2014-09-19T17:02:14-05:00 2014-06-30 203762051 THE MB GROUP LLC 5072 W PLANO PARKWAY SUITE 150 PLANO TX 75093 990 2013-07-01 752391148 NATIONAL BREAST CANCER FOUNDATION INC NATI 9722489200 2600 NETWORK BLVD NO 300 FRISCO TX 75034 JOHN T REECE II CFO 9722489200 2014-09-19 1 P00726888 4698651040 2014-09-19 2013 2015-11-30 17:44:51Z JANELLE HAIL 2600 NETWORK BLVD NO 300 FRISCO TX 75034 13894334 0 X WWW.NBCF.ORG X 1991 TX HELPING WOMEN NOW. PROVIDING HELP AND INSPIRING HOPE TO THOSE AFFECTED BY BREAST CANCER THROUGH EARLY DETECTION, EDUCATION, AND SUPPORT SERVICES. 6 5 37 1857 0 0 11962660 12603545 0 0 261383 149994 0 368 12224043 12753907 3424643 3718775 0 0 2976853 2998207 0 0 1082486 6724269 4869322 13125765 11586304 -901722 1167603 8251860 9624720 647171 629864 7604689 8994856 HELPING WOMEN NOW. PROVIDING HELP AND INSPIRING HOPE TO THOSE AFFECTED BY BREAST CANCER THROUGH EARLY DETECTION, EDUCATION, AND SUPPORT SERVICES. 0 0 4134605 2906487 FUNDING OF DIAGNOSTIC BREAST CARE SERVICES, INCLUDING MAMMOGRAMS, IN AUTHORIZED FACILITIES NATIONALLY WITH A CONCENTRATED EFFORT TO REACH UNDERSERVED/UNINSURED WOMEN AND TO INCREASE EARLY DETECTION OF BREAST CANCER IN THIS AT RISK GROUP BASED ON AN ACTUAL COUNT OF 15,638 FREE DIAGNOSTIC BREAST CARE SERVICES, INCLUDING MAMMOGRAMS, AND 158,079 PATIENT NAVIGATION SERVICES. 4366751 270200 DESIGNED AND DELIVERED EDUCATIONAL AND AWARENESS MATERIALS UTILIZED BY OVER 8,976,700 BREAST CANCER PATIENTS AND SUPPORTERS NATIONALLY AND INTERNATIONALLY, INCLUDING EDUCATIONAL AND AWARENESS MATERIALS ON NBCF.ORG, BEYOND THE SHOCK EDUCATIONAL PROGRAM, EARLY DETECTION PLAN, MYNBCF.ORG, BREASTCANCER.NET, BREAST CANCER EDUCATION BROCHURES, AND MEDIA PRESENTATIONS. 874941 542088 FUNDED BREAST CANCER RESEARCH INITIATIVES FOCUSED ON EARLY DETECTION, TREATMENT OR CURE OF BREAST CANCER. 9376297 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 1 0 0 0 1 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 43 0 1 37 1 0 0 0 0 0 0 0 0 0 0 X 6 5 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AL AK AR CA CO CT DC FL GA HI IL KS KY ME MD MA MI MN MS ND NH NJ NM NY NC NV OH OK PA RI SC TN UT VA WA WV WI OR X X X LINDSAY GRIFFIN 9722489200 2600 NETWORK BLVD STE 300 FRISCO TX 75034 JANELLE HAIL CEO/PRES,CHAIRMAN OF BOD 40.00 X X X 186461 0 23588 RONALD BROOKS TREASURER OF BOD 2.00 X 0 0 0 STEVE ENGLE DIRECTOR 2.00 X 0 0 0 GABI BARBARENA DIRECTOR 2.00 X 0 0 0 LANCE HAMILTON DIRECTOR 2.00 X 0 0 0 HAL DONALDSON DIRECTOR 0.00 X 0 0 0 KEVIN HAIL COO 40.00 X 160347 0 26618 JOHN REECE CFO & CSO 40.00 X 147520 0 25291 JO ANN TIMBERLAKE DIRECTOR OF COMPLIANCE 40.00 X 113224 0 16456 BRENT HAIL SENIOR VP, DEVELOPMENT 40.00 X 110892 0 17870 718444 0 109823 5 0 1 0 OVEN BITS 2211 NORTH LAMAR STREET STE 302 