SOCIETY EDUCATION AND RESEARCH FOUNDATION PO BOX 1457 MONTPELIER VT 05601 200183445 501(C)(3) 150000 0 TO SUPPORT A PHYSICIAN LEADERSHIP PROGRAM FOUNDATION OF THE PENNSYLVANIA MEDICAL SOCIETY 777 EAST PARK HARRISBURG PA 17105 371732501 501(C)(3) 74985 0 TO SUPPORT CHRONIC CARE MANAGEMENT BY INCORPORATING DRIVERS OF HEALTH FUTURE ALASKA MEDICAL LEADERS 4107 LAUREL ST ANCHORAGE AK 99508 831874375 501(C)(3) 150000 0 TO SUPPORT A PHYSICIAN LEADERSHIP PROGRAM MINNESOTA MEDICAL ASSOCIATION FOUNDATION 3433 BROADWAY STREET NE SUITE 187 MINNEAPOLIS MN 55413 416031551 501(C)(3) 117175 0 TO IMPLEMENT A PHYSICIAN-LED PEER COACHING PROGRAM. PHYSICIANS BENEVOLENT FUND 401 WEST 15TH STREET AUSTIN TX 78701 746062822 501(C)(3) 150000 0 EXPAND PHYSICIAN HEALTH AND WELLNESS PROGRAM IN TEXAS TENNESSEE FOUNDATION FOR QUALITY PATIENT HEALTHCARE 701 BRADFORD AVE NASHVILLE TN 37204 204232591 501(C)(3) 150000 0 TO SUPPORT THE JOHN INGRAM INSTITUTE FOR PHYSICIAN LEADERSHIP THE REGENTS OF THE UNIVERSITY OF COLORADO 13001 EAST 17TH PLACE AURORA CO 80045 846000555 501(C)(3) 149086 0 TO INVESTIGATE SMARTWATCH AND PHYSICIAN WELL-BEING: ARE WEARABLES PART OF THE SOLUTION? TRAVIS COUNTY MEDICAL SOCIETY FOUNDATION 4300 N LAMAR BLVD AUSTIN TX 78756 741720086 501(C)(3) 125000 0 ASSIST MEDICAL SOCIETIES AS THEY IMPLEMENT LIFEBRIDGE PHYSICIAN WELLNESS PROGRAM WSMA FOUNDATION FOR HEALTH CARE IMPROVEMENT 2001 SIXTH AVENUE SUITE 2700 SEATTLE WA 98121 916074463 501(C)(3) 150000 0 DEVELOP BEST PRACTICES TO FOSTER PHYSICIAN WELLNESS AND IMPLEMENT PEER SUPPORT 18 PART I, LINE 2: TO ENSURE THAT ITS ASSETS ARE USED FOR CHARITABLE PURPOSES, THE FOUNDATION MAKES GRANTS ONLY TO 501(C)(3) ORGANIZATIONS AND 501(C)(6) ORGANIZATIONS THAT ARE DEEMED TO BE DESCRIBED IN SECTION 509(A)(2). FUNDED PROJECTS ARE APPROVED ONLY AFTER A RIGOROUS APPLICATION PROCESS. THE GRANT COMMITTEE MEETS QUARTERLY TO DISCUSS RECOMMENDED PHYSICIAN LEADERSHIP PROPOSALS AND APPROVAL OF GRANTS THAT RELATE TO THE FOUNDATION'S MISSION. FINAL RECOMMENDATIONS ARE APPROVED BY THE FULL BOARD. GRANTS ARE MADE SUBJECT TO A WRITTEN AGREEMENT REQUIRING PERIODIC AND FINAL FINANCIAL AND NARRATIVE REPORTS AND PROVIDING THAT THE FOUNDATION MAY WITHHOLD FUTURE PAYMENTS AND DEMAND CORRECTION OF MISUSE OF FUNDS SHOULD THE FOUNDATION DETERMINE THAT FUNDS HAVE NOT BEEN USED FOR APPROVED PURPOSES. X X 0 0 0 0 0 0 0 0 0 DUSTIN CORCORAN MEMBER 12000 1062000 0 0 0 0 0 0 0 109630 12000 1171630 0 0 MICHAEL DARROUZET MEMBER 0 567000 0 28350 0 33866 0 30500 0 12047 0 671763 0 0 JOHN DORMAN COO 110000 401797 0 20090 0 49987 0 61000 0 12067 110000 544941 0 0 JENNIFER HANSCOM MEMBER 12000 312430 0 28157 0 7000 0 9150 0 12451 12000 369188 0 0 HURSHELL BAGGETT MEMBER 9000 300841 0 0 0 0 0 33900 0 16667 9000 351408 0 0 ROBERT SELIGSON CEO 312500 0 0 0 0 0 0 0 0 0 312500 0 0 0 LARRY DOWNS SECRETARY 14000 240196 0 0 0 9608 0 0 0 0 14000 249804 0 0 FORM 990, PART VI, SECTION A, LINE 2 JOHN DORMAN, COO, AND BOARD MEMBER MICHAEL DARROUZET ARE BOTH ORGANIZATIONAL OFFICERS AT TEXAS MEDICAL ASSOCIATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEDICAL ASSOCIATIONS AND SOCIETIES NAMED IN THE FOUNDATION'S BYLAWS HAVE THE POWER TO APPOINT MEMBERS OF THE BOARD OF DIRECTORS AND MAY REMOVE THEIR RESPECTIVE APPOINTEES. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE FORM 990 IS REVIEWED BY THE COO AND DISTRIBUTED TO EACH BOARD MEMBER PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST NO LESS FREQUENTLY THAN ANNUALLY. THE BOARD OF DIRECTORS REVIEWS THE DISCLOSURES AND ENSURES ALL TRANSACTIONS ARE FAIR TO THE FOUNDATION. IF THE POLICY IS VIOLATED, THE BOARD OF DIRECTORS MAY VOID THE CONTRACT OR TRANSACTION AND RECOVER DAMAGES OR MODIFY THE PRICE AND TERMS TO MATCH WHAT THE FOUNDATION WOULD RECEIVE IN AN ARM'S-LENGTH NEGOTIATION. FORM 990, PART VI, SECTION B, LINE 15A IN 2015, THE BOARD OF DIRECTORS CONTRACTED WITH AN INDEPENDENT COMPENSATION CONSULTANT TO ENSURE THAT AMOUNTS PAID TO DIRECTORS, CEO, AND COO ARE NOT EXCESSIVE. FORM 990, PART VI, SECTION C, LINE 19 ALL REQUIRED DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART IX, LINE 11G GRANT MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 204,090. MANAGEMENT AND GENERAL EXPENSES 191,357. