2014-05-08T11:29:30-05:00 2013-12-31 205711238 ADELSON & COMPANY PC 100 NORTH ST PITTSFIELD MA 01201 990 2013-01-01 367166993 NATIONAL PATIENT SAFETY FOUNDATION NATI 6173919900 268 SUMMER STREET 6TH FL BOSTON MA 02210 TEJAL GANDHI PRESIDENT 6173919900 2014-05-06 1 VINCENT T VISCUSO CPA P00097031 4134436408 2014-05-06 2013 2015-11-30 17:44:51Z TEJAL GANDHI 268 SUMMER STREET 6TH FL BOSTON MA 02210 4300350 0 X WWW.NPSF.ORG X 2001 MA NPSF PARTNERS WITH PATIENTS AND FAMILIES, THE HEALTH CARE COMMUNITY, AND KEY STAKEHOLDERS TO ADVANCE PATIENT SAFETY AND HEALTH CARE WORKFORCE SAFETY AND DISSEMINATE STRATEGIES TO PREVENT HARM. 17 16 25 50 0 0 730967 827720 1816075 2030688 292699 269852 179686 108074 3019427 3236334 199947 33331 0 0 1559202 1517522 0 0 343947 2187123 2286781 3946272 3837634 -926845 -601300 3903522 3389271 1037566 1029384 2865956 2359887 X NPSF PARTNERS WITH PATIENTS AND FAMILIES, THE HEALTH CARE COMMUNITY, AND KEY STAKEHOLDERS TO ADVANCE PATIENT SAFETY AND HEALTH CARE WORKFORCE SAFETY AND DISSEMINATE STRATEGIES TO PREVENT HARM. 0 0 1334549 1158185 THE NATIONAL PATIENT SAFETY FOUNDATION (NPSF) PATIENT SAFETY CONGRESS BRINGS TOGETHER KEY HEALTH CARE STAKEHOLDERS COMMITTED TO PATIENT SAFETY AND IS DESIGNED TO SHARE NEW LEARNINGS, PRESENT PRACTICAL TOOLS AND INNOVATIVE SOLUTIONS, AND ARM ATTENDEES WITH THE IMPLEMENTATION STRATEGIES AND KNOWLEDGE THEY NEED TO FOSTER CHANGE. THE 2013 CONGRESS ATTRACTED MORE THAN 800 REGISTRATIONS. 491125 582179 THE NPSF PROFESSIONAL LEARNING SERIES OFFERS CONTINUING EDUCATION IN AN ONLINE LEARNING ENVIRONMENT. DRAWING ON THE KNOWLEDGE AND EXPERTISE OF THE NATIONAL PATIENT SAFETY FOUNDATION, PROGRAMS OFFER BEST PRACTICES, CUTTING-EDGE PERSPECTIVES, AND UNMATCHED RESOURCES TO ADDRESS CURRENT AND EMERGING ISSUES IN PATIENT SAFETY. THROUGH THIS ONLINE LEARNING SERIES, HEALTHCARE PROFESSIONALS CAN ACCELERATE THEIR EFFORTS TO ADVANCE PATIENT SAFETY. 245176 52800 THE LUCIAN LEAPE INSTITUTE PROVIDES A STRATEGIC VISION FOR IMPROVING PATIENT SAFETY. COMPOSED OF NATIONAL THOUGHT LEADERS WITH A COMMON INTEREST IN PATIENT SAFETY, THE INSTITUTE FUNCTIONS AS A THINK TANK TO IDENTIFY NEW APPROACHES TO IMPROVING PATIENT SAFETY, CALLING FOR THE INNOVATION NECESSARY TO EXPEDITE THE WORK, CREATE SIGNIFICANT, SUSTAINABLE IMPROVEMENTS IN CULTURE, PROCESS AND OUTCOMES, AND ENCOURAGES KEY STAKEHOLDERS TO ASSUME SIGNIFICANT ROLES IN ADVANCING PATIENT SAFETY. 