FURP.ORG / PUBLIC DATA EXPLORER

THE PHYSICIANS FOUNDATION INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
THE PHYSICIANS FOUNDATION INC (EIN 20-0914085)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-01
IRS object ID
202233059349302958
Schema version
2021v4.2
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)
Return2022-11-01T18:35:13-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN463330935PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1AVENSON HAMANN CPAS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line17421 BURNET ROAD 522AddressLine1Txt
CityAUSTINCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78757ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN200914085EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE PHYSICIANS FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPHYSBusinessNameControlTxt
Phone6173990417PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 W 15TH STREET 100AddressLine1Txt
CityAUSTINCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78701ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN DORMANPersonNm
Person TitleCOOPersonTitleTxt
Phone6173990417PhoneNum
Signature2022-10-31SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJOHNPersonFirstNm
Person LastDORMANPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCATHERINE AVENSONPreparerPersonNm
PTINP01259734PTIN
Phone5126939131PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJOHN DORMANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 W 15TH STREET 100AddressLine1Txt
CityAUSTINCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78701ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$24,013,454GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PHYSICIANSFOUNDATION.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2003FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionTHE FOUNDATION'S PURPOSE IS TO ADVANCE THE WORK OF PRACTICING PHYSICIANS AND TO IMPROVE THE QUALITY OF HEALTH CARE FOR ALL AMERICANS.ActivityOrMissionDesc
Voting Members Governing Body21VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee2TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$10,000CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$4,549,667PYInvestmentIncomeAmt
CY Investment Income$7,615,645CYInvestmentIncomeAmt
PY Other Revenue$5,000PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$4,554,667PYTotalRevenueAmt
CY Total Revenue$7,625,645CYTotalRevenueAmt
PY Grants And Similar Paid$2,181,085PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,155,816CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$645,307PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$704,126CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,990,028PYOtherExpensesAmt
CY Other Expenses$2,986,723CYOtherExpensesAmt
PY Total Expenses$5,816,420PYTotalExpensesAmt
CY Total Expenses$5,846,665CYTotalExpensesAmt
PY Revenues Less Expenses-$1,261,753PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,778,980CYRevenuesLessExpensesAmt
Total Assets BOY$124,010,488TotalAssetsBOYAmt
Total Assets EOY$135,038,479TotalAssetsEOYAmt
Total Liabilities BOY$1,862,141TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,185,768TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$122,148,347NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$132,852,711NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO 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.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,732,201ExpenseAmt
Grant$1,192,968GrantAmt
DescPHYSICIAN LEADERSHIP - GRANTS AND PROGRAMS TO EQUIP PHYSICIANS WITH THE CORE MANAGEMENT AND LEADERSHIP SKILLS NEEDED AS THEY INCREASINGLY FACE ADMINISTRATIVE AND REGULATORY BURDENS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$913,477ExpenseAmt
Grant$199,588GrantAmt
