INSTITUTE OF MEDICAL HUMANISM INC: Form 990EZ, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- INSTITUTE OF MEDICAL HUMANISM INC (EIN 03-0371823)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-08-12
- IRS object ID
- 201632259349201808
- Schema version
- 2015v2.0
- 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 | 2016-08-12T12:57:22-07:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Crossroads AccountingLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 North Street | AddressLine1Txt |
| City | Bennington | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 030371823 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Institute of Medical Humanism Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INST | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 197 | AddressLine1Txt |
| City | Bennington | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05201 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Bernard M Bandman PhD | PersonNm |
| Person Title | Executive Direc | PersonTitleTxt |
| Signature | 2016-08-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Gail Mauricette | PreparerPersonNm |
| PTIN | P00140935 | PTIN |
| Phone | 8024428174 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Website Address | N/A | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Gross Receipts | $74,493 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $66,173 | ContributionsGiftsGrantsEtcAmt |
| Program Service Revenue | $8,292 | ProgramServiceRevenueAmt |
| Investment Income | $28 | InvestmentIncomeAmt |
| Cost Or Other Basis Expense Sale | $0 | CostOrOtherBasisExpenseSaleAmt |
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $0 | SpecialEventsDirectExpensesAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
| Total Revenue | $74,493 | TotalRevenueAmt |
| Salaries Other Comp Empl Bnft | $64,590 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $19,743 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $3,699 | OccupancyRentUtltsAndMaintAmt |
| Printing Publications Postage | $4,607 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $20,234 | OtherExpensesTotalAmt |
| Total Expenses | $112,873 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$38,380 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $97,758 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $59,378 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,418 | BOYAmt |
| EOY | $64,656 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,496 | BOYAmt |
| EOY | $2,388 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,914 | BOYAmt |
| EOY | $67,044 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,156 | BOYAmt |
| EOY | $7,666 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,758 | BOYAmt |
| EOY | $59,378 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | To redefine the medical encounter; to recognize the differences between the language of medicine and the language of the patient's world transformed by illness, to acknowledge the patient's voice as a cornerstone of best care, to bridge the communication between doctor and patient, and in so doing, improve quality of care. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (6 entries)
| Description Program Srvc AccomDescriptionProgramSrvcAccomTxt | Grants And AllocationsGrantsAndAllocationsAmt |
|---|---|
| Patient Education Programs:Difficult Conversations Toolkit: The Difficult Conversations video and workbook are components of a toolkit that help patients with serious illness better understand and communicate their needs and goals to doctors and nurses. The toolkit has been used in a pilot study with 10 patients at the VA Hospital in Vermont and introduced by oncologists at MD Anderson (Houston TX) and Massachusetts General Hospital (Boston, MA) to select patients to help refine the workbook prior to distribution. A pilot program has been implemented at Rutland Regional Medical Center's Cancer Center and in-patient palliative care service. Southwestern Vermont Cancer Center is offering the toolkit to patients and families.A program at the Stowe Weekend of Hope for patients and families introduced the Difficult Conversations Workbook as a tool to identify needs, preferences and goals for end of life care planning. There were 30 participants. Surveys showed that the program was very well received. | $89,719 |
| Education and Training Programs for Medical Professionals- Voices From The Lived World of Illness includes a film and medical education guide. It continues to be used at medical institutions and conferences for education/training of physicians, nurses, social workers and hospice staff. Approximately 1200 medical professionals have participated in programs since it's release in 2005. Men Do Talk is a toolkit that includes a film and workbook. It offers perspectives of prostate cancer patients and has been used for education/training of physicians, nurses and social workers. Approximately 200 medical professionals have participated in programs since its release in 2008. Difficult Conversations Toolkit is an interactive tool that includes a video and workbook. It offers the perspectives of patients with incurable cancer and has been used for end of life education programs for physicians, nurses and social workers. In addition, the toolkit has been used for programs to educate the community on how to prepare for conversations with health care providers.In-service educational programs on the use of the Difficult Conversations communication tool were offered at the Dartmouth Hitchcock Cancer Center (Manchester, NH, MD Anderson Cancer Center (Houston, TX),Springfield (VT) Cancer Center, Southwestern Vermont Medical Center and Brattleboro Memorial Hospital. The programs were attended by 200 physicians and nurses. | |
