2013-11-14T15:12:48-06:00 2012-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2012-01-01 362181944 AMERICAN SOCIETY OF ANESTHESIOLOGISTS AMER 8478255586 520 NORTH NORTHWEST HIGHWAY PARK RIDGE IL 600682573 PAUL POMERANTZ 8478255586 2013-10-23 1 LU ANN TRAPP P01506476 3122071040 2013-10-23 2012 2016-02-24 21:20:13Z PAUL POMERANTZ 520 NORTH NORTHWEST HIGHWAY PARK RIDGE IL 600682573 63590957 0 X WWW.ASAHQ.ORG X 1936 NY ADVANCING THE PRACTICE AND SECURING THE FUTURE OF ANESTHESIOLOGY (SEE SCHEDULE O CONTINUATION)THROUGH MEDICAL EDUCATION, CREATION AND DISSEMINATION OF NEW KNOWLEDGE, IMPROVEMENT OF PATIENT CARE, AND LEGISLATIVE AND REGULATORY ADVOCACY. 65 61 150 827 1195569 0 46292 59025 32989905 35859173 3521145 1876992 3845014 3762061 40402356 41557251 4566276 4398864 0 0 12366304 13019516 0 0 0 18853244 20487159 35785824 37905539 4616532 3651712 73777110 85088653 12982679 14437349 60794431 70651304 X ADVANCING THE PRACTICE AND SECURING THE FUTURE OF ANESTHESIOLOGY THROUGH MEDICAL EDUCATION, CREATION AND DISSEMINATION OF NEW KNOWLEDGE, IMPROVEMENT OF PATIENT CARE, AND LEGISLATIVE AND REGULATORY ADVOCACY. 0 0 MEMBERSHIP - MEMBERS OF ASA INCLUDE MD/DOS WHO ARE LICENSED PHYSICIANS AND HAVE COMPLETED A TRAINING PROGRAM IN ANESTHESIOLOGY, AS WELL AS MEDICAL STUDENTS INTERESTED IN ANESTHESIOLOGY, RESIDENTS ENROLLED IN AN ANESTHESIOLOGY TRAINING PROGRAM. ANESTHESIOLOGISTS PRACTICING OUTSIDE THE US AND SCIENTISTS INVOLVED IN ANESTHESIA RESEARCH MAY BECOME AFFILIATE MEMBERS. EDUCATIONAL MEMBERS INCLUDE NURSE ANESTHETISTS AND ANESTHESIOLOGIST ASSISTANTS. THE SOCIETY HAS 50,000 MEMBERS. PUBLICATIONS - ASA PRODUCES STATEMENTS, GUIDELINES AND STANDARDS WHICH FOCUS ON WAYS OF IMPROVING THE PRACTICE OF ANESTHESIOLOGY. ADDITIONAL PUBLICATIONS PROVIDE INFORMATION ON THE VARIOUS ASPECTS OF ANESTHETIC CARE FOR BOTH MEDICAL PERSONNEL AND THE LAY PUBLIC. A DISTINGUISHED SCIENTIFIC JOURNAL, 'ANESTHESIOLOGY', IS PUBLISHED MONTHLY, AS IS THE OFFICIAL NEWSLETTER WHICH PROVIDES GENERAL INFORMATION AND NEWS ON CURRENT ISSUES AFFECTING ANESTHESIOLOGY. CONTINUING EDUCATION - ASA SPONSORS CONTINUING MEDICAL EDUCATION DESIGNED TO PROVIDE PHYSICIAN ANESTHESIOLOGISTS WITH CURRENT KNOWLEDGE AND SKILLS ON NEWEST CLINICAL DEVELOPMENTS, TECHNOLOGY ADVANCEMENTS AND RESEARCH.ASA IN-PERSON EDUCATION PROGRAMS INCLUDE AN ANNUAL MEETING, THE WORLD'S LARGEST EDUCATION PROGRAM FOR PHYSICIAN ANESTHESIOLOGISTS, OFFERING A VARIETY OF SESSIONS AND WORKSHOPS THAT COVER THE CURRENT TOPICS AND EMERGING SCIENCE. OTHER ANNUAL PROGRAMS INCLUDE CONFERENCE ON PRACTICE MANAGEMENT, LEGISLATIVE CONFERENCE AND THE CERTIFICATE IN BUSINESS ADMINISTRATION.SELF STUDY COURSES INCLUDE TWO BASED ON A QUESTION AND ANSWER FORMAT: ANESTHESIOLOGY CONTINUING EDUCATION (ACE) AND THE SELF EDUCATION AND EVALUATION (SEE) THAT ARE USED TO ASSESS PROFESSIONAL KNOWLEDGE AND PREPARE FOR MAINTENANCE OF CERTIFICATION AND LICENSURE. OTHER SELF -STUDY COURSES INCLUDE A JOURNAL CME PROGRAM USING ARTICLES FROM "ANESTHESIOLOGY, REFRESHER COURSES IN ANESTHESIOLOGY" AN EXPANSION OF ANNUAL MEETING COURSES, PATIENT SAFETY, ETHICS AND A VARIETY OF E-LEARNING PROGRAMS ON CLINICAL TOPICS. OFFICE OF GOVERNMENTAL AFFAIRS - ASA'S OFFICE OF GOVERNMENTAL AFFAIRS (OGA), LOCATED IN WASHINGTON, D.C., MONITORS LEGISLATIVE AND REGULATORY ACTIVITIES AT THE STATE AND FEDERAL LEVEL; PARTICULARLY THOSE ISSUES THAT AFFECT THE PRACTICE OF ANESTHESIOLOGY AND THE DELIVERY OF QUALITY MEDICAL CARE IN THE UNITED STATES. 