DALLAS TX 75202 EDUCATIONAL VIDEO & WEB DEVELOPMENT 312206 RICHARDS PARTNERS 8750 N CENTRAL EXPWY STE 100 DALLAS TX 75231 BRAND MANAGEMENT 152108 BOOMERANG SUPPORT 5015 ADDISON CIRCLE STE 521 ADDISON TX 75001 IT SUPPORT 146162 3 76446 12527099 1806872 12603545 144052 144052 1142829 1500 1135865 2522 6964 -1022 5942 5942 2408 2040 368 368 12753907 368 0 149994 X 3701687 3701687 17088 17088 506293 408857 45663 51773 1497819 774408 406592 316819 379056 227719 84311 67026 459368 248199 125095 86074 155671 88699 37494 29478 37731 13238 1743 22750 16339 15374 965 1425398 1306805 6874 111719 49449 14589 18499 16361 258539 123072 82076 53391 477751 350675 48933 78143 511255 277859 136696 96700 173968 118221 9794 45953 15196 8184 3536 3476 190199 116332 37967 35900 21537 15935 3721 1881 EDUCATIONAL PROGRAMS/MA 844137 844137 EDUCATION EXPENSE 405554 405554 EVENT EXPENSE 399311 308930 56702 33679 AWARDS/RECOGNITION 18515 18515 24443 6109 6451 11883 11586304 9376297 1127521 1082486 1096284 1774447 13862 13876 984040 660859 79245 46284 1758982 1121252 779794 637730 4759863 5864986 538772 626538 8251860 9624720 57953 101845 360000 260000 229218 268019 647171 629864 X 7295793 8795956 308896 198900 7604689 8994856 8251860 9624720 X 1167603 222562 2 X 0 1 X 1 0 X 8287900 10332766 9353827 9382408 10796673 48153574 8287900 10332766 9353827 9382408 10796673 48153574 48153574 79437 186390 185458 261383 149994 862662 1 369 370 49016606 0.98240 0.96390 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 819886 437730 382156 518185 415616 102569 420911 267906 153005 637730 AAA/AA RATED CORPORATE BONDS 401704 F MUTUAL FUNDS 2243102 F CERTIFICATES OF DEPOSITS 1612692 F EQUITY SECURITIES 470505 F US GOVERNMENT BACKED SECURITIES 1136983 F 5864986 OTHER RECEIVABLE 501849 PREPAID EXPENSES 124689 626538 DEFERRED RENT 151156 DEFERRED PTO LIABILITY 116333 CREDIT CARD PAYABLE 530 268019 12983889 222562 6397 228959 12754930 -1023 -1023 12753907 11593722 6397 6397 11587325 -1021 -1021 11586304 PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON SALE OF EQUIPMENT -1,022. ROUNDING -1. PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON SALE OF EQUIPMENT -1,022. ROUNDING 1. 1 EUROPE 0 0 AWARENESS/EDUCATION THROUGH PRESENTATION OF BEYOND THE SHOCK SOFTWARE PROVIDED AN EDUCATIONAL RESOURCE TO HOSPITALS FOR PROGRAM PROVIDERS TO GIVE TO BREAST CANCER PATIENTS AND SUPPORTERS INTERNATIONALLY AND NATIONALLY. 