DescGENERAL HEALTH INITIATIVES - INCLUDE SOCIAL DETERMINANTS, DIRECT PRIMARY CARE EDUCATION, AND THE DEVELOPMENT OF TOOLS AND RESOURCES TO HELP PHYSICIAN PRACTICES IMPLEMENT TELEMEDICINE AND TECHNOLOGY.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$1,182,613ExpenseAmt
Grant$763,260GrantAmt
DescWELLNESS - 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.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$4,828,291TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document27IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee2EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members21GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJOHN DORMANPersonNm
Phone6173990417PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1401 W 15TH STREET SUITE 100AddressLine1Txt
CityAUSTINCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78701ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
GARY PRICE MD
CHAIRMAN20.00Yes (X)Yes (X)$51,167$0$0
SUBHI ALI MD
TREASURER5.00Yes (X)Yes (X)$15,500$0$0
SANDRA JOHNSON
MEMBER5.00Yes (X)$14,000$0$0
RUSSELL LIBBY MD
MEMBER5.00Yes (X)$2,000$0$0
RIP HOLLISTER MD
MEMBER5.00Yes (X)$13,500$0$0
RALPH NOBO MD
MEMBER5.00Yes (X)$14,000$0$0
PHIL SCHUH
MEMBER5.00Yes (X)$10,500$337,032$040.00
PAUL HARRINGTON
MEMBER5.00Yes (X)$13,500$0$0
PALMER JONES
MEMBER5.00Yes (X)$14,000$0$0
JOSEPH VALENTI MD
MEMBER5.00Yes (X)$14,000$0$0
JENNIFER HANSCOM
MEMBER5.00Yes (X)$14,000$333,304$20,85840.00
GERALD MCKENNA MD
MEMBER5.00Yes (X)$10,500$0$0
DUSTIN CORCORAN
MEMBER5.00Yes (X)$9,500$1,062,000$90,13040.00
DON ALEXANDER
MEMBER5.00Yes (X)$14,000$0$0
ALEX MALTER MD
MEMBER5.00Yes (X)$14,000$0$0
ROBERT SELIGSON
CEO40.00Yes (X)Yes (X)$300,000$0$015.00
LARRY DOWNS
SECRETARY5.00Yes (X)Yes (X)$16,000$210,196$040.00
LAWRENCE BRAUD MD
VICE PRESIDENT5.00Yes (X)Yes (X)$16,000$0$0
MARCH SEABROOK
MEMBER5.00Yes (X)$11,000$0$05.00
JOY MAXEY
MEMBER5.00Yes (X)$0$0$0
MICHAEL DARROUZET
MEMBER5.00Yes (X)$0$599,554$41,17040.00
HURSHELL BAGGETT
MEMBER5.00Yes (X)$14,000$317,177$17,53040.00
JERRY VAN METER
MEMBER5.00Yes (X)$0$0$0
JOHN DORMAN
COO5.00Yes (X)$100,000$450,462$70,19040.00
FieldValueIRS element (for citing)
Total Reportable Comp From Org$681,167TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,309,725TotReportableCompRltdOrgAmt
Total Other Compensation$239,878TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
WEIL MEDICAL COLLEGE OF CORNELL UNIVERSI
575 LEXINGTON AVE 9TH FLOORNEW YORKNY10022ACADEMIC RESEARCH$851,062
JPA HEALTH COMMUNICATIONS
111 CONNECTICUT AVE SUITE 600WASHINGTONDC20036COMMUNICATIONS$457,470
GMA FOUNDATIONS
2 LIBERTY SQUARE SUITE 500BOSTONMA02109GRANT MANAGEMENT$392,040
THE HEALTH INITIATIVE
255 FRANKLIN ST SUITE 350BOSTONMA02110IMPACT RESEARCH$226,202
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
All Other Contributions$10,000AllOtherContributionsAmt
Total Contributions$10,000TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,878,817TotalRevenueColumnAmt
Exclusion$1,878,817ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$22,124,637SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$16,387,809SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$5,736,828SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,736,828TotalRevenueColumnAmt
Exclusion$5,736,828ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,625,645TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$7,615,645ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,155,816TotalAmt
Program Services$2,155,816ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$681,167TotalAmt
Program Services$490,875ProgramServicesAmt
Management And General$190,292ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$22,959TotalAmt
Program Services$16,071ProgramServicesAmt
Management And General$6,888ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$34,444TotalAmt
Management And General$34,444ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$110,031TotalAmt