0 1 1 1 0 0 0 1 0 1 0 0 0 1 1 0 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 342 0 1 150 1 1 1 0 0 0 1 1 0 X 65 61 0 0 1 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X DAWN WINKELMANN 8472689150 520 NORTH NORTHWEST HIGHWAY PARK RIDGE IL 60068 JOHN M ZERWAS MD 37.50 0.00 X X 156250 0 0 JERRY A COHEN MD 29.00 0.00 X X 188000 0 0 MARK A WARNER MD 4.00 0.20 X X 6750 564 0 JANE CK FITCH MD 28.00 0.00 X X 81250 0 0 JOHN P ABENSTEIN MD 11.00 0.00 X X 15571 0 0 ARNOLD J BERRY MD 3.00 0.00 X X 5828 0 0 NORMAN A COHEN MD 5.00 0.00 X X 9061 0 0 LINDA J MASON MD 3.00 0.00 X X 5571 0 0 ARTHUR M BOUDREAUX MD 2.00 0.00 X X 3948 0 0 JAMES D GRANT MD 3.00 0.00 X X 5928 0 0 JEFFREY PLAGENHOEF MD 1.00 0.00 X X 2000 0 0 MARY DALE PETERSON MD 2.00 0.00 X X 3000 0 0 MICHAEL C GOSNEY MD 0.00 0.00 X 0 0 0 VERNON C HILL MD 0.00 0.00 X 0 0 0 DANIEL J COLE MD 2.00 0.00 X 3184 250 0 MICHAEL J VOLLERS MD 1.00 0.00 X 1500 0 0 MARK A SINGLETON MD 1.00 0.00 X 2166 0 0 RANDALL M CLARK MD 3.00 0.00 X 4761 0 0 JEFFREY B GROSS MD 2.00 0.00 X 3000 0 0 CHRIS A KITTLE MD 1.00 0.00 X 1500 0 0 JOHN F DOMBROWSKI MD 1.00 0.00 X 1521 0 0 DAVID VARLOTTA DO 0.30 0.00 X 750 0 0 PEGGY G DUKE MD 1.00 0.00 X 1500 0 0 WILLIAM H MONTGOMERY MD 1.00 0.00 X 1394 0 0 STEPHEN B PACKER MD 0.00 0.00 X 0 0 0 KENNETH J TUMAN MD 1.00 0.00 X 1500 0 0 GERARD T COSTELLO MD 1.00 0.00 X 1500 0 0 JOSEPH F CASSADY MD 1.00 0.00 X 1889 0 0 JAMES D KINDSCHER MD 1.00 0.00 X 1500 0 0 ANJUM BUX MD 0.00 0.00 X 0 0 0 DAVID M BROUSSARD MD 1.00 0.00 X 1955 0 0 GARY E PALMAN DO 1.00 0.00 X 1500 0 0 MURRAY A KALISH MD 2.00 0.00 X 2705 0 0 BEVERLY K PHILIP MD 4.00 0.00 X 7073 0 0 KENNETH ELMASSIAN DO 0.50 0.00 X 1000 0 0 RICHARD C PRIELIPP MD 3.00 2.00 X 5000 2807 0 CLAUDE D BRUNSON MD 1.00 0.00 X 1750 0 0 DONALD E ARNOLD MD 2.00 0.00 X 2750 0 0 BRIAN E HARRINGTON MD 1.00 0.00 X 1500 0 0 SHEILA J ELLIS MD 1.00 0.00 X 1500 0 0 BRETT E WINTHROP MD 1.00 0.00 X 1500 0 0 STEVEN J HATTAMER MD 3.00 0.00 X 4684 0 0 ARYEH SHANDER MD 1.00 0.00 X 2250 0 0 JOHN H WILLS MD 1.00 0.00 X 1500 0 0 SCOTT B GROUDINE MD 1.00 0.00 X 2500 0 0 GERALD A MACCIOLI MD 1.00 0.00 X 2000 0 0 VIJAY K GABA MD 0.30 0.00 X 750 0 0 ALAN P MARCO MD 0.00 0.00 X 0 0 0 JAY D CUNNINGHAM DO 1.00 0.00 X 1500 0 0 CHARLES K ANDERSON MD 1.00 0.00 X 2668 0 0 DONALD E MARTIN MD 2.00 0.00 X 2750 0 0 LUIS E CUMMINGS JR MD 0.00 0.00 X 0 0 0 FREDERICK W BURGESS MD 0.00 0.00 X 0 0 0 CHRISTOPHER A YEAKEL MD 1.00 0.00 X 1500 0 0 ROBERT G ALLEN JR MD 1.00 0.00 X 1250 0 0 JAMES M WEST MD 1.00 0.00 X 2000 0 0 SCOTT E KERCHEVILLE MD 38.00 0.00 X 62557 0 0 MICHAEL CAHALAN MD 1.00 0.00 X 1500 0 0 JOEL H MUMFORD MD 1.00 0.00 X 1500 0 0 GRANVILLE B WORK MD 1.00 0.00 X 1500 0 0 PETER J DUNBAR MD 2.00 0.00 X 2894 0 0 ROBERT E JOHNSTONE MD 0.00 0.00 X 0 0 0 JAMES R MESROBIAN MD 1.00 0.00 X 1763 0 0 CATHERINE C SCHMIDT MD 0.00 0.00 X 0 0 0 STEVEN J BARKER PHD MD 1.00 0.00 X 2000 0 0 NICOLE A WEISS MD 2.00 0.00 X 3750 0 0 CORRY J KUCIK MD 1.00 0.00 X 1500 796 0 PHILLIP G SCHMID MD 0.30 0.00 X 750 0 0 RAYMOND J SULLIVAN MD 1.00 0.00 X 1500 0 0 BRIAN P MCGLINCH MD 1.00 0.00 X 1750 0 0 RONALD L HARTER MD 1.00 0.00 X 1500 0 0 DEBORAH CAHILL MD 0.00 0.00 X 0 0 0 PAUL A SKAFF MD 0.30 0.00 X 750 0 0 ROBERT E KETTLER MD 