17088 0 0 0 0 0 0 17088 0 17088 EUROPE MEMBERSHIP IN INTERNATIONAL MEDICAL CANCER SYMPOSIUM FOR 2013 FOR WORLDWIDE INNOVATIVE NETWORKING 17088 WIRE TRANSFER EUROPE (INCLUDING ICELAND & GREENLAND) 1 0 0 0 0 0 0 0 PART I, LINE 2: THE SUBSTANTIATION OF THE AMOUNT OF ASSISTANCE PROVIDED TO ORGANIZATIONS IS BASED ON NEEDS EXPRESSED BY ORGANIZATIONS, BALANCED WITH THE TYPICAL RANGE OF NBCF GRANTS MADE TO ANY ONE ORGANIZATION. THE $17,088 ASSISTANCE MADE TO THE MEDICAL SYMPOSIUM IS WITHIN THIS RANGE. THE ELIGIBILITY FOR ASSISTANCE IS DETERMINED BY A REVIEW OF THE ORGANIZATION'S PROGRAM OFFERINGS AND ITS ALIGNMENT WITH NBCF'S MISSION. THE NBCF MISSION IS: HELPING WOMEN NOW. PROVIDING HELP AND INSPIRING HOPE TO THOSE AFFECTED BY BREAST CANCER THROUGH EARLY DETECTION, EDUCATION AND SUPPORT SERVICES. NBCF'S GLOBAL VISION IS TO ELIMINATE BARRIERS IN THE FIGHT AGAINST BREAST CANCER, TO SHARE KNOWLEDGE WHILE GAINING UNDERSTANDING ABOUT BREAST CANCER, AND TO SPREAD NBCF'S MISSION WORLDWIDE TO SAVE LIVES THROUGH EARLY DETECTION. THE SYMPOSIUM PROGRAM AND RESEARCH PROJECTS WERE REVIEWED AND DETERMINED TO BE IN ALIGNMENT WITH OUR MISSION OF PROVIDING HELP THROUGH EARLY DETECTION, EDUCATION AND SUPPORT SERVICES, AND ALSO IN ALIGNMENT WITH OUR GLOBAL VISION. THE SELECTION CRITERIA WAS BASED ON NBCF'S ABILITY TO EXTEND AND EXPAND ITS REACH OF FULFILLING ITS MISSION OF BREAST CANCER EARLY DETECTION AND EDUCATION. THE SYMPOSIUM IN PARTICULAR WAS ALSO RECOMMENDED BY AN ESTABLISHED PROGRAM PARTNER OF NBCF, AND WAS THE VENUE FOR LAUNCHING OUR MULTI-LANGUAGE EDUCATION PROGRAM. PART I, LINE 3: COST WAS THE METHOD USED TO ACCOUNT FOR THE TOTAL FOREIGN EXPENDITURES. 1 ADVENTIST MEDICAL CENTER 10123 SE MARKET STREET PORTLAND OR 97216 930429015 501(C)(3) 55000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ALABAMA DEPARTMENT OF PUBLIC HEALTH RSA TOWER 201 MONROE STREET SUITE 1364 MONTGOMERY AL 36104 631106545 65000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ALASKA DIV OF PUBLIC HEALTH SECTION OF WOMEN'S CHILDREN'S AND FAMILY HEALTH 3601 C STREET SUITE 322 ANKORAGE AK 99503 926001185 20000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ALLEGHANY HIGHLANDS FREE CLINIC 103 OLD CHURCH ROAD LOW MOOR VA 24457 541904342 501(C)(3) 40000 NATIONAL MAMMOGRAPHY PROGRAM GRANT AMERICAN-ITALIAN CANCER FOUNDATION 112 EAST 71ST STREET SUITE 2B NEW YORK NY 10021 133035711 501(C)(3) 108000 NATIONAL MAMMOGRAPHY PROGRAM GRANT & PATIENT NAVIGATION GRANT BAPTIST HEALTH FOUNDATION 9601 INTERSTATE 630 EXIT 7 LITTLE ROCK AR 72205 237166407 501(C)(3) 15000 NATIONAL MAMMOGRAPHY PROGRAM GRANT BETHESDA FOUNDATIONTRIHEALTH 10500 MONTGOMERY RD CINCINNATI OH 45242 310537133 501(C)(3) 25000 NATIONAL MAMMOGRAPHY PROGRAM GRANT BISMARCK CANCER CENTER FOUNDATION 500 NORTH 8TH STREET BISMARCK ND 58501 260466647 501(C)(3) 20000 PATIENT NAVIGATION PROGRAM GRANT BOCA RATON REGIONAL HOSPITALCHRISTINE E LYNN WOMEN'S HEALTH 690 MEADOWS ROAD BOCA RATON FL 33486 591006663 501(C)(3) 34000 NATIONAL MAMMOGRAPHY PROGRAM GRANT BRATTLEBORO MEMORIAL HOSPITAL 17 BELMONT AVENUE BRATTLEBORO VT 05301 030107300 