2011-11-04T09:56:48-05:00 2010-12-31 BLACKMAN KALLICK LLP 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2010-01-01 362181944 AMERICAN SOCIETY OF ANESTHESIOLOGISTS AMER 8478255586 520 NORTH NORTHWEST HIGHWAY PARK RIDGE IL 600682573 JOHN A THORNER JD CAE 8478255586 2011-10-21 1 LU ANN TRAPP 3122071040 2011-10-19 2010 2016-03-07 17:11:31Z MARK A WARNER MD 520 NORTH NORTHWEST HIGHWAY PARK RIDGE IL 600682573 38576830 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 62 135 716 1477583 -1559319 114355 77036 29296447 31396022 -661214 1425653 3277611 3426592 32027199 36325303 3645250 3497500 0 0 10357621 11579421 0 0 0 17096355 18285238 31099226 33362159 927973 2963144 61364888 72965236 10233871 12802207 51131017 60163029 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 CERTIFIED REGISTERED NURSE ANESTHETISTS AND ANESTHESIOLOGIST ASSISTANTS. THE SOCIETY HAS 46,000 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 ANESTHESIOLOGISTS WITH CURRENT INFORMATION ON NEWEST CLINICAL DEVELOPMENTS, TECHNOLOGY ADVANCEMENTS AND RESEARCH.ASA IN-PERSON EDUCATION PROGRAMS INCLUDE AN ANNUAL MEETING, THE WORLD'S LARGEST EDUCATION PROGRAM FOR 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 CERTIFICATION 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 AND ANNUAL MEETING HIGHLIGHTS, RECORDED SESSIONS FROM EACH ANNUAL MEETING.IN ADDITION, ASA ACTS AS THE SECRTARIAT FOR THE ABA (AMERICAN BOARD OF ANESTHESIOLOGY) - ASA JOINT COUNCIL ON IN-TRAINING EXAMINATIONS. THE JOINT COUNCIL IS RESPONSIBLE FOR THE PREPARATION AND ADMINISTRATON OF THE YEARLY IN-TRAINING EXAMINATION TO APPROXIMATELY 5,000 RESIDENTS IN ANESTHESIA RESIDENCY PROGRAMS IN THE UNITED STATES AND CANADA. THE IN-TRAINING EXAMINATION PROVIDES AN EVALUATION OF EACH RESIDENT'S KNOWLEDGE AND SKILL DURING HIS OR HER TRAINING PERIOD IN ANESTHESIOLOGY, AND ALLOWS THE RESIDENT'S SUPERVISING PHYSICIAN TO TAILOR FUTURE TRAINING IN SPECIFIC AREAS IN WHICH THE RESIDENT NEEDS ADDITIONAL ASSISTANCE BEFORE COMPLETING HIS OR HER RESIDENCY AND APPLYING FOR BOARD CERTIFICATION. THE ABA USES A SUBSET OF QUESTIONS FROM THE IN-TRAINING EXAMINATION AS AN ENTRY EXAMINATION INTO ITS CERTIFICATION PROCESS. 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 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 304 0 135 1 1 1 0 0 0 1 1 0 X 65 62 0 0 1 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X STEVE LOTHARY 8472689150 520 NORTH NORTHWEST HIGHWAY PARK RIDGE IL 60068 MARK A WARNER MD 37.50 X X 214250 1323 0 JERRY A COHEN MD 28.00 X X 68750 0 0 ALEXANDER A HANNENBERG MD 29.00 X X 188729 0 0 JOHN M ZERWAS MD 11.00 X X 17720 0 0 ARNOLD J BERRY MD 4.00 X X 6098 0 0 ROBERT E JOHNSTONE MD 13.00 X X 20833 0 0 ARTHUR M BOUDREAUX MD 3.00 X X 5550 0 0 JAMES D GRANT MD 3.00 X X 4813 0 0 LINDA J MASON MD 1.00 X X 2070 0 0 MARY DALE PETERSON MD 1.00 X X 2558 0 0 ROGER A MOORE MD 2.00 X X 3000 0 0 JEFFREY S PLAGENHOEF MD 2.00 X 2325 705 0 BRION J BEERLE MD 0.00 X 0 0 0 DANIEL J COLE MD 2.00 X 3763 0 0 