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 395,447. COMMUNICATIONS: PROGRAM SERVICE EXPENSES 365,500. MANAGEMENT AND GENERAL EXPENSES 30,126. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 395,626. ALASKA STATE MEDICAL ASSOCIATION 4107 LAUREL ST ANCHORAGE AK 99508 926002176 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS AK 501(C)(6) 0 CALIFORNIA MEDICAL ASSOCIATION 1201 J STREET SUITE 200 SACREMENTO CA 95814 940359340 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS CA 501(C)(6) 0 CONNECTICUT STATE MEDICAL SOCIETY 127 WASHINGTON AVE EAST 3RD FLOOR NORTH HAVEN CT 06473 060665164 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS CT 501(C)(6) 0 DENTON COUNTY MEDICAL SOCIETY 3537 S INTERSTATE 35 ESTE 302 DENTON TX 76210 751676014 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS TX 501(C)(6) 0 EL PASO COUNTY MEDICAL SOCIETY 730 CITADEL DR EAST SUITE 206 COLORADO SPRINGS CO 80909 741238007 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS CO 501(C)(6) 0 FLORIDA MEDICAL ASSOCIATION 1430 PIEDMONT DR E TALLAHASSEE FL 32308 590559672 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS FL 501(C)(6) 0 HAWAII MEDICAL ASSOCIATION 1360 S BERETANIA ST 200 HONOLULU HI 96814 990067306 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS HI 501(C)(6) 0 LOUISIANA STATE MEDICAL SOCIETY 6767 PERKINS ROAD SUITE 100 BATON ROUGE LA 70808 720386637 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS LA 501(C)(6) 0 MEDICAL ASSOCIATION OF GEORGIA 1849 THE EXCHANGE SUITE 200 ATLANTA GA 30339 580605267 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS GA 501(C)(6) 0 MEDICAL SOCIETY OF NEW JERSEY TWO PRINCESS ROAD LAWRENCEVILLE NJ 08648 210601684 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS NJ 501(C)(6) 0 MEDICAL SOCIETY OF NEW YORK 865 MERRICK AVE SUITE 200 WESTBURY NY 11590 131030760 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS NY 501(C)(6) 0 MEDICAL SOCIETY OF NORTHERN VIRGINA 4604 JONES BRANCH DR SUITE 3150 MCLEAN VA 22102 540739279 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS VA 501(C)(6) 0 NEBRASKA MEDICAL ASSOCIATION 233 S 13TH STREET SUITE 1200 LINCOLN NE 68508 470372108 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS NE 501(C)(6) 0 NEW HAMPSHIRE MEDICAL SOCIETY 7 NORTH STATE DTREET CONCORD NH 03301 020223176 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS NH 501(C)(6) 0 NORTH CAROLINA MEDICAL ASSOCIATION PO BOX 27167 RALEIGH NC 27611 560320130 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS NC 501(C)(6) 0 SOUTH CAROLINA MEDICAL ASSOCIATION 132 WESTPARK BLVD COLUMBIA SC 29210 570248750 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS SC 501(C)(6) 0 TENNESSEE MEDICAL ASSOCIATION 701 BRADFORD AVENUE NASHVILLE TN 37204 620382010 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS TN 501(C)(6) 0 TEXAS MEDICAL ASSOCIATION 401 WEST 15TH STREET SUITE 100 AUSTIN TX 78701 741078510 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS TX 501(C)(6) 0 VERMONT MEDICAL SOCIETY PO BOX 1457 MONTPELIER VT 05601 030164911 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS VT 501(C)(6) 0 WASHINGTON STATE MEDICAL ASSOCIATION 2001 SIXTH AVE SUITE 2700 SEATTLE WA 98121 910462170 PROFESSIONAL SOCIETY REPRESENTING PHYSICIANS WA 501(C)(6) 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 MEDICAL SOCIETY OF NEW JERSEY P 10253 FMV TEXAS MEDICAL ASSOCIATION P 27902 FMV TEXAS MEDICAL ASSOCIATION M 100000 CONTRACTED AMOUNT WASHINGTON STATE MEDICAL ASSOCIATION P 8579 FMV MEDICAL SOCIETY OF NORTHERN VIRGINIA R 12000 FMV TEXAS MEDICAL ASSOCIATION R 12000 FMV CALIFORNIA MEDICAL ASSOCIATION P 1009 FMV