Management And General$110,031ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$258,139TotalAmt
Management And General$258,139ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$772,897TotalAmt
Program Services$535,121ProgramServicesAmt
Management And General$237,776ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,521TotalAmt
Management And General$5,521ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$144,264TotalAmt
Program Services$92,329ProgramServicesAmt
Management And General$51,935ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$148,147TotalAmt
Program Services$111,110ProgramServicesAmt
Management And General$37,037ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$86,707TotalAmt
Program Services$65,030ProgramServicesAmt
Management And General$21,677ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$22,934TotalAmt
Management And General$22,934ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROFESSIONAL CONSULTING$1,411,410$1,378,651$32,759
SPONSORSHIPS$22,000$22,000
DUES AND SUBSCRIPTIONS$2,579$2,579
MISCELLANEOUS-$32,350-$38,712$6,362

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,846,665TotalAmt
Program Services$4,828,291ProgramServicesAmt
Management And General$1,018,374ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,472,455BOYAmt
EOY$924,870EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$8,481,322BOYAmt
EOY$4,414,894EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$10,906EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$186,318BOYAmt
EOY$436,201EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$50,204,995BOYAmt
EOY$69,223,769EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$63,665,398BOYAmt
EOY$60,027,839EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$124,010,488BOYAmt
EOY$135,038,479EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$124,985BOYAmt
EOY$18,666EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$1,737,156BOYAmt
EOY$2,167,102EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,862,141BOYAmt
EOY$2,185,768EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$122,148,347BOYAmt
EOY$132,852,711EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$122,148,347BOYAmt
EOY$132,852,711EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$124,010,488BOYAmt
EOY$135,038,479EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,778,980ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$8,925,384NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations64SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (64 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
ALASKA STATE MEDICAL ASSOCIATION
92600217610Yes (1)$0$0
CALIFORNIA MEDICAL ASSOCIATION
94035934010Yes (1)$0$0
CONNECTICUT STATE MEDICAL SOCIETY
06066516410Yes (1)$0$0
DENTON COUNTY MEDICAL SOCIETY
75167601410Yes (1)$0$0
EL PASO COUNTY MEDICAL SOCIETY
74123800710Yes (1)$0$0
FLORIDA MEDICAL ASSOCIATION
59055967210Yes (1)$0$0
LOUISIANA STATE MEDICAL SOCIETY
72038663710Yes (1)$0$0
ACCMA COMMUNITY HEALTH FOUNDATION
46170350870$150,000$0
MEDICAL ASSOCIATION OF GEORGIA
58060526710Yes (1)$0$0
MEDICAL SOCIETY OF NEW YORK
13103076010Yes (1)$0$0
MEDICAL SOCIETY OF NORTHERN VIRGINA
54073927910Yes (1)$0$0
NEBRASKA MEDICAL ASSOCIATION
47037210810Yes (1)$0$0
NEW HAMPSHIRE MEDICAL SOCIETY
02022317610Yes (1)$0$0
NORTH CAROLINA MEDICAL ASSOCIATION
56032013010Yes (1)$0$0
SOUTH CAROLINA MEDICAL ASSOCIATION
57024875010Yes (1)$0$0
TENNESSEE MEDICAL ASSOCIATION
62038201010Yes (1)$0$0
MEDICAL SOCIETY OF NEW JERSEY
21060168410Yes (1)$0$0
AMERICAN ACADEMY OF PEDIATRICS
362275597100$0$0
BOARD OF TRUSTEES OF THE LELAND STANFORD JR UNIVERSITY
94115636520$149,998$0
CENTER FOR A HEALTHY MARYLAND
52111064270$0$0
COMMUNITY SERVICE EDUCATION AND RESEARCH FUND
23700358170$144,320$0
CONNECTICUT STATE MEDICAL SOCIETY PHYSICIAN HEALTH & EDUCATION FUND
06142520570$0$0
DANIEL HANLEY CENTER FOR HEALTH LEADERSHIP
20427148870$0$0