MICHAEL J VOLLERS MD 1.00 X 1500 0 0 MARK A SINGLETON MD 2.00 X 2910 0 0 RANDALL M CLARK MD 1.00 X 1675 0 0 JEFFREY B GROSS MD 2.00 X 3928 0 0 CHRIS A KITTLE MD 1.00 X 1500 0 0 JOHN F DOMBROWSKI MD 1.00 X 2226 0 0 DAVID VARLOTTA DO 1.00 X 1500 0 0 PEGGY G DUKE MD 2.00 X 4078 0 0 WILLIAM H MONTGOMERY MD 8.00 X 12805 0 0 PHILIP G SCHMID III MD 0.00 X 0 0 0 KENNETH J TUMAN MD 1.00 X 1750 0 0 GERARD T COSTELLO MD 1.00 X 1500 0 0 JOHN R MOYERS MD 1.00 X 1750 0 0 JAMES D KINDSCHER MD 1.00 X 1500 0 0 RAYMOND J SULLIVAN MD 0.00 X 0 0 0 DAVID M BROUSSARD MD 1.00 X 1500 0 0 GARY E PALMAN DO 1.00 X 1500 0 0 MURRAY A KALISH MD 1.00 X 2250 0 0 BEVERLY K PHILIP MD 1.00 X 705 0 0 KENNETH ELMASSIAN DO 0.00 X 0 0 0 BRIAN P MCGLINCH MD 1.00 X 1955 0 0 CLAUDE D BRUNSON MD 1.00 X 1955 0 0 DONALD E ARNOLD MD 1.00 X 750 0 0 MIKE P SCHWEITZER MD 1.00 X 1500 0 0 SHEILA J ELLIS MD 1.00 X 1500 0 0 JONATHAN R ZUCKER MB 1.00 X 1500 0 0 STEVEN J HATTAMER MD 3.00 X 4988 0 0 KENNETH I MIRSKY MD 1.00 X 2410 0 0 JOHN H WILLS MD 1.00 X 750 0 0 KENNETH J FREESE MD 0.00 X 0 0 0 GERALD J MACCIOLI MD 1.00 X 2000 0 0 JOHN C CHATELAIN MD 1.00 X 1500 0 0 RONALD L HARTER MD 2.00 X 2776 0 0 JANE CK FITCH MD 3.00 X 4430 0 0 NORMAN A COHEN MD 4.00 X 6855 0 0 DONALD E MARTIN MD 2.00 X 2433 950 0 RICHARD A BROWNING MD 1.00 X 750 0 0 CHRISTOPHER A YEAKEL MD 1.00 X 750 0 0 ROBERT G ALLEN JR MD 1.00 X 1750 0 0 JAMES M WEST MD 1.00 X 1500 0 0 SCOTT E KERCHEVILLE MD 1.00 X 1660 0 0 PAUL N CLAYTON MD 1.00 X 2023 0 0 JOEL H MUMFORD MD 1.00 X 1925 0 0 STEPHEN P LONG MD 0.00 X 0 0 0 PETER J DUNBAR MD 1.00 X 750 0 0 PAUL A SKAFF MD 1.00 X 1500 0 0 ROBERT E KETTLER MD 1.00 X 2325 0 0 TODD M WITZELING MD 1.00 X 1500 0 0 STEVEN J BARKER PHD MD 1.00 X 1205 0 0 ZACH W CHAMBERS MD 2.00 X 2750 0 0 CORRY J KUCIK MD 1.00 X 1500 0 0 JAN EHRENWERTH MD 3.00 X 5000 0 0 MATTHEW J WOOD MD 0.00 X 0 0 0 LINDA F LUCAS MD 1.00 X 1500 0 0 MICHAEL H ENTRUP MD 1.00 X 1955 0 0 ANDRES MELENDEZ-DEDOS MD 0.00 X 0 0 0 FAROOQ A KHAN MD 0.00 X 0 0 0 JOHN A THORNER JD CAE 37.50 X 358212 0 60461 RONALD SZABAT JD LLM 37.50 X 315249 0 62735 THOMAS CONWAY MBA CPA 37.50 X 191572 0 55158 KAREN BUEHRING 37.50 X 170033 0 31919 MARY KUFFNER 37.50 X 164806 0 56479 SARA MOSER 37.50 X 149517 0 40039 MANUEL BONILLA 37.50 X 146135 0 47417 ROBERT FINE 37.50 X 142641 0 27342 2290846 2978 381550 24 0 1 0 FINANCIAL DYNAMICS INTERNATIONAL PO BOX 630391 BALTIMORE MD 21263 MKTG. CONSULTING FOR BRANDING INITIATIVE 1569997 ORGSOURCE 2033 MILWAUKEE AVENUE SUITE 324 RIVERWOODS IL 60015 WEBSITE CONSULTING 540187 UNIVERSITY OF WASHINGTON 12455 COLLECTIONS DRIVE CHICAGO IL 60693 DATA STUDIES ON CLOSED CLAIMS 412842 STRATEGIC ALLIANCE SERVICES 440 WEST 62ND STREET KANSAS CITY MO 64113 ANNUAL MEETING LOGISTICS CONSULTING 375420 FOUNDATION 648 INC 9190 PRIORITY WAY WEST DR STE 11 INDIANAPOLIS IN 46240 ECOMMERCE AND WEBSITE DEVELOPMENT 324672 18 77036 77036 MEMBERSHIP DUES 541900 17220607 17220607 ANNUAL MEETING 541900 7271096 7008135 262961 ANESTHESIA