ANTICOAGULATION FORUM INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- ANTICOAGULATION FORUM INC (EIN 03-0474134)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-12-15
- IRS object ID
- 202333499349301213
- Schema version
- 2022v5.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-12-15T10:54:24-08:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 043405131 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FELIX G CINCOTTA CPA & CONSULTANTS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE GATEWAY CENTER | AddressLine1Txt |
| City | NEWTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02458 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030474134 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANTICOAGULATION FORUM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ANTI | BusinessNameControlTxt |
| Phone | 6174675599 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LINCOLN STREET | AddressLine1Txt |
| City | NEWTON HIGHLANDS | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02461 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ELIZABETH GOLDSTEIN | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 6174675599 | PhoneNum |
| Signature | 2023-12-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ELIZABETH | PersonFirstNm |
| Person Last | GOLDSTEIN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | FELIX G CINCOTTA CPA | PreparerPersonNm |
| PTIN | P00514062 | PTIN |
| Phone | 6173322227 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ELIZABETH GOLDSTEIN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LINCOLN STREET 2B | AddressLine1Txt |
| City | NEWTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02461 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,899,604 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ACFORUM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | MA | LegalDomicileStateCd |
| Activity Or Mission | THE ANTICOAGULATION FORUM IS A MULTIDISCIPLINARY NONPROFIT ORGANIZATION OF HEALTH CARE PROFESSIONALS THAT WILL IMPROVE THE QUALITY OF CARE FOR PATIENTS TAKING ANTITHROMBOTIC MEDICATIONS | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 7 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $405,170 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,001,572 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $471,556 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $210,359 | CYProgramServiceRevenueAmt |
| PY Investment Income | $121,147 | PYInvestmentIncomeAmt |
| CY Investment Income | -$141,910 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,423,400 | PYOtherRevenueAmt |
| CY Other Revenue | $829,583 | CYOtherRevenueAmt |
| PY Total Revenue | $2,421,273 | PYTotalRevenueAmt |
| CY Total Revenue | $2,899,604 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $889,794 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $474,205 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $652,490 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $761,053 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $916,601 | PYOtherExpensesAmt |
| CY Other Expenses | $859,749 | CYOtherExpensesAmt |
| PY Total Expenses | $2,458,885 | PYTotalExpensesAmt |
| CY Total Expenses | $2,095,007 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$37,612 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $804,597 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,432,345 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,089,494 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $317,020 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $169,572 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,115,325 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,919,922 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ANTICOAGULATION FORUM IS A MULTIDISCIPLINARY NONPROFIT ORGANIZATION OF HEALTH CARE PROFESSIONALS THAT WILL IMPROVE THE QUALITY OF CARE FOR PATIENTS TAKING ANTITHROMBOTIC MEDICATIONS | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,841,860 | ExpenseAmt |
| Grant | $474,205 | GrantAmt |
| Revenue | $2,211,931 | RevenueAmt |
| Desc | PROVIDING EDUCATION AND NETWORKING OPPORTUNITIES FOR HEALTH CARE PROFESSIONALS. PROMOTING THE CLINICAL APPLICATION OF EVIDENCE-BASED PRACTICES. FACILITATING RESEARCH AIMED AT IMPROVING HEALTH OUTCOMES. INFORMING HEALTHCARE POLICY, REGULATORY AGENCIES, AND INDUSTRY ABOUT BEST PRACTICES. | Desc |
| Total Program Service Expenses | $1,841,860 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 7 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Excs Tax Sect4951 Or4952 Or4953 | false | ExcsTaxSect4951Or4952Or4953Ind |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ELIZABETH GOLDSTEIN | PersonNm |
| Phone | 6174675599 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LINCOLN STREET 2B | AddressLine1Txt |
| City | NEWTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02461 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| ELIZABETH GOLDSTEIN | ||||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | Yes (X) | $233,870 | $0 | $0 | ||
| ELAINE H WHALEN | ||||||||
| PROGRAM DIRECTOR | 40.00 | $138,667 | $0 | $0 | Yes (X) | |||
| DARREN TRILLER | ||||||||
| PROGRAM DIRECTOR | 40.00 | $145,282 | $0 | $0 | Yes (X) | |||
| ALLISON BURNETT | ||||||||