FOUNDATION OF THE AMERICAN ASSOCIATION OF MEDICAL SOCIETY EXECUTIVES
362915937100$0$0
INDIANA MEDICAL FOUNDATION
23700167270$150,000$0
TEXAS MEDICAL ASSOCIATION
74107851010Yes (1)$0$0
WASHINGTON STATE MEDICAL ASSOCIATION
91046217010Yes (1)$0$0
METRO OMAHA MEDICAL SOCIETY FOUNDATION
470814363100$0$0
MEDICAL SOCIETY OF VIRGINIA FOUNDATION
52139476870$0$0
MEDICAL EDUCATION AND SCIENTIFIC FOUNDATION OF NY
11278036070$50,000$0
MEDICAL ASSOCIATION OF GEORGIA FOUNDATION
58606643170$150,000$0
ASSOCIATION OF WOMEN SURGEONS FOUNDATION
364029232100$0$0
PALM BEACH COUNTY MEDICAL SOCIETY SERVICES
65104829970$0$0
KANSAS MEDICAL FOUNDATION
48119466370$0$0
TRAVIS COUNTY MEDICAL SOCIETY FOUNDATION
74172008670$0$0
OHIO MEDICAL EDUCATION FOUNDATION
310907287100$150,000$0
SOUTH CAROLINA MEDICAL ASSOCIATION FOUNDATION
570168534100$0$0
MAYO CLINIC
416011702100$0$0
PHYSICIANS FOR A HEALTHY CALIFORNIA
94606282270$150,000$0
FOUNDATION FOR HEALTHY FLORIDIANS
46225949770$150,000$0
TWIN CITIES MEDICAL SOCIETY FOUNDATION
510178010100$142,968$0
AMERICAN MEDICAL ASSOCIATION
360727175100$0$0
NORTH CAROLINA MEDICAL SOCIETY FOUNDATION
56608814270$0$0
INSTITUTE OF MEDICINE AND PUBLIC OF NEW JERSEY
20067801270$0$0
TENNESSEE MEDICAL EDUCATION FUND INC (TN MEDICAL ASSOCIATION STUDENT EDUCA
62604992070$0$0
TEXAS MEDICAL ASSOCIATION SPECIAL FUNDS FOUNDATION
74274987970$0$0
WYOMING MEDICAL SOCIETY SCHOLARSHIP FUND
83600484670$150,000$0
MONTANA MEDICAL ASSOCIATION FOUNDATION
463696068100$50,000$0
NEBRASKA MEDICAL FOUNDATION
47603682770$150,000$0
WSMA FOUNDATION FOR HEALTH CARE IMPROVEMENT
91607446370$0$0
DOCS FOR PATIENT CARE FOUNDATION
464752703100$0$0
PAGNY HEALTH AND RESEARCH FOUNDATION INC
81131852270$0$0
MAINE MEDICAL EDUCATION TRUST
01044392670$0$0
BROWN UNIVERSITY OF PROVIDENCE
05025880920$0$0
ACADEMY OF MEDICINE EDUCATION FOUNDATION
32000620170$24,988$0
DR LORNA BREEN HEROES' FOUNDATION
85150908170$75,000$0
IOWA MEDICAL SOCIETY FOUNDATION
42607862670$49,600$0
MASSACHUSETTS MEDICAL SOCIETY AND ALLIANCE CHARITABLE FOUNDATION
22319962470$25,000$0
MISSISSIPPI STATE MEDICAL ASSOCIATION FOUNDATION
570906060100$150,000$0
THE RESEARCH INSTITUTE AT NATIONWIDE CHILDREN'S HOSPITAL
31605623070$93,942$0
FUTURE ALASKA MEDICAL LEADERS
83187437570$0$0
LOUISIANA STATE MEDICAL SOCIETY EDUCATION AND RESEARCH FOUNDATION
237029259100$0$0
VERMONT MEDICAL SOCIETY
03016491110Yes (1)$0$0
HAWAII MEDICAL ASSOCIATION
99006730610Yes (1)$0$0
FieldValueIRS element (for citing)
Supported Organizations Total64SupportedOrganizationsTotalCnt
Support Sum$2,155,816SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing Doc0ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationYes (1)SuprtOrgNoIRSDeterminationInd
Supported Org Section C456Yes (1)SupportedOrgSectionC456Ind
Supported Org QualifiedYes (1)SupportedOrgQualifiedInd
Suprt Exclusively Sec170c2 BYes (1)SuprtExclusivelySec170c2BInd
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgYes (1)OrganizationChangeSuprtOrgInd
Supported Org Class DesignatedYes (1)SupportedOrgClassDesignatedInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgYes (1)OperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 2021 THE FOUNDATION MADE NEW GRANTS TO 6 ORGANIZATIONS THAT WERE NOT LISTED ON THE 2020 FORM 990: ACADEMY OF MEDICINE EDUCATION FOUNDATION, MASSACHUSETTS MEDICAL SOCIETY AND ALLIANCE CHARITABLE FOUNDATION, IOWA MEDICAL SOCIETY FOUNDATION, MISSISSIPPI STATE MEDICAL ASSOCIATION FOUNDATION, THE REEARCH INSTITUTE AT NATIONWIDE CHILDREN'S HOSPITAL, AND DR. LORNA BREEN HEROES' FOUNDATION. SOME OF THE SUPPORTED ORGANIZATIONS DID NOT RECEIVE SUPPORT DURING 2021, BUT THEY ARE ALL LISTED ON SCHEDULE A, PART VI OF THE 2021 FORM 990. 7 ORGANIZATIONS THAT WERE LISTED AS SUPPORTED ORGANIZATIONS ON THE 2020 FORM 990, SCHEDULE A ARE NO LONGER SUPPORTED ORGANIZATIONS AND WERE REMOVED FROM THE 2021 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.