CONTINUING 541900 1694188 1694188 OTHER PROGRAM INCOME 900099 1570288 1570288 SELF-EDUCATION AND EVA 541900 1520196 1520196 2119647 968940 1150707 31396022 1672928 1672928 3426592 63915 3362677 2004252 2251527 -247275 -247275 -247275 36325303 29982354 1477583 4788330 3477500 2000 18000 1696071 6895433 689546 1747676 550695 415426 75300 593473 144721 2055028 1492237 1321458 299021 853347 415331 4736531 62280 906608 66630 OTHER OUTSIDE SERVICES 2291682 SUBSCRIPTIONS 732797 CREDIT CARD FEES 459884 RESEARCH SERVICE PAYMEN 357972 CONSULTING 266325 739187 33362159 803955 3719360 615854 3369474 3197513 3335348 533734 283721 16585721 7232520 8410774 9353201 47694585 52707195 108473 196937 61364888 72965236 4117838 4093393 1941728 4522912 4000000 4000000 174305 185902 10233871 12802207 X 51131017 60163029 51131017 60163029 61364888 72965236 X 2963144 6068868 X 0 1 1 X 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 AMERICAN SOCIETY OF ANESTHESIOLOGISTS POLITICAL ACTION COMMITTEE 1501 M STREET NW SUITE 300 WASHINGTON DC 20005 363887214 39150 0 0 1 17220607 973035 -377612 595423 1549855 -954432 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 0 1000000 450000 550000 0 4420193 4420193 4977936 2396448 2581488 107479 84893 22586 6513084 4598456 1914628 567029 152723 414306 9353201 DEFERRED RENT 183402 DUE TO RELATED PARTY 2500 185902 36325303 33362159 2963144 5881818 187050 6068868 9032012 42187170 5881818 187050 6068868 36118302 144721 62280 207001 36325303 33155158 0 33155158 144721 62280 207001 33362159 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: THE SOCIETY WOULD ACCOUNT FOR ANY POTENTIAL INTEREST OR PENALTIES RELATED TO POSSIBLE FUTURE LIABILITIES FOR UNRECOGNIZED INCOME TAX BENEFITS AS OTHER EXPENSE. THE SOCIETY IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR FEDERAL, STATE OR LOCAL INCOME TAXES FOR PERIODS BEFORE 2007. PART XI, LINE 8 - OTHER ADJUSTMENTS: BENEFIT PLAN CHANGES OTHER THAN NET PERIODIC POSTRETIREMENT BENEFIT COSTS 187,050. PART XII, LINE 2D - OTHER ADJUSTMENTS: BENEFIT PLAN CHANGES OTHER THAN NET PERIODIC POSTRETIREMENT BENEFIT COSTS 187,050. PART XII, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSE NETTED AGAINST REVENUE 62,280. PART XIII, LINE 4B - OTHER ADJUSTMENTS: INTEREST EXPENSE NETTED AGAINST REVENUE 62,280. 1 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 GRANT TO RECIPIENT LOCATED IN REGION SPONSOR PUBLICATION OF AN ANESTHESIA HANDBOOK. 15000 NORTH AMERICA 0 0 GRANT TO RECIPIENT LOCATED IN REGION SPONSORSHIP FOR THE INTERNATIONAL CONFERENCE FOR PERIANESTHESIA NURSES 3000 CENTRAL AMERICA AND THE CARIBBEAN 0 0 DUES REVENUE MEMBERSHIP DUES 0 EAST ASIA AND THE PACIFIC 0 0 DUES REVENUE MEMBERSHIP DUES 0 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 DUES REVENUE MEMBERSHIP DUES 0 MIDDLE EAST AND NORTH AFRICA 0 0 DUES REVENUE MEMBERSHIP DUES 0 NORTH AMERICA 0 0 DUES REVENUE MEMBERSHIP DUES 0 RUSSIA & THE NEWLY INDEPENDENT STATES 0 0 DUES REVENUE MEMBERSHIP DUES 0 SOUTH AMERICA 