3.00 0.00 X 5310 0 0 TODD M WITZELING MD 0.00 0.00 X 0 0 0 LESLIE SIMS MD 2.00 0.00 X 3205 0 0 JOHN A THORNER JD CAE 37.50 0.00 X 507379 0 34965 RONALD SZABAT JD LLM 37.50 0.00 X 398010 0 29817 THOMAS CONWAY MBA CPA 37.50 0.00 X 281602 0 55285 KAREN BUEHRING 37.50 0.00 X 250028 0 51736 BARBARA DIANE GAMBILL 37.50 0.00 X 228129 0 22391 MANUEL BONILLA 37.50 0.00 X 197912 0 49933 MARY KUFFNER 37.50 0.00 X 190130 0 59967 SARA MOSER 37.50 0.00 X 177270 0 41272 2888596 4417 345366 17 0 1 0 FTI CONSULTING (SC) INC PO BOX 418005 BOSTON MA 022418005 MEDIA AND MARKETING CONSULTING SERVICES 818904 LAKE COUNTY PRESS PO BOX 9209 WAUKEGAN IL 60079 PRINTING SERVICES 602297 BRIDGEPOINT TECHNOLOGIES LLC 1111 WEST 22ND STREET SUITE 245 OAK BROOK IL 60523 IT SERVICES AND CONSULTING 450630 UNIVERSITY OF WASHINGTON 12455 COLLECTIONS DRIVE CHICAGO IL 60693 DATA STUDIES ON CLOSED CLAIMS 383548 MUTUAL TARGET ASSOCIATES INC 7002 HAMILTON DRIVE GURNEE IL 60031 E-COMMERCE 321420 18 59025 59025 MEMBERSHIP DUES 541900 19223340 19223340 ANNUAL MEETING 541900 7439706 6991136 448570 ANESTHESIA CONTINUING EDUCATION 541900 2568269 2568269 SELF-EDUCATION AND EVALUATION PRO 541900 1646495 1646495 OTHER PROGRAM INCOME 541900 1556993 1510462 46531 3424370 2723902 700468 35859173 2408525 2408525 3762061 3762061 21502173 22033706 -531533 -531533 -531533 41557251 34663604 1195569 5639053 4386864 12000 1965193 7802103 737339 1808552 706329 247794 44960 545502 117951 2117413 661099 1656633 532457 937634 650161 5399096 60258 1355679 74182 OTHER OUTSIDE SERVICES 2250418 SUBSCRIPTIONS 981464 CREDIT CARD FEES 559989 RESEARCH SERVICE PAYMEN 396029 1898440 37905539 1525098 2282878 553240 295703 1707271 1488529 551817 640671 17692010 5579175 9731846 12112835 59600478 68017980 107360 250057 73777110 85088653 3878298 4296550 5000 4919366 5954279 4000000 4000000 185015 181520 12982679 14437349 X 60794431 70651304 60794431 70651304 73777110 85088653 X 3651712 5941989 263172 X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 AMERICAN SOCIETY OF ANESTHESIOLOGISTS POLITICAL ACTION COMMITTEE 1501 M STREET NW SUITE 300 WASHINGTON DC 20005 363887214 0 177503 0 0 1 19223340 872160 -1189403 -317243 1153400 -1470643 ORGANIZATIONS DIRECT AND INDIRECT POLITICAL CAMPAIGN ACTIVITIES: PART I-A, LINE 1: THE ORGANIZATION COLLECTS CONTRIBUTIONS ON BEHALF OF A RELATED POLITICAL ACTION COMMITTEE AND PROMPTLY AND DIRECTLY DELIVERS THE CONTRIBUTIONS TO THE POLITICAL ACTION COMMITTEE. 1 550000 1200000 900000 850000 0 7225871 7225871 5412646 2845415 2567231 107479 102824 4655 4379515 2401257 1978258 566499 229679 336820 12112835 DEFERRED RENT 180221 DUE TO RELATED PARTY 1299 181520 X 47321032 5941989 5941989 41379043 117950 60258 178208 41557251 37464159 36828 36828 37427331 117950 360258 478208 37905539 PART IV, LINE 1B: PART IV, LINE 1B: ASA AND ANESTHESIA QUALITY INSTITUTE (AQI), A RELATED ORGANIZATION HAVE NEGOTIATED AN ARRANGEMENT UNDER WHICH THE FUNDS OF AQI WILL BE INVESTED WITH THE FUNDS OF ASA AND UNDER WHICH ASA MAY PROVIDE ASSISTANCE TO AQI UPON REQUEST. ASA AND AQI AGREE TO HAVE FUNDS FROM THEIR RESPECTIVE FUNDS INVESTED BY, AND TO CONFER INVESTMENT RESPONSIBILITY FOR THEIR FUNDS ON, THE INVESTMENT MANAGER(S) SELECTED BY ASA WITH ASA AS AGENT FOR THE INVESTMENT MANAGER. ASA AND AQI AGREE THAT THE INVESTMENT MANAGER(S) SHALL ASSUME THE MANAGEMENT OF, AND INVESTMENT RESPONSIBILITY FOR, THE FUNDS OF ASA AND AQI THAT ARE HELD AND INVESTED, AND PROVIDING THE INFORMATION THAT WILL BE THE BASIS FOR DISCLOSURE MATERIALS. THE INVESTMENT MANAGER'S PERFORMANCE SHALL BE OVERSEEN BY ASA, WHICH SHALL FROM TIME TO TIME DESIGNATE, AND MAY AT ANY TIME TERMINATE THE DESIGNATION OF, INVESTMENT MANAGERS OF THE COMMONLY INVESTED FUNDS. FROM TIME TO TIME, ASA SHALL REVIEW INVESTMENT PERFORMANCE, OBJECTIVES, GOALS AND FUND MANAGEMENT. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SOCIETY AND RECOGNIZE A TAX LIABILITY IF THE SOCIETY HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SOCIETY AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2012 AND 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE SOCIETY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2009. PART XI, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSE NETTED AGAINST REVENUE 60,258. PART XII, LINE 2D - OTHER ADJUSTMENTS: BENEFIT PLAN CHANGES OTHER THAN NET PERIODIC POSTRETIREMENT BENEFIT COSTS 36,828. PART XII, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSE NETTED AGAINST REVENUE 60,258. RETURNED GRANT FUNDS 300,000. EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS MIDDLE EAST AND NORTH AFRICA 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS SOUTH AMERICA 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS EAST ASIA AND THE PACIFIC 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS NORTH AMERICA 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS SOUTH ASIA 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS CENTRAL AMERICA AND THE CARIBBEAN 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS RUSSIA & THE NEWLY INDEPENDENT STATES 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS CENTRAL AMERICA AND THE CARIBBEAN 0 0 REGISTRATION INCOME ANNUAL MEETING SOUTH AMERICA 0 0 REGISTRATION INCOME ANNUAL MEETING EAST ASIA AND THE PACIFIC 0 REGISTRATION INCOME ANNUAL MEETING EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 REGISTRATION INCOME ANNUAL MEETING MIDDLE EAST AND NORTH AFRICA 0 0 REGISTRATION INCOME ANNUAL MEETING SOUTH ASIA 0 0 REGISTRATION INCOME ANNUAL MEETING NORTH AMERICA 0 0 REGISTRATION INCOME ANNUAL MEETING SUB-SAHARAN AFRICA 0 0 REGISTRATION INCOME ANNUAL MEETING RUSSIA & THE NEWLY INDEPENDENT STATES 0 0 REGISTRATION INCOME ANNUAL MEETING NORTH AMERICA 0 0 REGISTRATION INCOME CONFERENCE ON PRACTICE MANAGEMENT CENTRAL AMERICA AND THE CARIBBEAN 0 0 DUES REVENUE MEMBERSHIP DUES SOUTH AMERICA 0 0 DUES REVENUE MEMBERSHIP DUES EAST ASIA AND THE PACIFIC 0 0 DUES REVENUE MEMBERSHIP DUES EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 DUES REVENUE MEMBERSHIP DUES MIDDLE EAST AND NORTH AFRICA 0 0 DUES REVENUE MEMBERSHIP DUES SOUTH ASIA 0 0 DUES REVENUE MEMBERSHIP DUES NORTH AMERICA 0 0 DUES REVENUE MEMBERSHIP DUES SUB-SAHARAN AFRICA 0 0 DUES REVENUE MEMBERSHIP DUES RUSSIA & THE NEWLY INDEPENDENT STATES 0 0 DUES REVENUE MEMBERSHIP DUES 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 FOUNDATION FOR ANESTHESIA EDUCATION & RESEARCH 520 N NORTHWEST HIGHWAY PARK RIDGE IL 60068 521494164 501(C)(3) 2000000 OPERATING SUPPORT ANESTHESIA PATIENT SAFETY FOUNDATION 520 N NORTHWEST HIGHWAY PARK RIDGE IL 60068 510287258 501(C)(3) 500000 OPERATING SUPPORT WOOD LIBRARY MUSEUM 520 N NORTHWEST HIGHWAY PARK RIDGE IL 60068 363573324 501(C)(3) 