CONNECTICUT CENTER FOR PATIENT SAFETY: Form 990EZ, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- CONNECTICUT CENTER FOR PATIENT SAFETY (EIN 20-1517678)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2016-10-14
- IRS object ID
- 201642889349200034
- Schema version
- 2015v2.1
- 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 | 2016-10-14T10:26:03-07:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 061555293 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dixon & Company | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | POBox 938 | AddressLine1Txt |
| City | Windsor | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06095 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201517678 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Connecticut Center for Patient Safety | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CONN | BusinessNameControlTxt |
| Phone | 2036100610 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 857 Post Road Number 220 | AddressLine1Txt |
| City | Fairfield | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06824 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lisa Freeman | PersonNm |
| Person Title | Executive Director | PersonTitleTxt |
| Phone | 2036100610 | PhoneNum |
| Signature | 2016-08-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Sharon Dixon Peay | PreparerPersonNm |
| PTIN | P01275297 | PTIN |
| Phone | 8606885818 | PhoneNum |
| Preparation | 2016-08-24 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Website Address | www.ctcps.org | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $94,606 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $94,605 | ContributionsGiftsGrantsEtcAmt |
| Program Service Revenue | $0 | ProgramServiceRevenueAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Investment Income | $1 | InvestmentIncomeAmt |
| Sale Of Assets Gross | $0 | SaleOfAssetsGrossAmt |
| Cost Or Other Basis Expense Sale | $0 | CostOrOtherBasisExpenseSaleAmt |
| Gain Or Loss From Sale Of Assets | $0 | GainOrLossFromSaleOfAssetsAmt |
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $0 | SpecialEventsDirectExpensesAmt |
| Special Events Net Income Loss | $0 | SpecialEventsNetIncomeLossAmt |
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
| Gross Profit Loss Sls Of Invntry | $0 | GrossProfitLossSlsOfInvntryAmt |
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
| Total Revenue | $94,606 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $0 | GrantsAndSimilarAmountsPaidAmt |
| Benefits Paid To Or For Members | $0 | BenefitsPaidToOrForMembersAmt |
| Salaries Other Comp Empl Bnft | $0 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $76,725 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $0 | OccupancyRentUtltsAndMaintAmt |
| Printing Publications Postage | $259 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $8,161 | OtherExpensesTotalAmt |
| Total Expenses | $85,145 | TotalExpensesAmt |
| Excess Or Deficit For Year | $9,461 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $76,636 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $86,097 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,821 | BOYAmt |
| EOY | $86,167 | EOYAmt |
Land And Buildings LandAndBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,821 | BOYAmt |
| EOY | $86,167 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185 | BOYAmt |
| EOY | $70 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,636 | BOYAmt |
| EOY | $86,097 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | The Connecticut Center for Patient Safety works to promote patient safety, improve the quality of health care and protect the rights of patients. Quality health care is a right. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (2 entries)
| Description Program Srvc AccomDescriptionProgramSrvcAccomTxt | Grants And AllocationsGrantsAndAllocationsAmt | Program Service ExpensesProgramServiceExpensesAmt |
|---|---|---|
| Education to Professionals -provide education to health professionals, participate as a patient voice on panels, committees and national organizations. We put a face on the patient experience. Work to form partnerships to improve patient outcomes. Produces data, information and analysis pertaining to the extent, type and source of hospital infections and pharmaceuticals in Connecticut | $80,035 | $71,908 |
| Public Education- raise public awareness and provide factual information to the public and members. Educate consumers/patients on patient engagement and what they need to know and do as informed consumers. During the year, we hold educational sessions, build relationships with legislative, advocacy and business organizations. Maintain our websites. Work to form partnerships to improve patient outcomes. | $14,570 | $13,237 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $85,145 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (5 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| Gus Velez | ||||
| President | 5 | $0 | $0 | $0 |
| Alan Manning | ||||
| Vice President | 5 | $0 | $0 | $0 |
| Sandy Cayo | ||||
| Director | 5 | $0 | $0 | $0 |
| Jean Rexford | ||||
| Secreatary and Treasurer (Former Executive Director) | 5 | $0 | $0 | $0 |
| Patricia Kelmar | ||||
| Vice President- RESIGNED 10/3/2015 | 0 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Form1120 Pol Filed | 0 | Form1120PolFiledInd |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | CT | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Lisa Freeman | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 857 Post Road | AddressLine1Txt |
| Address Line2 | Number 220 | AddressLine2Txt |
| City | Fairfield | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06824 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2036100610 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $116,016 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $245,173 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $299,433 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $116,708 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $94,605 | CurrentTaxYearAmt |
| Total | $871,935 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $116,016 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $245,173 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $299,433 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $116,708 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $94,605 | CurrentTaxYearAmt |
| Total | $871,935 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $871,935 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $144 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1 | CurrentTaxYearAmt |
| Total | $162 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $872,097 | TotalSupportAmt |
| Public Support CY170 | 0.99981 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99983 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests PY170 | Yes (X) | ThirtyThrPctSuprtTestsPY170Ind |
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 C IRS990ScheduleC
Total Grassroots Lobbying TotalGrassrootsLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Total Direct Lobbying TotalDirectLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $5,835 | FilingOrganizationsTotalAmt |
Total Lobbying Expend TotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $5,835 | FilingOrganizationsTotalAmt |
Other Exempt Purpose Expend OtherExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $79,310 | FilingOrganizationsTotalAmt |
Total Exempt Purpose Expend TotalExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $85,145 | FilingOrganizationsTotalAmt |
Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $17,029 | FilingOrganizationsTotalAmt |
Grassroots Nontaxable GrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $4,257 | FilingOrganizationsTotalAmt |
Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $0 | CurrentYearMinus3Amt |
| Current Year Minus2 | $0 | CurrentYearMinus2Amt |
| Current Year Minus1 | $0 | CurrentYearMinus1Amt |
| Current Year | $17,029 | CurrentYearAmt |
| Total | $17,029 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $25,544 | LobbyingCeilingAmt |
Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $0 | CurrentYearMinus3Amt |
| Current Year Minus2 | $0 | CurrentYearMinus2Amt |
| Current Year Minus1 | $0 | CurrentYearMinus1Amt |
| Current Year | $5,835 | CurrentYearAmt |
| Total | $5,835 | TotalAmt |
Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $0 | CurrentYearMinus3Amt |
| Current Year Minus2 | $0 | CurrentYearMinus2Amt |
| Current Year Minus1 | $0 | CurrentYearMinus1Amt |
| Current Year | $4,257 | CurrentYearAmt |
| Total | $4,257 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $6,386 | GrassrootsCeilingAmt |
Avg Grassroots Lobbying Expend AvgGrassrootsLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | $0 | CurrentYearMinus3Amt |
| Current Year Minus2 | $0 | CurrentYearMinus2Amt |
| Current Year Minus1 | $0 | CurrentYearMinus1Amt |
| Current Year | $0 | CurrentYearAmt |
| Total | $0 | TotalAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990-EZ, Part I, Line 16 | Description;Amount^Bank Fees and Paypal;27|Insurance;614|Marketing and Outreach;135|Internet Expenses;315|Memberships;100|Telephone;1130|Meeting Expenses;680|Office Supplies and Utilities;900|Travel;4260^Total;8161^ |
| Form 990-EZ, Part II, Line 26 | Description;EOY Amount^credit cards;70^Total;70^ |
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