0 0 DUES REVENUE MEMBERSHIP DUES 0 SOUTH ASIA 0 0 DUES REVENUE MEMBERSHIP DUES 0 SUB-SAHARAN AFRICA 0 0 DUES REVENUE MEMBERSHIP DUES 0 CENTRAL AMERICA AND THE CARIBBEAN 0 0 REGISTRATION INCOME ANNUAL MEETING 0 EAST ASIA AND THE PACIFIC 0 0 REGISTRATION INCOME ANNUAL MEETING 0 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 REGISTRATION INCOME ANNUAL MEETING 0 MIDDLE EAST AND NORTH AFRICA 0 0 REGISTRATION INCOME ANNUAL MEETING 0 NORTH AMERICA 0 0 REGISTRATION INCOME ANNUAL MEETING 0 RUSSIA & THE NEWLY INDEPENDENT STATES 0 0 REGISTRATION INCOME ANNUAL MEETING 0 SOUTH AMERICA 0 0 REGISTRATION INCOME ANNUAL MEETING 0 SOUTH ASIA 0 0 REGISTRATION INCOME ANNUAL MEETING 0 SUB-SAHARAN AFRICA 0 0 REGISTRATION INCOME ANNUAL MEETING 0 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 REGISTRATION INCOME TEE WORKSHOP 0 NORTH AMERICA 0 0 REGISTRATION INCOME TEE WORKSHOP 0 SOUTH ASIA 0 0 REGISTRATION INCOME TEE WORKSHOP 0 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS 0 EAST ASIA AND THE PACIFIC 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS 0 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS 0 MIDDLE EAST AND NORTH AFRICA 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS 0 NORTH AMERICA 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS 0 SOUTH AMERICA 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS 0 SOUTH ASIA 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS 0 SUB-SAHARAN AFRICA 0 0 PUBLICATION SALES SALES OF PUBLICATIONS, INCLUDING CONTINUING EDUCATION MATERIALS 0 0 0 0 18000 0 18000 EUROPE (INCLUDING ICELAND & GREENLAND) DONATION TO SPONSOR PRODUCTION OF SPANISH EDITION OF ANESTHESIA HANDBOOK 15000 1 0 0 0 0 0 0 PROCEDURE FOR MONITORING GRANTS OUTSIDE THE U.S.: SCHEDULE F, PART I, LINE 2: THE ORGANIZATION MADE CONTRIBUTIONS TO FOREIGN ENTITIES WITH SIMILAR RELATED MISSIONS FOR THE SPONSORSHIP OF ANESTHESIA RELATED PROJECTS AND CONFERENCES. SINCE THE FUNDS ARE TO BE USED FOR THE GENERAL SUPPORT OF THEIR MISSION, THE ORGANIZATION DOES NOT REQUIRE THE ORGANIZATION TO SUBSTANTIATE THEIR EXPENDITURES RELATED TO THESE CONTRIBUTIONS. 1 FOUNDATION FOR ANESTHESIA EDUCATION & RESEARCH 520 N NORTHWEST HIGHWAY PARK RIDGE IL 60068 521494164 501(C)(3) 1596000 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) 200000 OPERATING SUPPORT ANESTHESIA QUALITY INSTITUTE 520 N NORTHWEST HIGHWAY PARK RIDGE IL 60068 263848288 501(C)(3) 1000000 OPERATING SUPPORT UTAH SOCIETY OF ANESTHESIOLOGISTS 310 EAST 4500 SOUTH SUITE 500 SALT LAKE CITY UT 84107 870635004 501(C)(6) 30000 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 FLORIDA SOCIETY OF ANESTHESIOLOGISTS PO BOX 13978 TALLAHASSEE FL 32317 596138053 501(C)(6) 20000 OPERATING SUPPORT AMERICAN GERIATRIC SOCIETY INC 350 FIFTH AVE STE 801 NEW YORK NY 10118 131950856 501(C)(3) 6000 OPERATING SUPPORT ARIZONA SOCIETY OF ANESTHESIOLOGISTS 810 W BETHANY HOME RD PHOENIX AZ 85013 860193130 501(C)(6) 22000 OPERATING SUPPORT OKLAHOMA SOCIETY OF ANESTHESIOLOGISTS PO BOX 4087 