400000 OPERATING SUPPORT ANESTHESIA QUALITY INSTITUTE 520 N NORTHWEST HIGHWAY PARK RIDGE IL 60068 263848288 501(C)(3) 1200000 OPERATING SUPPORT IOWA SOCIETY OF ANESTHESIOLOGISTS 1215 PLEASANT ST 400 DES MOINES IA 50309 426066162 501(C)(6) 55785 OPERATING SUPPORT FLORIDA SOCIETY OF ANESTHESIOLOGISTS PO BOX 13978 TALLAHASEE FL 32317 596138053 501(C)(6) 30000 OPERATING SUPPORT COLORADO SOCIETY OF ANESTHESIOLOGISTS PO BOX 4834 ENGLEWOOD CO 80155 840962223 501(C)(6) 35000 OPERATING SUPPORT HOPE FOR THE WARRIORS 44 WATER STREET NEW YORK NY 10041 205182295 501(C)(3) 20000 OPERATING SUPPORT MALIGNANT HYPERTHERMIA ASSOCIATION 11 E STATE ST PO BOX 1069 SHERBURNE NY 13460 061076301 501(C)(3) 20000 OPERATING SUPPORT EMORY UNIVERSITY 1762 CLIFTON ROAD SUITE 1400 ATLANTA GA 30322 580566256 501(C)(3) 19080 OPERATING SUPPORT WISCONSIN SOCIETY OF ANESTHESIOLOGISTS 6737 W WASHINGTON SUITE 1300 MILWAUKEE WI 53214 391087656 501(C)(6) 35000 OPERATING SUPPORT SOUTH CAROLINA SOCIETY OF ANESTHESIOLOGISTS 1932 TELFAIR WAY CHARLESTON SC 29412 237367505 501(C)(6) 35000 OPERATING SUPPORT NEW MEXICO SOCIETY OF ANESTHESIOLOGISTS 7770 JEFFERSON ST NE SUITE 400 ALBUQUERQUE NM 87109 850352129 501(C)(6) 13000 OPERATING SUPPORT UNIVERSITY OF NORTH CAROLINA 101 MANNING DRIVE CB 7010 CHAPEL HILL NC 27599 566001393 501(C)(3) 5000 OPERATING SUPPORT 8 6 EDUCATIONAL GRANTS - POLICY RESEARCH ROTATION IN POLITICAL AFFAIRS PROGRAM 6 12000 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ASA ISSUES GRANTS TO ITS RELATED ORGANIZATIONS WHICH, IN TURN, ADHERE TO THEIR PARTICULAR GUIDELINES FOR REVIEWING GRANT APPLICATIONS, THE DISBURSEMENT OF AWARDS AND THE MONITORING OF GRANT FUNDS. ASA ALSO AWARDS GRANTS TO OUTSIDE ENTITIES, WHO ARE THEN REQUIRED TO PROVIDE WRITTEN REPORTS ON THE PROGRESS OF THE INITIATIVE. X X 1 1 X X X X 1 0 0 JOHN M ZERWAS MD 156250 0 0 0 0 0 0 0 0 0 156250 0 0 0 JERRY A COHEN MD 188000 0 0 0 0 0 0 0 0 0 188000 0 0 0 JOHN A THORNER JD CAE 212679 0 53544 0 241156 0 24329 0 10636 0 542344 0 0 0 RONALD SZABAT JD LLM 170234 0 43667 0 184109 0 18008 0 11809 0 427827 0 0 0 THOMAS CONWAY MBA CPA 254947 0 25370 0 1285 0 29342 0 25943 0 336887 0 0 0 KAREN BUEHRING 227143 0 21778 0 1107 0 27194 0 24542 0 301764 0 0 0 BARBARA DIANE GAMBILL 205985 0 20263 0 1881 0 14533 0 7858 0 250520 0 0 0 MANUEL BONILLA 177099 0 20256 0 557 0 25950 0 23983 0 247845 0 0 0 MARY KUFFNER 169749 0 19800 0 581 0 24742 0 35225 0 250097 0 0 0 SARA MOSER 157219 0 19281 0 770 0 23137 0 18135 0 218542 0 0 0 PART I, LINE 1A THE ASA ADMINISTRATIVE PROCEDURES ALLOW DOMESTIC FIRST-CLASS AIRFARE FOR PRESIDENT, PRESIDENT-ELECT, FIRST VP, ROVENSTINE LECTURER, RECIPIENT OF THE DISTINGUISHED SERVICE AWARD, RECIPIENT OF THE EXCELLENCE IN RESEARCH AWARD, LEGISLATIVE CONFERENCE KEYNOTE SPEAKER, AND THE NICHOLAS M. GREENE, MD OUTSTANDING HUMANITARIAN CONTRIBUTION AWARD, ALONG WITH THE SPOUSES OF EACH. ASA ALLOWS DOMESTIC FIRST-CLASS TRAVEL FOR THE SPEAKER AT THE JOHN W. SEVERINGHAUS LECTURE ON TRANSLATIONAL SCIENCE. THE EXECUTIVE VICE-PRESIDENT'S CONTRACT INCLUDED THAT ASA WOULD ALLOW FOUR PAID TRIPS FOR SPOUSE, ANNUALLY. PART I, LINE 4A JOHN A. THORNER, EXECUTIVE VICE PRESIDENT, RECEIVED $237,622 IN SEVERANCE BENEFITS. RONALD SZABAT, EXECUTIVE VICE PRESIDENT, RECEIVED $182,345 IN SEVERANCE BENEFITS. FORM 990, PART VI, SECTION A, LINE 4 THE FOLLOWING CHANGES WERE