| Writing is Good Medicine Program-This program prescribes the pen as a tool that helps patients better understand their physical, psychosocial and spiritual needs. The program helps to empower patients to clarify and communicate their needs and goals in the planning of care. Approximately, 50 patients participated in workshops. | |
| Community Education Programs- "Good Communication is Good Medicine" programs educate the public about the key role of communication in improving quality of healthcare delivery and increasing patient satisfaction. The program format includes viewing films of actual patients sharing their experiences and panel discussions with experts. Audience participation is encouraged. Approximately 75 people attended the programs. | |
| Medical Humanist Program- the consultation service educates patients and families about how to effectively communicate with medical professionals. Participants learn how to document their needs and concerns in preparation for addressing these issues at medical office visits. Approximately 20 patients/family have participated in the program. | |
| New website SpeakSooner.org: A new website featuring the Difficult Conversations initiative. The Difficult Conversations Workbook & Video is available on the site for completing writing exercises and download for office visits. The website also offers patients, loved ones and health care professionals a portal to share their views and experiences about end of life care. SpeakSooner.org places an emphasis on empowering patients to open conversations with doctors and nurses about their needs, concerns and goals for care. Avoidance of talking sooner about prognosis can lead to unmet needs, unnecessary suffering and regrets. The website serves as a platform to educate a wider audience and offer resources to support of all of those impacted by illness. | $2,594 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $92,313 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (5 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|
| Bernard M Bandman PhD | ||
| Executive Direc | 20.00 | $30,000 |
| David L Schroedel | ||
| President | 10.00 | $0 |
| Anne L Gatling | ||
| Secretary/Treas | 10.00 | $0 |
| Dan Klores | ||
| Trustee | 0 | $0 |
| Carol Salazar MD | ||
| Vice President | 0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Organization Filed990 T | false | OrganizationFiled990TInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Initiation Fees And Cap Contri | $0 | InitiationFeesAndCapContriAmt |
| Gross Receipts For Public Use | $0 | GrossReceiptsForPublicUseAmt |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Bernard M Bandman PhD | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 160 Benmont Ave | AddressLine1Txt |
| City | Bennington | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8024425800 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Form720 Filed | false | Form720FiledInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Related Org Sect527 Org | false | RelatedOrgSect527OrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (true) | 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 | $33,970 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $45,990 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $72,747 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $60,896 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $66,173 | CurrentTaxYearAmt |
| Total | $279,776 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $33,970 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $45,990 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $72,747 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $60,896 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $66,173 | CurrentTaxYearAmt |
| Total | $279,776 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $98,453 | SubstantialContributorsTotAmt |
| Public Support Total170 | $181,323 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $63 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $46 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $30 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $28 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28 | CurrentTaxYearAmt |
| Total | $195 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $279,971 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $13,152 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.64760 | PublicSupportCY170Pct |
| Public Support PY170 | 0.65580 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Other Expenses.1001 | Advertising and Promotion $100 |
| Other Expenses.1002 | Office Expenses $1680 |
| Other Expenses.1005 | Travel $3408 |
| Other Expenses.1009 | Depreciation $963 |
| Other Expenses.1012 | Insurance $2341 |
| Other Expenses.1 | Telephone $3761 |
| Other Expenses.3 | Program Expenses $2990 |
| Other Expenses.4 | Website $2594 |
| Other Expenses.5 | Books, subscriptions $2397 |
| Other Assets.1003 | Machinery and Equipment - Beginning $1240 Machinery and Equipment - Ending $2132 |
| Other Assets.1 | Deposits - Beginning $256 Deposits - Ending $256 |
| Total Liabilities.1001 | Accounts Payable and Accrued Expenses - Beginning $4156 Accounts Payable and Accrued Expenses - Ending $7666 |
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