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (5 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
ISHARES CORE S&P SMALL CAP E$12,455,825F
ISHARES CORE S&P 500 ETF$21,366,290F
ISHARES S&P MIDCAP 400 INDEX$10,778,554F
ISHARES TR RUS 1000 GRW ETF$8,584,023F
ISHARES RUSSELL 1000 VALUE ETF$6,843,147F
FieldValueIRS element (for citing)
Total Book Value Securities$60,027,839TotalBookValueSecuritiesAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$16,292,890TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$8,925,384NetUnrealizedGainsInvstAmt
Revenue Not Reported$8,925,384RevenueNotReportedAmt
Revenue Subtotal$7,367,506RevenueSubtotalAmt
Investment Expenses Not Incld$258,139InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$258,139RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$7,625,645TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$5,588,526TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$5,588,526ExpensesSubtotalAmt
Investment Expenses Not Incld2$258,139InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$258,139ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$5,846,665TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE 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, 2021 AND 2020, THE FOUNDATION DOES NOT HAVE ANY UNRECOGNIZED TAX BENEFITS RESULTING FROM ITS TAX POSITIONS.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (19 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
THE OSMA FOUNDATION
5115 PARKCENTER AVENUE SUITE 200DUBLINOH43017310907287501(C)(3)$150,000$0TO ADDRESS BURNOUT AMONG THE STATE'S PHYSICIANS BY PROVIDING TRAINING AND SUPPORT FOR IMPLEMENTING PRACTICE-LEVEL CHANGES
TWIN CITIES MEDICAL SOCIETY FOUNDATION
1300 GODWARD STREET STE 2000MINNEAPOLISMN55413510178010501(C)(3)$142,968$0TO SUPPORT EXPANSION OF THE CURRENT COHORT OF THE PUBLIC HEALTH LEADERSHIP PROGRAM
MEDICAL EDUCATION AND SCIENTIFIC FOUNDATION OF NY
865 MERRICK AVEWESTBURYNY11590112780360501(C)(3)$50,000$0TO SUPPORT A LEADERSHIP PROGRAM TARGETING WOMEN PHYSICIANS; TO ADDRESS BURNOUT AMONG THE STATE'S PHYSICIANS BY PROVIDING TRAINING AND SUPPORT FOR IMPLEMENTING PRACTICE-LEVEL CHANGES
ACADEMY OF MEDICINE EDUCATION FOUNDATION
6111 OAK TREE BLVD SUITE 150INDEPENDENCEOH44131320006201501(C)(3)$24,988$0TO SUPPORT TELEHEALTH
ACCMA COMMUNITY HEALTH FOUNDATION
6230 CLAREMONT AVE 3RD FLOOROAKLANDCA94618461703508501(C)(3)$150,000$0TO DEVELOP AND DELIVER LEADERSHIP PROGRAM
BOARD OF TRUSTEES OF THE LELAND STANFORD JR UNIVERSITY
1520 PAGE MILL ROADPALO ALTOCA94304941156365501(C)(3)$149,998$0TO DEVELOP AND IMPLEMENT A PROGRAM TO DRIVE PHYSICIAN ENGAGEMENT FOR A CULTURE OF WELLNESS
COMMUNITY SERVICE EDUCATION AND RESEARCH FUND
5380 ELVAS AVE SUITE 104SACRAMENTOCA95819237003581501(C)(3)$144,320$0TO ESTABLISH THE JOY OF MEDICINE PROGRAM TO IMPROVE PHYSICIAN WELL-BEING
DR LORNA BREEN HEROES' FOUNDATION
1867 WINSTON RDCHARLOTTESVILLEVA22903851509081501(C)(3)$75,000$0TO PROMOTE A WELLNESS PROGRAM