751203 33331 1271248 - STAND UP FOR PATIENT SAFETY- PATIENT AND FAMILY INITIATIVES- NPSF PATIENT SAFETY COALITION- AMERICAN SOCIETY OF PROFESSIONALS IN PATIENT SAFETY- RESEARCH PROGRAMS- PATIENT SAFETY AWARENESS WEEK- PATIENT SAFETY LEADERSHIP FELLOWSHIP- CURRENT AWARENESS LITERATURE ALERT- PATIENT SAFETY LISTSERV- FOCUS ON PATIENT SAFETY NEWSLETTER 751203 33331 1271248 2822053 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 15 0 1 25 1 0 0 0 0 0 1 1 0 0 0 0 X 17 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL MA X X CORPORATION 6173919900 268 SUMMER STREET 6TH FLOOR BOSTON MA 02210 TEJAL GANDHI MD PRESIDENT 40.00 X X 158080 0 400 GERALD B HICKSON MD CHAIR 2.00 X X 0 0 0 CHARLES G BENDA PHD TREASURER 2.00 X X 0 0 0 SUSAN EDGMAN-LEVITAN PA DIRECTOR 0.50 X 0 0 0 GREGG S MEYER MD VICE CHAIR 2.00 X X 0 0 0 SAUL N WEINGART MD DIRECTOR 0.50 X 0 0 0 RICHARD E ANDERSON MD DIRECTOR 0.50 X 0 0 0 PATRICIA MCGAFFIGAN RN COO & SR. VP OF PROGRAM STRATEGY 40.00 X X 194725 0 15812 ANN SCOTT BLOUIN PHD DIRECTOR 0.50 X 0 0 0 DOUG BONACUM MBA DIRECTOR 0.50 X 0 0 0 JENNIFER DALEY MD DIRECTOR 0.50 X 0 0 0 LILLEE GELINAS MSN DIRECTOR 0.50 X 0 0 0 JONATHAN PERLIN MD DIRECTOR 0.50 X 0 0 0 MARY BETH NAVARRA-SIRIO MBA SECRETARY 0.50 X X 0 0 0 GARY S KAPLAN MD DIRECTOR 0.50 X 0 0 0 ALAN D AVILES JD DIRECTOR 0.50 X 0 0 0 RICHARD C BOOTHMAN JD DIRECTOR 0.50 X 0 0 0 HELEN HASKELL MA DIRECTOR 0.50 X 0 0 0 DAVID COLETTA VP, STRATEGIC ALLIANCES 40.00 X 166435 0 15812 519240 0 32024 3 0 1 0 PERFECT PLANIT 317 TIFFANY COURT GIBSONIA PA 15044 TRADE SHOW MANAGEMENT 264647 DIANE PINAKIEWICZ 43 MARKET STREET NEWBURYPORT MA 01950 CONSULTING SERVICES 213990 ACCOUNTING MANAGEMENT SOLUTIONS 800 SOUTH STREET SUITE 195 WALTHAM MA 02453 CONTRACTED SERVICES 131000 AUDIO VISUAL ONE PO BOX 1115 BEDFORD PARK IL 60499 SOUND AND LIGHTING SERVICES 106773 4 681037 20300 126383 827720 EDUCATION AND LIASON 900099 1258139 1258139 CONFERENCE REGISTRATION FEES 900099 568114 568114 CORPORATE COUNCIL 900099 191666 191666 CONSULTING & MISCELLANEOUS 900099 12769 12769 2030688 97620 97620 1150405 978173 172232 172232 172232 206005 20300 85843 120162 120162 LOSS FROM EQUITY INTEREST IN CBPP 900099 -12088 -12088 -12088 3236334 2030688 0 377926 X 33331 33331 841799 556445 155795 129559 515352 340657 95378 79317 37049 24750 6715 5584 123322 81518 22824 18980 53895 53895 18250 18250 14534 14534 570151 408414 130564 31173 202138 180050 12101 9987 61019 43983 9301 7735 301680 199416 55833 46431 130520 111929 10150 8441 18176 12015 3364 2797 6458 4269 1195 994 PROGRAM DEVELOPMENT 844281 807799 33801 2681 RECRUITING & RELOCATION 47612 47612 DUES & SUBSCRIPTIONS 18067 17477 322 268 3837634 2822053 