2022-06-21T15:13:43-05:00 2021-09-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2020-10-01 943084159 NORTHERN CALIFORNIA INSTITUTE FOR RESEARCH AND EDUCATION INC NORT 4157506954 4150 CLEMENT STREET 151NC SAN FRANCISCO CA 941211563 REBECCA A ROSALES CEO/EXECUTIVE DIRECTOR 4157506954 2022-06-21 1 REBECCA ROSALES 999009999 MICHAEL LUMSDEN P01262236 4159561500 2022-05-24 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z REBECCA A ROSALES 4150 CLEMENT STREET 151NC SAN FRANCISCO CA 941211563 46685916 0 X WWW.NCIRE.ORG X 1988 CA TO IMPROVE THE HEALTH AND WELL-BEING OF VETERANS AND THE PUBLIC BY SUPPORTING A WORLD-CLASS BIOMEDICAL RESEARCH PROGRAM CONDUCTED BY SAN FRANCISCO VA MEDICAL CENTER. 18 6 274 0 0 0 39219620 39836684 5447650 6847953 21954 207 618 0 44689842 46684844 0 0 0 0 17337866 17792794 0 0 0 27372295 25968420 44710161 43761214 -20319 2923630 15917081 16307751 10788259 8255299 5128822 8052452 X TO IMPROVE THE HEALTH AND WELL-BEING OF VETERANS AND THE GENERAL PUBLIC BY SUPPORTING A WORLD-CLASS BIOMEDICAL RESEARCH PROGRAM CONDUCTED BY UCSF FACULTY AT THE SAN FRANCISCO VA MEDICAL CENTER. 0 0 34850052 0 6847953 THE NORTHERN CALIFORNIA INSTITUTE FOR RESEARCH AND EDUCATION, INC. ("NCIRE") IS A RESEARCH INSTITUTE AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS ("VA") IN SAN FRANCISCO, CALIFORNIA AND THE UNIVERSITY OF CALIFORNIA AT SAN FRANCISCO. NCIRE WORKS WITH SPONSORS AND THE U.S. DEPARTMENT OF VETERANS AFFAIRS IN ADMINISTERING CONTRIBUTIONS FOR CONDUCTING RESEARCH TO FIND NEW AND IMPROVED WAYS TO COMBAT HUMAN DISEASE AND TO HELP PEOPLE WITH DISABILITIES. THE RESEARCH ADMINISTERED BY NCIRE IS VA-APPROVED RESEARCH, CONDUCTED AT VA FACILITIES. NCIRE WAS ESTABLISHED UNDER TITLE 38, SUBCHAPTER IV, SUBSECTIONS 7361-7366 AND IS SUBJECT TO DEPARTMENT OF VETERANS AFFAIRS HANDBOOK 1200 17. UNDER TITLE 38, SUBSECTION 7 363, NCIRE'S BOARD OF DIRECTORS CURRENTLY INCLUDES THREE MEMBERS WHO SERVE BY VIRTUE OF THEIR STATUTORY POSITIONS WITHIN THE SAN FRANCISCO VA MEDICAL CENTER. THEY ARE THE MEDICAL CENTER DIRECTOR, THE CHIEF OF STAFF, AND THE ASSOCIATE CHIEF OF STAFF FOR RESEARCH. 