EDMOND OK 73083 730739936 501(C)(6) 20000 OPERATING SUPPORT IOWA SOCIETY OF ANESTHESIOLOGISTS 1215 PLEASANT ST 400 DES MOINES IA 50309 426066162 501(C)(6) 40000 OPERATING SUPPORT 7 5 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 0 0 0 MARK A WARNER MD 214250 0 0 0 0 1323 0 0 0 0 214250 1323 0 0 ALEXANDER A HANNENBERG MD 188729 0 0 0 0 0 0 0 0 0 188729 0 0 0 JOHN A THORNER JD CAE 350258 0 7954 0 0 0 39103 0 21358 0 418673 0 0 0 RONALD SZABAT JD LLM 298860 0 16389 0 0 0 35197 0 27538 0 377984 0 0 0 THOMAS CONWAY MBA CPA 186318 0 5254 0 0 0 25220 0 29938 0 246730 0 0 0 KAREN BUEHRING 164771 0 5262 0 0 0 22100 0 9819 0 201952 0 0 0 MARY KUFFNER 163993 0 813 0 0 0 21941 0 34538 0 221285 0 0 0 SARA MOSER 149263 0 254 0 0 0 12501 0 27538 0 189556 0 0 0 MANUEL BONILLA 145881 0 254 0 0 0 19279 0 28138 0 193552 0 0 0 ROBERT FINE 142384 0 257 0 0 0 18123 0 9219 0 169983 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, THE SPEAKER AT THE JOHN W. SEVERINGHAUS LECTURE ON TRANSLATIONAL SCIENCE AND THE LEGISLATIVE CONFERENCE KEYNOTE SPEAKER, ALONG WITH THE SPOUSES OF EACH. THE EXECUTIVE VICE-PRESIDENT'S CONTRACT INCLUDES THAT ASA WILL ALLOW FOUR PAID TRIPS FOR SPOUSE, ANNUALLY. FORM 990, PART VI, SECTION A, LINE 4 THE FOLLOWING CHANGES WERE MADE TO THE ORGANIZATION'S BYLAWS: COMMITTEES: COMMITTEE DETAILS WERE REMOVED FROM BYLAWS AND TRANSFERRED TO ADMINISTRATIVE PROCEDURES. COMMITTEE LISTINGS REMAIN IN BYLAWS. INDIVIDUALS APPOINTED TO COMMITTEES MAY BE "NOT ELIGIBLE FOR ASA MEMBERSHIP" BUT REQUIRE PRESIDENT'S APPROVAL UNLESS DELEGATED. EXECUTIVE COMMITTEE MAY CALL FOR SPECIAL MEETINGS TO ADDRESS DISCIPLINARY ISSUES. SUBSPECIALTY REPRESENTATION - SUB-SPECIALTY PRESIDENT SHALL SERVE AS EX-OFFICIO COMMITTEE MEMBER. ADDITION TO COMMITTEE OF PROFESSIONAL EDUCATION OVERSIGHT. SFA: (SECTION ON FISCAL AFFAIRS) AUDITORS CAN PRESENT THEIR REPORT VIA TELECONFERENCING. 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 5: NET UNREALIZED GAINS ON INVESTMENTS: 5,881,818. BENEFIT PLAN CHANGES OTHER THAN NET PERIODIC POSTRETIREMENT BENEFIT COSTS 187,050. TOTAL TO FORM 990, PART XI, LINE 5: 6,068,868. 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 1 0 1 1 0 1 0 0 WOOD LIBRARY-MUSEUM OF ANESTHESIOLOGY B 200000 MAINTAINED RECORDS AT FMV WOOD LIBRARY-MUSEUM OF ANESTHESIOLOGY P 393268 MAINTAINED RECORDS AT FMV FOUNDATION FOR ANESTHESIA EDUCATION & RESEARCH B 1596000 MAINTAINED RECORDS AT FMV FOUNDATION FOR ANESTHESIA EDUCATION & RESEARCH K 13020 MAINTAINED RECORDS AT FMV FOUNDATION FOR ANESTHESIA EDUCATION & RESEARCH P 137382 MAINTAINED RECORDS AT FMV ANESTHESIA PATIENT SAFETY FOUNDATION B 500000 MAINTAINED RECORDS AT FMV ANESTHESIA PATIENT SAFETY FOUNDATION K 12500 MAINTAINED RECORDS AT FMV ANESTHESIA PATIENT SAFETY FOUNDATION P 1252 MAINTAINED RECORDS AT FMV ANESTHESIA QUALITY INSTITUTE B 1000000 MAINTAINED RECORDS AT FMV ANESTHESIA QUALITY INSTITUTE P 240852 MAINTAINED RECORDS AT FMV ANESTHESIA QUALITY INSTITUTE K 37928 MAINTAINED RECORDS AT FMV