MADE TO THE ORGANIZATION'S GOVERNING DOCUMENTS: OFFICER VACANCIES: IF THE PRESIDENT BECOMES UNABLE OR UNWILLING TO SERVE OR IS REMOVED FROM OFFICE, THE PRESIDENT-ELECT SHALL SERVE THE REMAINDER OF THE VACATED TERM AS ACTING PRESIDENT. IN THIS EVENT, THE OFFICE OF PRESIDENT-ELECT SHALL REMAIN UNFILLED UNTIL ELECTION AT THE NEXT ANNUAL MEETING AND THE ACTING PRESIDENT SHALL ALSO PERFORM ANY OF THE PRESIDENT-ELECT'S DUTIES. IF THE FIRST VICE-PRESIDENT BECOMES UNABLE OR UNWILLING TO SERVE OR IS REMOVED FROM OFFICE, THIS OFFICE SHALL REMAIN VACANT UNTIL ELECTION AT THE NEXT ANNUAL MEETING, AND THE PRESIDENT-ELECT SHALL ALSO PERFORM ANY OF THE FIRST VICE PRESIDENT'S DUTIES. IF ANY OF THE OFFICES OF ASSISTANT SECRETARY, ASSISTANT TREASURER AND VICE-SPEAKER BECOMES VACANT, IT SHALL REMAIN VACANT UNTIL ELECTION AT THE NEXT ANNUAL MEETING. RETENTION: RETENTION POLICY WAS REVIEWED AND MODIFIED TO BE IN CONJUNCTION WITH OUTSIDE AUDIT TEAM. CHANGES INCLUDED THE FOLLOWING: RETENTION OF PUBLICATIONS AND HISTORICAL MATERIALS INDICATES THAT DIGITIZED COPIES OF EACH PUBLICATION LISTED IN THE ADMINISTRATIVE PROCEDURES WILL BE RETAINED, IF FEASIBLE, AND IF ANY PUBLICATION CEASES TO BE AVAILABLE IN PRINT, ONE DIGITAL COPY SHOULD BE RETAINED. THE ANESTHESIA CONTINUING EDUCATION PROGRAM WAS ADDED AS A PUBLICATION TO RETAIN. THE WOOD LIBRARY IS THE OFFICIAL REPOSITORY FOR THE ARCHIVES OF THE ASA. WHILE FILES AND CORRESPONDENCE ON CURRENT AND PRIOR ASA MEMBERS MUST BE RETAINED FOR THREE YEARS, ALL APPLICATIONS FOR MEMBERSHIP MUST BE RETAINED PERMANENTLY. POTENTIAL CONFLICT OF INTEREST STATEMENTS SHOULD BE KEPT FOR TEN YEARS AND COPYRIGHT ASSIGNMENTS AND/OR LICENSES SHOULD BE RETAINED PERMANENTLY. CONTRACTS MUST BE KEPT FOR THE LIFE OF THE CONTRACT, PLUS TEN YEARS. CANCELLED CHECKS AND BANKING ADVICES SHOULD BE KEPT FOR SEVEN YEARS. FINANCIAL STATEMENTS, AUDIT REPORTS, STATE TAX EXEMPTION RECORDS, INSURANCE POLICIES, INSURANCE CLAIM RECORDS, STRATEGIC PLANS AND ADMINISTRATIVE PROCEDURES SHOULD BE RETAINED PERMANENTLY. BACK-UP COPIES OF THE ASA FILE SERVER AND MAIL SERVER ARE CREATED ON A DAILY BASIS. BACK-UP COPIES WILL BE SAVED FOR 90 DAYS. REAL ESTATE DOCUMENTS SHOULD BE KEPT FOR TWENTY YEARS FROM DATE OF PURCHASE OR SALE. COMMITTEES: COMMITTEES ESTABLISHED IN 2012 WERE THE FOLLOWING: COMMITTEE ON GOVERNANCE EFFECTIVENESS AND EFFICIENCIES (REPLACES AD HOC COMMITTEE ON GOVERNANCE), COMMITTEE ON FUTURE MODELS OF ANESTHESIA PRACTICE, COMMITTEE ON LARGE GROUP PRACTICE, EDITORIAL BOARD FOR SIMULATION-BASED TRAINING (REPLACES SIMULATION EDUCATION COMMITTEE), EDUCATIONAL TRACK SUBCOMMITTEES AND ABSTRACT REVIEW SUBCOMMITTEES. AN ADJUNCT COMMITTEE MEMBER'S INITIAL APPOINTMENT WILL BE FOR A TWO-YEAR TERM AND MAY HAVE SUBSEQUENT ADJUNCT APPOINTMENTS TO THE SAME COMMITTEE FOR A ONE-YEAR TERM. AN INDIVIDUAL MAY SERVE AS A MEMBER OF AN EDITORIAL BOARD FOR THREE THREE-YEAR TERMS. THE EDITOR-IN-CHIEF MAY SERVE UP TO THREE TWO-YEAR TERMS. THE COMMITTEE ON GLOBAL HUMANITARIAN OUTREACH ESTABLISHED THE NICHOLAS M. GREENE, MD OUTSTANDING HUMANITARIAN AWARD. MEMBERSHIP: A NEW CATEGORY OF MEMBERSHIP WAS CREATED ENTITLED INTERNATIONAL RESIDENT AND MEDICAL STUDENT MEMBERS, AS DESCRIBED IN THE BYLAWS. DUES, PRIVILEGES AND OTHER CRITERIA ARE CONTAINED IN THE ADMINISTRATIVE PROCEDURES. THE BENEFIT OF 50% REDUCTION IN ACTIVE MEMBERS' DUES CAN NOW BE