501(C)(3) 22560 PATIENT NAVIGATION PROGRAM GRANT CANDLER FOUNDATION INC 5353 REYNOLDS STREET SAVANNAH GA 31405 580593388 501(C)(3) 15000 NATIONAL MAMMOGRAPHY PROGRAM GRANT C-CHANGE 1634 EYE ST NW SUITE 800 WASHINGTON DC 20006 161641769 501(C)(3) 25000 BREAST CANCER RESEARCH PROGRAM GRANT CLEVELAND CLINIC FOUNDATION 9500 EUCLID AVENUE CLEVELAND OH 44195 340714585 501(C)(3) 90000 NATIONAL MAMMOGRAPHY PROGRAM GRANT CONVOY OF HOPE 330 S PATTERSON AVENUE SPRINGFIELD MO 65802 680051386 501(C)(3) 270100 BREAST HEALTH EDUCATION GRANT DANA-FARBER CANCER INSTITUTE 450 BROOKLINE AVENUE BOSTON MA 02215 042263040 501(C)(3) 30000 NATIONAL MAMMOGRAPHY PROGRAM GRANT FOX CHASE CANCER CENTER 333 COTTMAN AVE PHILADELPHIA PA 19111 232003072 501(C)(3) 38604 PATIENT NAVIGATION PROGRAM GRANT FRED HUTCHINSON CANCER RESEARCH CENTER 1100 FAIRVIEW AVENUE N SEATTLE WA 98109 237156071 501(C)(3) 100000 NATIONAL MAMMOGRAPHY PROGRAM GRANT & PATIENT NAVIGATION GRANT GOOD NEWS CLINIC 810 PINE STREET GAINESVILLE GA 30501 582058853 501(C)(3) 15000 NATIONAL MAMMOGRAPHY PROGRAM GRANT HUMBOLDT COMMUNITY BREAST HEALTH PROJECT 987 8TH STREET ARCATA CA 95521 651205183 501(C)(3) 20950 PATIENT NAVIGATION PROGRAM GRANT JOHNS HOPKINS CANCER CENTER 600 N WOLFE STREET BALTIMORE MD 21287 520595110 501(C)(3) 100000 PATIENT NAVIGATION PROGRAM GRANT KINGMAN REGIONAL MEDICAL CENTER FOUNDATION 3269 STOCKTON HILL ROAD KINGMAN AZ 864093619 742388735 501(C)(3) 72908 PATIENT NAVIGATION PROGRAM GRANT LOS ANGELES CHRISTIAN HEALTH CENTERS 311 WINSTON STREET LOS ANGELES CA 90013 954315734 501(C)(3) 50000 PATIENT NAVIGATION PROGRAM GRANT LSUHSC FOUNDATIONLOUISIANA BREAST AND CERVICAL HEALTH PROGRAM 450 A SOUTH CLAIBORNE AVENUE NEW ORLEANS LA 70112 742388735 501(C)(3) 40000 NATIONAL MAMMOGRAPHY PROGRAM GRANT MAD RIVER COMMUNITY HOSPITAL 3800 JANES ROAD ARCATA CA 95521 941698406 501(C)(3) 50000 NATIONAL MAMMOGRAPHY PROGRAM GRANT MAGEE WOMEN'S HOSPITAL 300 HALKET STREET PITTSBURGH PA 15213 250965420 501(C)(3) 73772 PATIENT NAVIGATION PROGRAM GRANT MAINE MEDICAL CENTER 100 CAMPUS DRIVE UNIT 110 SCARBOROUGH ME 04074 010238552 501(C)(3) 49000 PATIENT NAVIGATION PROGRAM GRANT MARTIN MEMORIAL HEALTH SYSTEMS FOUNDATION 2135 S E OCEAN BLVD STUART FL 349969010 522304522 501(C)(3) 15000 NATIONAL MAMMOGRAPHY PROGRAM GRANT MAYO CLINIC 200 1ST STREET SW ROCHESTER MN 55902 416011702 501(C)(3) 23196 NATIONAL MAMMOGRAPHY PROGRAM GRANT MCKEE MEDICAL CENTER 2000 BOISE AVE LOVELAND CO 80538 742182919 501(C)(3) 14083 PATIENT NAVIGATION PROGRAM GRANT MISSISSIPPI STATE DEPARTMENT OF HEALTH 570 E WOODROW WILSON JACKSON MS 392151700 646000775 170(C)(1) 50000 NATIONAL MAMMOGRAPHY PROGRAM GRANT MONTANA DEPARTMETN OF PUBLIC HEALTH AND HUMAN SERVICES 1400 BROADWAY RM C317 HELENA MT 596202951 810302402 