HEALTH STORY COLLABORATIVE INC: Form 990EZ, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
HEALTH STORY COLLABORATIVE INC (EIN 46-3707918)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-14
IRS object ID
201823189349202082
Schema version
2017v2.3
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)
Return2018-11-14T10:15:24-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN431985162PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SMITH SULLIVAN & BROWN PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line180 FLANDERS ROAD - SUITE 200AddressLine1Txt
CityWESTBOROUGHCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01581ZIPCd
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN463707918EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HEALTH STORY COLLABORATIVE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHEALBusinessNameControlTxt
Phone6177143201PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1105 COOLIDGE HILLAddressLine1Txt
CityCAMBRIDGECityNm
State AbbreviationMAStateAbbreviationCd
ZIP02138ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBRIAN VALLIMONTPersonNm
Person TitleTREASURERPersonTitleTxt
Phone6177143201PhoneNum
Signature2018-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSANDRA M BROWN CPAPreparerPersonNm
PTINP01614103PTIN
Phone5088717178PhoneNum
Preparation2018-11-14PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address71.248.188.134IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-14IPDt
IP Tm11:11:22IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id72A4FA07CE53DEC3A28436150D2A9659B101DAD9AtSubmissionCreationDeviceId
At Submission Filing Device Id69E9977AC052CEB93F1ED3E2D4B07C277CAC5DE2AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Website AddressWWW.HEALTHSTORYCOLLABORATIVE.ORGWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$48,061GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$46,046ContributionsGiftsGrantsEtcAmt
Program Service Revenue$2,000ProgramServiceRevenueAmt
Investment Income$15InvestmentIncomeAmt
Total Revenue$48,061TotalRevenueAmt
Salaries Other Comp Empl Bnft$10,000SalariesOtherCompEmplBnftAmt
Fees And Other Pymt To Ind Cntrct$13,555FeesAndOtherPymtToIndCntrctAmt
Printing Publications Postage$186PrintingPublicationsPostageAmt
Other Expenses Total$6,797OtherExpensesTotalAmt
Total Expenses$30,538TotalExpensesAmt
Excess Or Deficit For Year$17,523ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$61,780NetAssetsOrFundBalancesBOYAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Net Assets Or Fund Balances EOY$79,303NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIYes (X)InfoInScheduleOPartIIInd

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$58,280BOYAmt
EOY$59,528EOYAmt

Other Assets Total Detail OtherAssetsTotalDetail

FieldValueIRS element (for citing)
BOY$6,000BOYAmt
EOY$19,775EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$64,280BOYAmt
EOY$79,303EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,500BOYAmt
EOY$0EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$61,780BOYAmt
EOY$79,303EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
Primary Exempt PurposeTHE MISSION OF HEALTH STORY COLLABORATIVE IS TO KEEP THE PATIENT VOICE ALIVE IN HEALTHCARE AND TO HARNESS THE HEALING POWER OF STORIES. BY COLLECTING, HONORING AND SHARING STORIES OF ILLNESS AND HEALING, WE STRIVE TO MAKE THE PROCESS OF NAVIGATING ILLNESS LESS ISOLATING AND TO EMPOWER INDIVIDUALS AND FAMILIES FACING HEALTH CHALLENGES. OUR BELIEF, SUPPORTED BY RESEARCH, IS THAT STORYTELLING IS HEALING FOR BOTH STORY SHARERS AND LISTENERS. STORIES HAVE THE POWER TO TRANSFORM INDIVIDUALS AS WELL AS THE HEALTHCARE SYSTEM.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (4 entries)