| PRESIDENT | 2.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| SCOTT KAATZ | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ARTHUR ALLEN | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| JACK ANSELL | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| GEOFFREY BARNES | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| MARILYN BLUMENSTEIN | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| BISHOY RAGHEB | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| ANITA RAJASEKHAR | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| WILLIAM DAGER | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| STEVEN DEITELZWEIG | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| STACY ELLSWORTH | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| ANDREA VAN BEEK | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| DEBORAH SIEGAL | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| SARA VAZQUEZ | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| ANDREW GELLER | ||||||||
| DIRECTOR | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $517,819 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MYELIN & ASSOCIATES | |||||
| 118 JAMES ST STE 200 | CANADA CA | MA | 00000 | CONSULTING | $154,225 |
| NATIONAL QUALITY FORUM | |||||
| 1099 14TH ST NW SUITE 500 | WASHINGTON | DC | 20005 | CONSULTING | $147,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $2,001,572 | AllOtherContributionsAmt |
| Total Contributions | $2,001,572 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SERVICE REVENUE | Desc |
| Business | 813219 | BusinessCd |
| Total Revenue Column | $210,359 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $210,359 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$141,910 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$141,910 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SPONSORSHIPS | Desc |
| Business | 813212 | BusinessCd |
| Total Revenue Column | $829,583 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $829,583 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $829,583 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,899,604 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,039,942 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$141,910 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $474,205 | TotalAmt |
| Program Services | $474,205 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $663,168 | TotalAmt |
| Program Services | $497,376 | ProgramServicesAmt |
| Management And General | $165,792 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,559 | TotalAmt |
| Program Services | $37,169 | ProgramServicesAmt |
| Management And General | $12,390 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,326 | TotalAmt |
| Program Services | $36,245 | ProgramServicesAmt |
| Management And General | $12,081 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $480 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $480 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,451 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $11,451 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,162 | TotalAmt |
| Program Services | $4,334 | ProgramServicesAmt |
| Management And General | $19,828 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,567 | TotalAmt |
| Program Services | $13,447 | ProgramServicesAmt |
| Management And General | $3,120 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,122 | TotalAmt |
| Program Services | $13,561 | ProgramServicesAmt |
| Management And General | $13,561 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,745 | TotalAmt |
| Program Services | $119,745 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,939 | TotalAmt |
| Program Services | $253,939 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,544 | TotalAmt |
| Program Services | $8,772 | ProgramServicesAmt |
| Management And General | $8,772 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACT STAFF | $356,097 | $354,007 | $2,090 | $0 |
| COMMUNICATION | $8,940 | $5,358 | $3,582 | $0 |
| ACCREDITATION | $23,702 | $23,702 | $0 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,095,007 | TotalAmt |
| Program Services | $1,841,860 | ProgramServicesAmt |
| Management And General | $253,147 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,186 | BOYAmt |
| EOY | $203,873 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $168,871 | BOYAmt |
| EOY | $330,523 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,000 | BOYAmt |
| EOY | $1,271,449 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,548 | BOYAmt |
| EOY | $23,977 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,000 | BOYAmt |
| EOY | $24,334 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,988,940 | BOYAmt |
| EOY | $3,178,066 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,800 | BOYAmt |
| EOY | $57,272 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,432,345 | BOYAmt |
| EOY | $5,089,494 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $317,020 | BOYAmt |
| EOY | $75,896 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $71,617 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $22,059 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $317,020 | BOYAmt |
| EOY | $169,572 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,886,863 | BOYAmt |
| EOY | $2,616,885 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,228,462 | BOYAmt |
| EOY | $2,303,037 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,115,325 | BOYAmt |
| EOY | $4,919,922 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,432,345 | BOYAmt |
| EOY | $5,089,494 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $804,597 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
| Other Support Sum | $0 | OtherSupportSumAmt |