501(C)(3) 30000 NATIONAL MAMMOGRAPHY PROGRAM GRANT NEVADA HEALTH CENTERS INC 1802 N CARSON STREET SUITE 100 CARSON CITY NV 89701 943199117 501(C)(3) 45000 NATIONAL MAMMOGRAPHY PROGRAM GRANT OKLAHOMA UNIVERSITY FOUNDATIONOU BREAST INSTITUTE 1000 STANTON L YOUNG BLVD BIRD LIBRARY SUITE 162 OKLAHOMA CITY OK 73117 731477155 170(C)(1) & 115(A) 80000 NATIONAL MAMMOGRAPHY PROGRAM GRANT PARKLAND FOUNDATION 2777 N STEMMONS FWY SUITE 1700 DALLAS TX 75207 752089180 501(C)(3) 100000 NATIONAL MAMMOGRAPHY PROGRAM GRANT & PATIENT NAVIGATION GRANT POH RILEY FOUNDATION - REGIONAL MEDICAL CENTER - MCLAREN OAKLAND 50 NORTH PERRY STREET PONTIAC MI 48342 381428164 501(C)(3) 20000 NATIONAL MAMMOGRAPHY PROGRAM GRANT PRESBYTERIAN HEALTH FOUNDATION 200 HAWTHORNE LANE CHARLOTTE NC 28204 581413074 501(C)(3) 44890 NATIONAL MAMMOGRAPHY PROGRAM GRANT QUEEN'S MEDICAL CENTERWOMEN'S HEALTH CENTER 1301 PUNCHBOWL STREET HONOLULU HI 96813 990073524 501(C)(3) 73240 PATIENT NAVIGATION PROGRAM GRANT SHARP HEALTHCARE FOUNDATION 8695 SPECTRUM CENTER BOULEVARD SAN DIEGO CA 92123 952367304 501(C)(3) 47500 PATIENT NAVIGATION PROGRAM GRANT SIBLEY MEMORIAL HOSPITAL FOUNDATION 5255 LOUGHBORO ROAD NW WASHINGTON DC 20016 450562642 501(C)(3) 50000 PATIENT NAVIGATION PROGRAM GRANT SOUTH DAKOTA DEPARMENT OF HEALTH 615 EAST 4TH STREET PIERRE SD 57501 466000364 501(C)(3) 37500 NATIONAL MAMMOGRAPHY PROGRAM GRANT SPECTRUM HEALTH FOUNDATION 145 MICHIGAN NE MC 202 GRAND RAPIDS MI 49503 382752328 501(C)(3) 60000 NATIONAL MAMMOGRAPHY PROGRAM GRANT & PATIENT NAVIGATION GRANT ST ALEXIUS MEDICAL CENTER 1555 BARRINGTON ROAD DOB 3 HOFFMAN ESTATES IL 60169 364251846 501(C)(3) 65000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ST ALPHONSUS MEDICAL CENTER 6200 WEST EMERALD BOISE ID 83706 820200895 501(C)(3) 11000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ST ANTHONY'S MEDICAL CENTER 10010 KENNERLY ROAD ST LOUIS MO 63128 430980256 501(C)(3) 36000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ST FRANCIS FOUNDATION INC ONE ST FRANCIS DRIVE GREENVILLE SC 29601 582504528 501(C)(3) 34000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ST JOSEPH'S HEALTH SERVICES 200 HIGH SERVICE AVENUE NORTH PROVIDENCE RI 02904 050259026 501(C)(3) 47384 PATIENT NAVIGATION PROGRAM GRANT ST LUKE'S ESPICOPAL PRESBYTERIAN HOSPITAL 232 SOUTH WOODS MILL ROAD CHESTERFIELD MO 63017 430652680 501(C)(3) 20000 NATIONAL MAMMOGRAPHY PROGRAM GRANT ST ROSE DOMINICAN HEALTH FOUNDATION 102 E EAST LAKE MEAD PARKWAY HENDERSON NV 89015 880349432 501(C)(3) 35800 NATIONAL MAMMOGRAPHY PROGRAM GRANT ST VINCENT HOSPITAL FOUNDATION 8402 HARCOURT ROAD STE 210 INDIANAPOLIS IN 46260 356088862 501(C)(3) 90000 NATIONAL MAMMOGRAPHY PROGRAM GRANT SWEDISH COVENANT HOSPITAL FOUNDATION 5145 CALIFORNIA