RECEIVED BY THOSE UNDER ACTIVE DUTY MILITARY OR ARE AN ACTIVATED RESERVIST, AS OPPOSED TO THOSE UNDER THE SOLDIER'S AND SAILOR'S CIVIL RELIEF ACTION OF 1940. FINANCIAL: THE ASA TREASURER AND ASSISTANT TREASURER ARE NOW INCLUDED IN OVERSIGHT OF EXPENSE DISBURSEMENTS AND HAVE THE OPPORTUNITY TO REVIEW ASA'S ONGOING EXPENDITURES. ALL CHECKS OVER $50,000 NOW REQUIRE A SECOND SIGNATURE. APPROVED SECONDARY SIGNORS INCLUDE THE CHIEF ADMINISTRATIVE OFFICER, CHIEF EXECUTIVE OFFICER OR DIRECTOR OF FINANCE. THE ASA CHARITABLE FOUNDATION WAS ADDED AS ASA REPRESENTATION TO EXTERNAL ORGANIZATIONS. ASA REPRESENTATIVES ARE APPOINTED MEMBERS OF THE CF BOARD OF DIRECTORS, NAMED BY THE ASA PRESIDENT AND APPROVED BY THE ASA BOARD OF DIRECTORS. THE BOARD MEMBERS SERVE FOR A THREE-YEAR TERM AND THERE IS NO LIMIT ON THE NUMBER OF TERMS. THE DISCIPLINARY PROCEDURES NOW STATES THAT THE JUDICIAL COUNCIL MAY EXPEL OR SANCTION A MEMBER OF THE SOCIETY IF HE OR SHE FAILS TO ADHERE TO THE GUIDELINES FOR THE ETHICAL PRACTICE OF ANESTHESIOLOGY OF THE ASA. FORM 990, PART VI, SECTION A, LINE 7A THE HOUSE OF DELEGATES MEETS ON AN ANNUAL BASIS TO AFFIRM THE MANAGEMENT OF THE ORGANIZATION BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS EXERCISES FINAL AUTHORITY OVER AND MANAGES THE BUSINESS AND FINANCIAL AFFAIRS OF THE SOCIETY, INCLUDING, BUT NOT LIMITED TO, THE ACQUISITION, MANAGEMENT, CONTROL AND DISPOSITION OF ITS PROPERTY AND THE AUTHORIZATION OF ALL CONTRACTS ON ITS BEHALF; THE BOARD OF DIRECTORS MAY DELEGATE PORTIONS OF SUCH AUTHORITY TO THE OFFICERS, COUNCILS, SECTIONS OR COMMITTEES AND PERFORM SUCH OTHER DUTIES AS ARE PROVIDED FOR IN THE BYLAWS. CERTAIN MEMBERS OF THE HOUSE OF DELEGATES ARE MEMBERS OF THE BOARD OF DIRECTORS UNDER THE ORGANIZATION'S BYLAWS. OFFICERS ARE ELECTED BY THE HOUSE OF DELEGATES AT THE ANNUAL MEETING. FORM 990, PART VI, SECTION A, LINE 7B THE HOUSE OF DELEGATES HAS THE AUTHORITY TO CHANGE THE ORGANIZATION'S BYLAWS AND MODIFY SELECT DECISIONS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE SECTION ON FISCAL AFFAIRS, WHICH IS A SUB-COMMITTEE OF THE BOARD OF DIRECTORS, DURING THE COURSE OF THE AUGUST ANNUAL BOARD MEETING, REVIEWS THE FORM 990 WITH THE INDEPENDENT CPA FIRM THAT PREPARED THE RETURN. A REPORT OF THIS REVIEW AND A FULL COPY WILL BE POSTED TO THE "MEMBERS ONLY" PORTION OF THE WEBSITE, WWW.ASAHQ.ORG, AS SOON AS POSSIBLE FOLLOWING THE MEETING WITH THE CPA FIRM. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, ASA BOARD MEMBERS AND OFFICERS ARE REQUIRED TO DISCLOSE WHETHER OR NOT THEY HAVE ANY POTENTIAL CONFLICTS OF INTEREST, AND IF SO, ARE REQUIRED TO DISCLOSE THEM. THE GOVERNANCE UNIT SHALL MONITOR COMPLIANCE WITH THE POLICY. THE ASA OFFICE OF GENERAL COUNSEL, IN CONSULTATION WITH THE ADMINISTRATIVE COUNCIL, SHALL HAVE PRIMARY RESPONSIBILITY TO MONITOR AND ENFORCE THE CONFLICT OF INTEREST POLICY AS IT PERTAINS TO THE ADMINISTRATIVE COUNCIL. ON OR BEFORE COMMENCEMENT OF A NEW TERM OF OFFICE OR SERVICE, THE INCOMING COMMITTEE CHAIRS, ADMINISTRATIVE COUNCIL, AND THE OFFICE OF GENERAL COUNSEL SHALL INITIATE REVIEW OF THE POTENTIAL CONFLICT OF INTEREST DISCLOSURE STATEMENTS AND COMPLETE INITIAL REVIEW OF SUCH STATEMENTS WITHIN 30 DAYS OF THE COMMENCEMENT OF THE TERM. THE SECRETARY SHALL BE NOTIFIED IN THE EVENT OF AN ALLEGED FAILURE TO CONFORM TO THE STANDARDS. THE SECRETARY SHALL