| Public Support CY170 | 0 | PublicSupportCY170Pct |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $335,425 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,795,669 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $328,635 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $405,170 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,001,572 | CurrentTaxYearAmt |
| Total | $5,866,471 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $739,439 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,139,838 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $958,556 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,894,956 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,039,942 | CurrentTaxYearAmt |
| Total | $5,772,731 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,074,864 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,935,507 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,287,191 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,300,126 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,041,514 | CurrentTaxYearAmt |
| Total | $11,639,202 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $11,639,202 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,265 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $91,806 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $166,065 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $121,147 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $53,401 | CurrentTaxYearAmt |
| Total | $439,684 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,265 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $91,806 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $166,065 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $121,147 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $53,401 | CurrentTaxYearAmt |
| Total | $439,684 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | -$195,311 | CurrentTaxYearAmt |
| Total | -$195,311 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,883,575 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.97940 | PublicSupportCY509Pct |
| Public Support PY509 | 0.96050 | PublicSupportPY509Pct |
| Investment Income CY | 0.03700 | InvestmentIncomeCYPct |
| Investment Income PY | 0.03950 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LONG TERM LEASE LIABILITY | Desc |
| Amt | $22,059 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $22,059 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $2,899,604 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $2,899,604 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $2,899,604 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,095,007 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $2,095,007 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $2,095,007 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt XI, Line 2d | FormAndLineReferenceDesc |
| Explanation | UNREALIZED LOSS ON INVESTMENTS | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|
| BOSTON MEDICAL CENTER | ||||||
| 660 HARRISON AVE 2nd FL | BOSTON | MA | 02118 | 043314093 | $26,565 | FELLOWSHIP |
| UNIVERSITY OF MICHIGAN | ||||||
| 3003 S STATE ST | ANN ARBOR | MI | 48109 | 386006309 | $29,900 | FELLOWSHIP |
| UNIVERSITY HOSPITAL CLEVELAND MED CTR | ||||||
| 11100 EUCLID AVE | CLEVELAND | OH | 44106 | 341567805 | $48,000 | FELLOWSHIP |
| STANFORD UNIVERSITY | ||||||
| 450 JANE STANFORD WAY | STANFORD | CA | 94305 | 941156365 | $36,000 | FELLOWSHIP |
| BETH ISRAEL DEACONESS MEDICAL CENTER | ||||||
| 330 BROOKLINE AVE | BOSTON | MA | 02215 | 042103881 | $36,000 | FELLOWSHIP |
| JOHN HOPKINS UNIVERSITY | ||||||
| 600 N WOLFE ST | BALTIMORE | MD | 21287 | 520595110 | $31,998 | FELLOWSHIP |
| VANDERBILT UNIVERSITY MEDICAL CENTER | ||||||
| 1285 MEDICAL RESEARCH BLDG | NASHVILLE | TN | 37232 | 352528741 | $45,742 | FELLOWSHIP |
| EMORY UNIVERSITY | ||||||
| 1599 CLIFTON ROAD 4TH FLOOR | ATLANTA | GA | 30322 | 580566256 | $36,000 | FELLOWSHIP |
| MARY HITCHCOCK HOSPITAL | ||||||
| 1 MEDICAL CENTER DRIVE | LEBANON | NH | 03756 | 020222140 | $36,000 | FELLOWSHIP |
| PRO MEDICA TOLEDO HOSPITAL | ||||||
| 2109 N HUGHES DRIVE SUITE 400 | TOLEDO | OH | 43606 | 344428256 | $36,000 | FELLOWSHIP |
| MA GENERAL HOSPITAL | ||||||
| 55 FRUIT STREET | BOSTON | MA | 02114 | 041564655 | $36,000 | FELLOWSHIP |
| THOMAS JEFFERSON UNIVERSITY | ||||||
| 833 CHESTNUT STREET SUITE 900 | PHILADELPHIA | PA | 19107 | 231352651 | $36,000 | FELLOWSHIP |
| HENRY FORD HOSPITAL | ||||||
| 2799 WEST GRAND BLVD | DETROIT | MI | 48202 | 381357020 | $20,000 | FELLOWSHIP |
| SANFORD MEDICAL CENTER | ||||||
| 1305 WEST 18TH ST | SIOUX FALLS | SD | 57105 | 460227855 | $20,000 | FELLOWSHIP |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ELIZABETH GOLDSTEIN | PersonNm |
| Base Compensation Filing Org | $233,870 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $14,032 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $7,788 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $255,690 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt I Line 3 | FormAndLineReferenceDesc |
| Explanation | THE BOARD OF DIRECTORS APPROVES THE EXECUTIVE DIRECTORS COMPENSATION | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 11b | THE EXECUTIVE DIRECTOR REVIEWS THE FORM 990 |
| Pt VI, Line 19 | NO OTHER DOCUMENTS AVAILABLE TO THE PUBLIC |
| Pt VI, Line 15a | COMPENSATION REVIEWED BY BOARD |
| Pt VI, Line 8a | THE BOARD OF DIRECTORS HELD SCHEDULED MEETINGS AND KEPT WRITTEN MINUTES OF MEETING |
| Pt VI, Line 8b | EACH BOARD MEMBER HAD VOTING POWER |
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