AVENUE CHICAGO IL 60625 262179813 501(C)(3) 95000 NATIONAL MAMMOGRAPHY PROGRAM GRANT THOMAS JEFFERSON UNIVERSITY HOSPITAL 1015 CHESTNUT STREET SUITE 617 PHILADELPHIA PA 19107 232829095 501(C)(3) 50000 NATIONAL MAMMOGRAPHY PROGRAM GRANT UNITED HOSPITAL CENTER 327 MEDICAL PARK DRIVE BRIDGEPORT WV 26330 550525724 501(C)(3) 67000 PATIENT NAVIGATION PROGRAM GRANT UNIVERSITY HEALTH SYSTEM INC (UNIV OF TENN) 1934 ALCOA HWY SUITE 473 KNOXVILLE TN 37920 311626179 501(C)(3) 70000 NATIONAL MAMMOGRAPHY PROGRAM GRANT UNIVERSITY HOSPITAL FOUNDATION 50 NORTH MEDICAL DRIVE SALT LAKE CITY UT 84112 870474422 501(C)(3) 25000 NATIONAL MAMMOGRAPHY PROGRAM GRANT UNIVERSITY OF KANSAS CANCER CENTER 2330 SHAWNEE MISSION PRKWY 1102 WESTWOOD KS 66205 480547734 501(C)(3) 25000 PATIENT NAVIGATION PROGRAM GRANT UNIVERSITY OF LOUISIVILLE FOUNDATION INC 529 SOUTH JACKSON STREET LOUISVILLE KY 40202 237078461 501(C)(3) 45000 NATIONAL MAMMOGRAPHY PROGRAM GRANT UNIVERSITY OF TEXAS M D ANDERSON CANCER CENTER THE DEVELOPMENT OFFICE UNIT 705 BOX 301439 HOUSTON TX 772301439 746000203 170(A) 580000 NATIONAL MAMMOGRAPHY PROGRAM GRANT, BREAST CANCER RESEARCH PROGRAM GRANT, & PATIENT NAVIGATION PROGRAM GRANT UNIVERSITY OF NEW MEXICO HOSPITALS 700 LOMAS BLVD NE TWO WOODWARD CENTER SUITE 108 ALBUQUERQUE NM 87102 850275408 501(C)(3) 65000 NATIONAL MAMMOGRAPHY PROGRAM GRANT VANDERBILT UNIVERSITY MEDICAL CENTER 719 THOMPSON LANE SUITE 25008 NASHVILLE TN 37204 620476822 501(C)(3) 15000 NATIONAL MAMMOGRAPHY PROGRAM GRANT WHITE MEMORIAL MEDICAL CENTER 1720 CESAR E CHAVEZ AVE LOS ANGELES CA 90033 953760201 501(C)(3) 105100 NATIONAL MAMMOGRAPHY PROGRAM GRANT WINTHROP P ROCKEFELLER CANCER INSTITUTE 4301 W MARKHAM STREET MS 623F LITTLE ROCK AR 72205 716056774 501(C)(3) 45000 NATIONAL MAMMOGRAPHY PROGRAM GRANT WYOMING DEPARTMENT OF HEALTH 6101 YELLOWSTONE ROAD SUITE 259A CHEYENNE WY 82002 830208667 501(C)(3) 40000 NATIONAL MAMMOGRAPHY PROGRAM GRANT 62 0 PART I, LINE 2: THE NATIONAL MAMMOGRAPHY PROGRAM (NMP) NETWORK PARTNER-MEDICAL FACILITY PROVIDER GRANT APPLICATION REQUIRES THE GRANTEE ORGANIZATIONS TO DOCUMENT THEIR QUALIFICATION FOR A NMP GRANT. AMONG OTHER CRITERIA, THE FACILITIES MUST BE CAPABLE TO DELIVER MAMMOGRAMS, HAVE THE CAPACITY TO RUN A NBCF MAMMOGRAPHY PROGRAM, AND HAVE A POTENTIAL POOL OF RECIPIENTS CONSISTENT WITH THE NBCF TARGET DEMOGRAPHIC OF UNDERSERVED WOMEN UNDER MEDICARE AGE. OUR FUNDING IS RESTRICTED EXCLUSIVELY FOR SCREENING AND DIAGNOSTIC MAMMOGRAMS AND ULTRASOUNDS, CLINICAL BREAST EXAMS, CAD READINGS, AND LIMITED BIOPSIES. GRANTEE ORGANIZATIONS ARE ENCOURAGED TO DEVELOP A PROCESS FOR A FULL CONTINUUM OF BREAST CARE NEEDED, INCLUDING BIOPSIES (THAT ARE NOT COVERED BY NBCF), MRI'S AND SURGICAL AND CANCER TREATMENT AS NEEDED. THE APPLICATION