FOUNDATION FOR HEALTHY FLORIDIANS
1430 PIEDMONT DRIVE EASTTALLAHASSEEFL32308462259497501(C)(3)$150,000$0TO DEVELOP EDUCATIONAL CONTENT AND PROMOTE INNOVATIVE PHYSICIAN-LED MODELS
INDIANA MEDICAL FOUNDATION
23 CANAL WALKINDIANAPOLISIN46202237001672501(C)(3)$150,000$0TO SUPPORT THE LAUNCH OF A PHYSICIAN LEADERSHIP PROGRAM
IOWA MEDICAL SOCIETY FOUNDATION
515 LOCUST ST SUITE 400DES MOINESIA50309426078626501(C)(3)$49,600$0TO SUPPORT TELEHEALTH IN RURAL AMERICA
MASSACHUSETTS MEDICAL SOCIETY AND ALLIANCE CHARITABLE FOUNDATION
860 WINTER STREETWALTHAMMA02451223199624501(C)(3)$25,000$0TO SUPPORT TELEHEALTH
MEDICAL ASSOCIATION OF GEORGIA FOUNDATION
1849 THE EXCHANGE SE 200ATLANTAGA30339586066431501(C)(3)$150,000$0TO SUPPORT A PHYSICIAN LEADERSHIP PROGRAM
MISSISSIPPI STATE MEDICAL ASSOCIATION FOUNDATION
408 WEST PARKWAY PLACERIDGELANDMS39157570906060501(C)(3)$150,000$0TO SUPPORT A PHYSICIAN LEADERSHIP PROGRAM
MONTANA MEDICAL ASSOCIATION FOUNDATION
2021 11TH AVENUE STE 1HELENAMT59601463696068501(C)(3)$50,000$0TO SUPPORT A PHYSICIAN LEADERSHIP PROGRAM
NEBRASKA MEDICAL FOUNDATION
233 S 13TH STREET SUITE 1200LINCOLNNE68508476036827501(C)(3)$150,000$0TO SUPPORT A PHYSICIAN LEADERSHIP PROGRAM
PHYSICIANS FOR A HEALTHY CALIFORNIA
1201 J STREET SUITE 200SACRAMENTOCA95814946062822501(C)(3)$150,000$0TO DEVELOP PROGRAMS TO INCREASE WELLNESS OF ETHNIC MINORITY WOMAN PHYSICIANS
THE RESEARCH INSTITUTE AT NATIONWIDE CHILDREN'S HOSPITAL
700 CHILDRENS DRIVECOLUMBUSOH43205316056230501(C)(3)$93,942$0TO SUPPORT A WELLLNESS PROGRAM
WYOMING MEDICAL SOCIETY SCHOLARSHIP FUND
122 E 17TH STREETCHEYENNEWY82001836004846501(C)(3)$150,000$0TO SUPPORT A PHYSICIAN LEADERSHIP PROGRAM
FieldValueIRS element (for citing)
Total501c3 Org19Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTO 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.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DUSTIN CORCORAN
MEMBER$9,500$775,000$0$275,000$0$12,000$0$26,100$0$64,030$9,500$1,152,130$0$0
MICHAEL DARROUZET
MEMBER$0$540,000$0$27,000$0$32,554$0$29,000$0$12,170$0$640,724$0$0
JOHN DORMAN
COO$100,000$382,664$0$19,133$0$48,665$0$58,000$0$12,190$100,000$520,652$0$0
JENNIFER HANSCOM
MEMBER$14,000$302,956$0$23,348$0$7,000$0$8,700$0$12,158$14,000$354,162$0$0
HURSHELL BAGGETT
MEMBER$14,000$282,822$0$34,355$0$0$0$0$0$17,530$14,000$334,707$0$0
PHIL SCHUH
MEMBER$10,500$337,032$0$0$0$0$0$0$0$0$10,500$337,032$0$0
ROBERT SELIGSON
CEO$300,000$0$0$0$0$0$0$0$0$0$300,000$0$0$0
LARRY DOWNS
SECRETARY$16,000$204,196$0$0$0$6,000$0$0$0$0$16,000$210,196$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 7ATHE 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 11BA 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 12CBOARD 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 15AIN 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 19ALL REQUIRED DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST.