Description Program Srvc AccomDescriptionProgramSrvcAccomTxtGrants And AllocationsGrantsAndAllocationsAmtProgram Service ExpensesProgramServiceExpensesAmt
AUDIO STORIES: THE ORGANIZATION CONTINUED TO DEVELOP AUDIO STORIES IN 2017. THE GOAL OF THIS PROGRAM IS TO GROW A COLLECTION OF AUDIO STORIES FROM PATIENTS AND THEIR LOVED ONES THAT CAN BE SHARED FOR THE BENEFIT OF OTHERS GOING THROUGH SIMILAR CIRCUMSTANCES.$0$3,365
HEALING STORY SESSIONS: HEALING STORY SESSIONS ARE LIVE STORYTELLING EVENTS FOUNDED ON THE BELIEF THAT STORY SHARING IS HEALING. IN PREPARATION FOR THESE SESSIONS, WE WORK CLOSELY WITH PARTICIPANTS TO CONSTRUCT THEIR STORIES OF ILLNESS AND HEALING, AND TO BECOME COMFORTABLE SHARING THEIR STORIES IN SPOKEN WORD. PARTICIPANTS THEN INVITE A GROUP OF SUPPORTIVE COMMUNITY MEMBERS TO ATTEND THEIR SESSION AND TO WITNESS THEIR STORIES.$0$6,797
SHARING CLINIC: SHARING CLINIC IS AN AUDIO LISTENING KIOSK THAT RESIDES AT THE MASSACHUSETTS GENERAL HOSPITAL PAUL S, RUSSELL MUSEUM OF MEDICAL HISTORY AND INNOVATION AS AN INTERACTIVE EXHIBIT. THE LISTENING KIOSK HOUSES AN ARRAY OF AUDIO CLIPS TAKEN FROM INTERVIEWS WITH PATIENTS, PATIENT'S LOVED ONES, AND HEALTHCARE PROVIDERS. LISTENERS SELECT STORIES THEY WANT TO HEAR BY DIAGNOSIS AND/OR THEME USING A TOUCH SCREEN.$0$3,440
OTHER PROGRAM SERVICE ACCOMPLISHMENTS - OTHER PROGRAM SERVICE ACTIVITIES$0$9,720
FieldValueIRS element (for citing)
Total Program Service Expenses$23,322TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (5 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
NINA COSLOV
DIRECTOR1.00$0$0$0
NED RIMER
DIRECTOR1.00$0$0$0
ANNE C BREWSTER
PRESIDENT & EXECUTIVE DIRECTOR25.00$10,000$0$0
BRIAN VALLIMONT
TREASURER1.00$0$0$0
KATIE RIMER
CLERK1.00$0$0$0
FieldValueIRS element (for citing)
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not Rpt0ChgMadeToOrgnzngDocNotRptInd
Organization Had UBI0OrganizationHadUBIInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Direct Indirect Pltcl Expend$0DirectIndirectPltclExpendAmt
Made Loans To From Officers0MadeLoansToFromOfficersInd
Tax Imposed Under IRC4911$0TaxImposedUnderIRC4911Amt
Tax Imposed Under IRC4912$0TaxImposedUnderIRC4912Amt
Tax Imposed Under IRC4955$0TaxImposedUnderIRC4955Amt
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
Tax Imposed On Organization Mgr$0TaxImposedOnOrganizationMgrAmt
Tax Reimbursed By Organization$0TaxReimbursedByOrganizationAmt
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BRIAN VALLIMONTBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1105 COOLIDGE HILLAddressLine1Txt
CityCAMBRIDGECityNm
State AbbreviationMAStateAbbreviationCd
ZIP02138ZIPCd
FieldValueIRS element (for citing)
Phone6177143201PhoneNum
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccountInd
Foreign Office0ForeignOfficeInd
Donor Advised Fnds0DonorAdvisedFndsInd
Operate Hospital0OperateHospitalInd
Tanning Services Provided0TanningServicesProvidedInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
School Operating0SchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Filed Schedule AYes (1)FiledScheduleAInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$42,372CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$47,272CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$34,694CurrentTaxYearMinus1YearAmt
Current Tax Year$46,046CurrentTaxYearAmt
Total$170,384TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$42,372CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$47,272CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$34,694CurrentTaxYearMinus1YearAmt
Current Tax Year$46,046CurrentTaxYearAmt
Total$170,384TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$118,864SubstantialContributorsTotAmt
Public Support Total170$51,520PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$3CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$23CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$27CurrentTaxYearMinus1YearAmt
Current Tax Year$15CurrentTaxYearAmt
Total$68TotalAmt
FieldValueIRS element (for citing)
Total Support$170,452TotalSupportAmt
Gross Receipts Rltd Activities$5,000GrossReceiptsRltdActivitiesAmt
First5 Years170Yes (X)First5Years170Ind

Schedule B IRS990ScheduleB

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOMEDESCRIPTION: INTEREST INCOME. AMOUNT: 15.
FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSESDESCRIPTION: OFFICE EXPENSES. AMOUNT: 28. DESCRIPTION: COMPUTER & IT EXPENSES. AMOUNT: 3,868. DESCRIPTION: TRAVEL. AMOUNT: 107. DESCRIPTION: MEETINGS AND EVENTS. AMOUNT: 797. DESCRIPTION: MISCELLANEOUS EXPENSES. AMOUNT: 20. DESCRIPTION: DUES, FEES AND SUBSCRIPTIONS. AMOUNT: 35. DESCRIPTION: PROGRAM SUPPLIES. AMOUNT: 542. DESCRIPTION: AMORTIZATION EXPENSE. AMOUNT: 1,200. DESCRIPTION: GIFTS. AMOUNT: 200. TOTAL TO FORM 990-EZ, LINE 16: 6,797.
FORM 990-EZ, PART II, LINE 24 - OTHER ASSETSDESCRIPTION: INTANGIBLE: SOFTWARE. BEG. OF YEAR AMOUNT: 6,000. END OF YEAR AMOUNT: 4,800. DESCRIPTION: PLEDGES RECEIVABLE. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 14,475. DESCRIPTION: PREPAID EXPENSES. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 500.
FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIESDESCRIPTION: ACCRUED EXPENSES. BEG. OF YEAR AMOUNT: 2,500. END OF YEAR AMOUNT: 0.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationTHE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.DeclarationDesc

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