FORM IS DESIGNED TO IDENTIFY THOSE MEDICAL FACILITIES WHICH PROVIDE THE SERVICES NEEDED TO THE POPULATION TARGETED BY THE NBCF MISSION, AND ALSO, COMPLY WITH THE ESTABLISHED FACILITY CRITERIA. NATIONAL MAMMOGRAPHY PROGRAM: THE NATIONAL MAMMOGRAPHY PROGRAM - RESULTS SUBMISSION FORM IS A REQUIREMENT OF GRANT RECIPIENTS FOR SEMI-ANNUAL MONITORING OF GRANTS AWARDED. GRANTEE ORGANIZATIONS ARE REQUIRED TO REPORT THE AMOUNT OF GRANT FUNDS USED TO-DATE, AND THE NUMBER OF PATIENTS SERVED. IF THE MEDICAL PROVIDER IS SUCCESSFUL IN FULFILLING THE NBCF MISSION WHILE COMPLYING WITH THE ESTABLISHED FACILITY CRITERIA, AND NEEDS ADDITIONAL FUNDS FOR THEIR PROGRAM, NBCF WILL ENCOURAGE THEM TO APPLY FOR ADDITIONAL GRANTS. IN THE RARE EVENT THAT A MEDICAL PROVIDER FINDS THEY ARE UNABLE TO USE THE GRANT PER THE GRANT RESTRICTIONS, NBCF HAS THE GRANT REFUNDED TO NBCF AND RE-DISTRIBUTES THE FUNDS TO ANOTHER MEDICAL PROVIDER THROUGH THE APPLICATION PROCESS. GRANTEE ORGANIZATIONS RECEIVING NMP PATIENT NAVIGATION PROGRAM GRANTS MUST REPORT THE FOLLOWING TO NBCF: PROGRAM COORDINATOR ACTIVITIES, PROCESSES, TYPES OF SERVICES PROVIDED, NUMBER OF WOMEN SERVICED THROUGH NAVIGATION, TIMELINESS OF CARE, AND THE AMOUNT OF GRANT FUNDS USED TO-DATE. NBCF STAYS IN CLOSE CONTACT WITH FACILITIES RECEIVING BREAST CANCER RESEARCH GRANTS TO CONFIRM THE GRANTS ARE FURTHERING RESEARCH PROJECTS WHICH ARE FOCUSED ON EARLY DETECTION, TREATMENT OR CURE OF BREAST CANCER. X X X 0 0 0 0 0 0 0 0 0 JANELLE HAIL CEO/PRES,CHAIRMAN OF BOD 186461 0 0 0 0 0 0 0 23588 0 210049 0 0 0 KEVIN HAIL COO 160347 0 0 0 0 0 0 0 26618 0 186965 0 0 0 JOHN REECE CFO & CSO 147520 0 0 0 0 0 0 0 25291 0 172811 0 0 0 JANELLE HAIL CEOCHAIRMAN OF BOARD BOARD OF DIRECTOR FOR WORLDWIDE INNOVATIVE NETWORKING MEMBERSHIP IN INTERNATIONAL MEDICAL CANCER SYMPOSIUM FOR 2013 OF $17,088. 0 GABRIELA BARBARENA DIRECTOR FOR NA DIRECTOR FOR WHITE MEMORIAL MEDICAL CENTER NATIONAL MAMMOGRAPHY PROGRAM GRANT OF $105,100 TO WHITE MEMORIAL MEDICAL CENTER 0 STEVE ENGLEDIRECTOR FOR NATIONAL B OFFICER FOR MAD RIVER COMMUNITY HOSPITAL NATIONAL MAMMOGRAPHY PROGRAM GRANT OF $50,000 TO MAD RIVER COMMUNITY HOSPITAL 0 X 1 1999 MARKET VALUE PER CLOSE X EDUCATIONAL M 68 1394488 FAIR MARKET VALUE X MEDICAL EQUIP 1 221000 FAIR MARKET VALUE X OFFICE DECOR 4 154300 FAIR MARKET VALUE X FUNDRAISER IT 2120 43225 FAIR MARKET VALUE X OFFICE EQUIPM 3 10298 FAIR MARKET VALUE X SOFTWARE 1 3995 FAIR MARKET VALUE 0 1 0 FORM 990, PART VI, SECTION A, LINE 2 THE CEO AND SENIOR CONSULTANT ARE RELATED THROUGH MARRIAGE AND EMPLOYED BY THE ORGANIZATION. ADDITIONALLY, TWO OF THEIR SONS ARE EMPLOYED BY THE ORGANIZATION, ONE AS COO AND THE OTHER AS SENIOR VICE PRESIDENT, DEVELOPMENT. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE TAX RETURN IS PROVIDED TO THE ORGANIZATION BY THE CPA FIRM. THE TAX RETURN IS REVIEWED BY THE CEO, COO, AND THE CFO IN DETAIL AFTER THE DIRECTOR OF COMPLIANCE IS SATISFIED WITH IT. ONCE THE CEO, COO, AND CFO HAVE APPROVED IT, THE RETURN IS FORWARDED TO ALL OF THE BOARD MEMBERS ELECTRONICALLY. COMMENTS ARE SUBMITTED. IF ANY CHANGES ARE MADE, THE REVIEW PROCESS IS REPEATED UNTIL THERE ARE NO CHANGES. FORM 990, PART VI, SECTION B, LINE 12C NBCF ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY HAVING EACH MEMBER OF THE BOARD READ THE DOCUMENT ANNUALLY AND RESPOND IN WRITING AS TO WHETHER OR NOT THERE ARE CONFLICTS. EACH BOARD MEMBER SIGNS THE DOCUMENT STATING THAT THEY HAVE READ AND UNDERSTAND THE CONFLICT OF INTEREST POLICY AND AGREE TO BE BOUND BY THEM. IN ADDITION, THE IMPORTANCE OF THE CONFLICT OF INTEREST POLICY IS OPENLY DISCUSSED IN THE BOARD MEETINGS AND BOARD MEMBERS ARE ASKED IF THEY HAVE ANY ACTIVITIES FOR WHICH THEY NEED TO CONFIRM WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST IS FOUND TO EXIST, APPROPRIATE ACTION IS TAKEN SUCH AS THE CONFLICTED BOARD MEMBER NOT PARTICIPATING IN DISCUSSIONS OR VOTING ON RELATED ISSUES. DEPENDENT ON THE NATURE OF THE CONFLICT, THE NON-CONFLICTED BOARD MEMBERS MAY PROPOSE AND VOTE ON A MOTION CONCERNING THE RESOLUTION OF CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS APPROVES THE COMPENSATION FOR THE OFFICERS OF THE ORGANIZATION AFTER COMPARING THE SALARIES WITH OTHER ORGANIZATIONS, AS WELL AS COMPARISON WITH COMPENSATION SURVEYS AND STUDIES. THE ACTION OF THE BOARD OF DIRECTORS IS THEN DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 NBCF MAKES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENT, FORM 990, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THEY OFFER TO FAX, U.S. FIRST CLASS MAIL OR EMAIL THE DOCUMENTS TO INTERESTED PARTIES. NBCF'S ANNUAL REPORT, FORM 990, AND FINANCIAL STATEMENTS WITH INDEPENDENT AUDITOR'S REPORT ARE ALSO AVAILABLE ON THE NBCF'S WEBSITE, WWW.NBCF.ORG. NBCF'S FORM 990 IS AVAILABLE ON THE WEBSITE WWW.GUIDESTAR.ORG. FINANCIAL AND OTHER INFORMATION ABOUT NBCF IS AVAILABLE ON THE WEBSITE WWW.CHARITYNAVIGATOR.ORG. FORM 990, PART IX, LINE 11G CONSULTANTS & CONTRACT SERVICES : PROGRAM SERVICE EXPENSES 1,306,805. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,306,805. CONSULTANTS & CONTRACT SERVICES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,455. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,455. PAYROLL EXPENSE : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 3,419. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,419. CONSULTANTS & CONTRACT SERVICES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 111,719. TOTAL EXPENSES 111,719. FORM 990, PART XI, LINE 9: ROUNDING 2.