REFER THE EXCEPTION OR FAILURE TO THE ADMINISTRATIVE COUNCIL. THE ADMINISTRATIVE COUNCIL MAY DETERMINE THAT A CONFLICT DOES NOT EXIST, DETERMINE THAT A CONFLICT DOES EXIST BUT GRANT A WAIVER, DETERMINE THAT THE MATTER SHOULD BE HEARD BY THE JUDICIAL COUNCIL, OR IN THE CASE OF ALLEGED CONFLICT BY A DIRECTOR OR ALTERNATE DIRECTOR, REFER THE MATTER TO THE COMPONENT SOCIETY NOMINATING THE DIRECTOR OR ALTERNATE DIRECTOR FOR APPROPRIATE ACTION. THESE REQUIREMENTS SHALL APPLY EQUALLY TO THE MEMBERS OF THE ASA EXECUTIVE STAFF. IN THE CASE OF SUCH INDIVIDUALS, THE EXECUTIVE COMMITTEE OF THE ADMINISTRATIVE COUNCIL SHALL BE RESPONSIBLE FOR MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY AS IT PERTAINS TO THE ASA EXECUTIVE STAFF, INCLUDING THE DETERMINATION OF ANY WAIVER OR FOR THE APPLICATION OF SANCTIONS IN THE EVENT OF ANY VIOLATIONS OF THE POLICY. THE COI STATEMENT AND FORMS ARE AVAILABLE ON THE ASA WEBSITE IN THE MEMBERS ONLY SECTION. HARD COPIES MAY BE OBTAINED FROM THE ASA EXECUTIVE OFFICE. FORM 990, PART VI, SECTION B, LINE 15 OUTSIDE COMPENSATION EXPERTS ARE UTILIZED REGARDING BENCHMARKED POSITIONS OF THE EXECUTIVE VICE PRESIDENT, PARK RIDGE AND EXECUTIVE VICE PRESIDENT, WASHINGTON D.C. OUTSIDE COMPENSATION EXPERTS ARE UTILIZED FOR RECOMMENDATIONS ON COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES. THE EXECUTIVE COMPENSATION COMMITTEE MAKES DECISIONS ON ANY MERIT INCREASES FOR THE EVP BASED ON DATA PROVIDED BY AN EXTERNAL COMPENSATION CONSULTANT. FORM 990, PART VI, SECTION C, LINE 19 CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: BENEFIT PLAN CHANGES OTHER THAN NET PERIODIC POSTRETIREMENT BENEFIT COSTS -36,828. RETURNED GRANT FUNDS 300,000. WOOD LIBRARY-MUSEUM OF ANESTHESIOLOGY 520 N NORTHWEST HIGHWAY PARK RIDGE IL 60068 363573324 COLLECTION OF ANESTHESIA LITERATURE IL 501(C)(3) LINE 11A, I 1 FOUNDATION FOR ANESTHESIA EDUCATION & RESEARCH 520 N NORTHWEST HIGHWAY PARK RIDGE IL 60068 521494164 ANESTHESIA CARE EDUCATION AND RESEARCH DE 501(C)(3) LINE 7 1 ANESTHESIA PATIENT SAFETY FOUNDATION 520 N NORTHWEST HIGHWAY PARK RIDGE IL 60068 510287258 ANESTHESIA PATIENT SAFETY EDUCATION DE 501(C)(3) LINE 7 1 AMERICAN SOCIETY OF ANESTHESIOLOGISTS POLITICAL ACTION COMMITTEE 520 N NORTHWEST HIGHWAY PARK RIDGE IL 60068 363887214 POLITICAL CAMPAIGN ACTIVITIES IL 527 0 ANESTHESIA QUALITY INSTITUTE 520 N NORTHWEST HIGHWAY PARK RIDGE IL 60068 263848288 ADVANCES IN QUALITY OF CARE MEASUREMENT AND DELIVERY IN ANESTHESIA CARE DC 501(C)(3) LINE 11A, I 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 1 0 0 WOOD LIBRARY-MUSEUM OF ANESTHESIOLOGY B 400000 MAINTAINED RECORDS AT FMV WOOD LIBRARY-MUSEUM OF ANESTHESIOLOGY Q 407168 MAINTAINED RECORDS AT FMV FOUNDATION FOR ANESTHESIA EDUCATION & RESEARCH B 2000000 MAINTAINED RECORDS AT FMV FOUNDATION FOR ANESTHESIA EDUCATION & RESEARCH L 14560 MAINTAINED RECORDS AT FMV FOUNDATION FOR ANESTHESIA EDUCATION & RESEARCH Q 256057 MAINTAINED RECORDS AT FMV ANESTHESIA PATIENT SAFETY FOUNDATION B 500000 MAINTAINED RECORDS AT FMV ANESTHESIA PATIENT SAFETY FOUNDATION L 14560 MAINTAINED RECORDS AT FMV ANESTHESIA PATIENT SAFETY FOUNDATION Q 19557 MAINTAINED RECORDS AT FMV ANESTHESIA QUALITY INSTITUTE B 1200000 MAINTAINED RECORDS AT FMV ANESTHESIA QUALITY INSTITUTE Q 267346 MAINTAINED RECORDS AT FMV ANESTHESIA QUALITY INSTITUTE L 41691 MAINTAINED RECORDS AT FMV