671634 343947 X 200 200 3515147 2884284 180449 292537 74766 0 43302 138139 266974 244986 37535 21988 52123 52123 3903522 3389271 351250 212698 686316 816686 1037566 1029384 X 2856156 2359887 9800 0 2865956 2359887 3903522 3389271 -601300 95231 0 X 0 1 X 1 0 X 1236809 1109177 1177947 730967 827720 5082620 1236809 1109177 1177947 730967 827720 5082620 258792 4823828 102663 107458 103226 96130 97620 507097 5589717 10256688 0.86300 0.83800 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 36344 24662 11682 230630 220324 10306 21988 3326831 95231 9800 105031 3221800 14534 14534 3236334 3823100 0 3823100 14534 14534 3837634 PART XI, LINE 2D - OTHER ADJUSTMENTS: ASSETS RELEASED FROM RESTRICTION 9,800. GALA 226305 20300 206005 85843 226305 20300 206005 85843 85843 120162 1 TEXAS TECH UNIVERSITY 2500 BROADWAY STREET LUBBOCK TX 79409 756002622 501(C)(3) 33331 PATIENT SAFETY RESEARCH PART I, LINE 2: PROGRAMMATIC AND FINANCIAL REPORTS ARE SUBMITTED BY GRANT RECIPIENTS. X X 0 0 0 0 0 0 0 0 0 TEJAL GANDHI MD PRESIDENT 158080 0 0 0 0 0 0 0 400 0 158480 0 0 0 PATRICIA MCGAFFIGAN RN COO & SR. VP OF PROGRAM STRATEGY 194725 0 0 0 0 0 0 0 15812 0 210537 0 0 0 DAVID COLETTA VP, STRATEGIC ALLIANCES 166435 0 0 0 0 0 0 0 15812 0 182247 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 WILL BE REVIEWED BY THE FINANCE COMMITTEE WHO WILL THEN REPORT ON IT TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST DISCLOSURE STATEMENT MUST BE COMPLETED BY MEMBERS OF THE BOARD OF DIRECTORS, BOARD OF GOVERNORS, MEMBERS OF NPSF STAFF, AND LUCIAN LEAPE INSTITUTE AT NPSF ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION B, LINE 15 BASED UPON RECOMMENDATIONS FROM AN INDEPENDENT CONSULTANT, THE BOARD SETS THE BASE SALARY AND BONUS STRUCTURE FOR THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AVAILABLE TO THEIR BOARD OF DIRECTORS, BOARD OF GOVERNORS AND TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 408,414. MANAGEMENT AND GENERAL EXPENSES 130,564. FUNDRAISING EXPENSES 31,173. TOTAL EXPENSES 570,151. CERTIFICATION BOARD FOR PROFESSIONALS IN PATIENT SAFETY INC 268 SUMMER STREET 6TH FL BOSTON MA 02210 452197138 HEALTH CARE SAFETY MA 501(C)(3) LINE 9 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 CERTIFICATION BOARD FOR PROFESSIONALS IN PUBLIC SAFETY L 233602 FAIR MARKET VALUE CERTIFICATION BOARD FOR PROFESSIONALS IN PUBLIC SAFETY N NO VALUE ASSIGNED CERTIFICATION BOARD FOR PROFESSIONALS IN PUBLIC SAFETY O 93720 FAIR MARKET VALUE CERTIFICATION BOARD FOR PROFESSIONALS IN PUBLIC SAFETY Q 93720 FAIR MARKET VALUE