FORM 990, PART IX, LINE 11GGRANT MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 198,745. MANAGEMENT AND GENERAL EXPENSES 149,930. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 348,675. COMMUNICATIONS: PROGRAM SERVICE EXPENSES 306,000. MANAGEMENT AND GENERAL EXPENSES 77,722. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 383,722. CONSULTING: PROGRAM SERVICE EXPENSES 30,376. MANAGEMENT AND GENERAL EXPENSES 10,124. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,500.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtControlled OrganizationControlledOrganizationInd
ALASKA STATE MEDICAL ASSOCIATION
4107 LAUREL STANCHORAGEAK99508926002176PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSAK501(C)(6)0
CALIFORNIA MEDICAL ASSOCIATION
1201 J STREET SUITE 200SACREMENTOCA95814940359340PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSCA501(C)(6)0
CONNECTICUT STATE MEDICAL SOCIETY
127 WASHINGTON AVE EAST 3RD FLOORNORTH HAVENCT06473060665164PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSCT501(C)(6)0
DENTON COUNTY MEDICAL SOCIETY
3537 S INTERSTATE 35 ESTE 302DENTONTX76210751676014PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSTX501(C)(6)0
EL PASO COUNTY MEDICAL SOCIETY
730 CITADEL DR EAST SUITE 206COLORADO SPRINGSCO80909741238007PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSCO501(C)(6)0
FLORIDA MEDICAL ASSOCIATION
1430 PIEDMONT DR ETALLAHASSEEFL32308590559672PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSFL501(C)(6)0
HAWAII MEDICAL ASSOCIATION
1360 S BERETANIA ST 200HONOLULUHI96814990067306PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSHI501(C)(6)0
LOUISIANA STATE MEDICAL SOCIETY
6767 PERKINS ROAD SUITE 100BATON ROUGELA70808720386637PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSLA501(C)(6)0
MEDICAL ASSOCIATION OF GEORGIA
1849 THE EXCHANGE SUITE 200ATLANTAGA30339580605267PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSGA501(C)(6)0
MEDICAL SOCIETY OF NEW JERSEY
TWO PRINCESS ROADLAWRENCEVILLENJ08648210601684PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSNJ501(C)(6)0
MEDICAL SOCIETY OF NEW YORK
865 MERRICK AVE SUITE 200WESTBURYNY11590131030760PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSNY501(C)(6)0
MEDICAL SOCIETY OF NORTHERN VIRGINA
4604 JONES BRANCH DR SUITE 3150MCLEANVA22102540739279PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSVA501(C)(6)0
NEBRASKA MEDICAL ASSOCIATION
233 S 13TH STREET SUITE 1200LINCOLNNE68508470372108PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSNE501(C)(6)0
NEW HAMPSHIRE MEDICAL SOCIETY
7 NORTH STATE DTREETCONCORDNH03301020223176PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSNH501(C)(6)0
NORTH CAROLINA MEDICAL ASSOCIATION
PO BOX 27167RALEIGHNC27611560320130PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSNC501(C)(6)0
SOUTH CAROLINA MEDICAL ASSOCIATION
132 WESTPARK BLVDCOLUMBIASC29210570248750PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSSC501(C)(6)0
TENNESSEE MEDICAL ASSOCIATION
701 BRADFORD AVENUENASHVILLETN37204620382010PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSTN501(C)(6)0
TEXAS MEDICAL ASSOCIATION
401 WEST 15TH STREET SUITE 100AUSTINTX78701741078510PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSTX501(C)(6)0
VERMONT MEDICAL SOCIETY
PO BOX 1457MONTPELIERVT05601030164911PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSVT501(C)(6)0
WASHINGTON STATE MEDICAL ASSOCIATION
2001 SIXTH AVE SUITE 2700SEATTLEWA98121910462170PROFESSIONAL SOCIETY REPRESENTING PHYSICIANSWA501(C)(6)0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (9 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
MEDICAL SOCIETY OF NEW JERSEY
P$3,935FMV
MEDICAL SOCIETY OF THE STATE OF NY
P$2,327FMV
TEXAS MEDICAL ASSOCIATION
P$23,322FMV
TEXAS MEDICAL ASSOCIATION
M$100,000CONTRACTED AMOUNT
WASHINGTON STATE MEDICAL ASSOCIATION
P$1,912FMV
MEDICAL SOCIETY OF NV
R$12,000FMV
MEDICAL SOCIETY OF THE STATE OF NY
R$3,500FMV
TEXAS MEDICAL ASSOCIATION
R$11,000FMV
CALIFORNIA MEDICAL ASSOCIATION
P$3,277FMV