34850052 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 21 0 1 274 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X JOANNA ZHAO 4152214810 4150 CLEMENT STREET 151NC SAN FRANCISCO CA 941211563 X HUBERT T KIM MD PHD VICE CHAIR 1.00 40.00 X X 0 420402 0 KENNETH R MCQUAID MD DIRECTOR 1.00 40.00 X 0 385193 0 MICHAEL D HOPE MD DIRECTOR 1.00 40.00 X 0 379174 0 REBECCA ROSALES CEO/EXECUTIVE DIRECTOR 40.00 0.00 X 303726 0 32915 THEODORA MAURO MD CHAIR 8.00 40.00 X X 0 334567 0 BRUCE OVBIAGELE MD MSC MAS MBA DIRECTOR 1.00 40.00 X 0 315312 0 CARL GRUNFELD MD PHD DIRECTOR 1.00 40.00 X 0 269702 0 KRISTINE YAFFE MD DIRECTOR 1.00 40.00 X 0 260789 0 MICHAEL SHLIPAK MD MPH DIRECTOR 1.00 40.00 X 0 250148 0 LOUISE C WALTER MD DIRECTOR 1.00 40.00 X 0 249896 0 JOANNA ZHAO CONTROLLER, SECRETARY & TREASURER 40.00 0.00 X 192378 0 51858 DIANA SACREY DIRECTOR OF VAARC RESEARCH OPERATIONS 40.00 0.00 X 176505 0 50411 BONNIE S GRAHAM MBA DIRECTOR 1.00 40.00 X 0 201505 0 DEREK FLENNIKEN CIND IT DIRECTOR 40.00 0.00 X 147554 0 41005 JOHN R MCQUAID PHD DIRECTOR 1.00 40.00 X 0 170800 0 ZIN KAY CHAN DIRECTOR, INFORMATION SYSTEMS 40.00 0.00 X 146281 0 23299 BRIAN ROACH LAB MANAGER/PROGRAM ANALYST IV 40.00 0.00 X 134948 0 31898 JIAN PU ACCOUNTING MANAGER 40.00 0.00 X 116239 0 44177 ERIN MADDEN SENIOR STATISTICIAN 40.00 0.00 X 124042 0 12941 RAQUEL GARDNER MD DIRECTOR 1.00 40.00 X 0 28959 0 NEAL H COHEN MD MPH MS DIRECTOR 1.00 0.00 X 0 0 0 HAROLD R COLLARD MD DIRECTOR 1.00 0.00 X 0 0 0 LT COLONEL STEVE COUNTOURIOTIS DIRECTOR 1.00 0.00 X 0 0 0 DAVID O MORGAN PHD DIRECTOR 1.00 0.00 X 0 0 0 STEPHEN PEARY JD LLM DIRECTOR 1.00 0.00 X 0 0 0 JULES WALKER MBA DIRECTOR 1.00 0.00 X 0 0 0 LT COLONEL HIROSHI YAMAGUCHI DIRECTOR THROUGH 11/2020 1.00 0.00 X 0 0 0 1341673 3266447 288504 20 0 1 0 IPSOS PUBLIC AFFAIRS LLC PO BOX 360609 PITTSBURGH PA 152516609 SURVEY SERVICES 154579 ALANIZ MARKETING INC 7250 REDWOOD BLVD 355 NOVATO CA 94945 SUBJECT RECRUITMENT MARKETING 124400 MOSS ADAMS LLP PO BOX 101822 PASADENA CA 911891812 AUDIT AND TAX SERVICES 105350 THE ULTIMATE SOFTWARE GROUP INC PO BOX 930953 ATLANTA GA 311930953 PAYROLL AND HR SERVICES PROVIDER 100814 4 38874054 962630 39836684 PERSONNEL REIMBURSEMENTS - SFVA 541700 3728468 3728468 CLINICAL RESEARCH REVENUE 541700 3083807 3083807 SERVICE REVENUE 541700 35678 35678 6847953 1279 1279 1072 -1072 -1072 -1072 46684844 6847953 0 207 X 816637 229891 586746 13193480 10218217 2975263 1022721 474106 548615 1706687 802850 903837 1053269 526064 527205 47285 188 47097 88610 88610 8250248 6399355 1850893 295535 88651 206884 145939 31595 114344 301417 21646 279771 20761 16200 4561 25667 498 25169 18738 18738 230376 126280 104096 96011 96011 SUBCONTRACTS 14724892 14724892 LAB SUPPLIES 952279 672506 279773 SUBJECT COSTS 451718 446243 5475 DUES 111054 12904 98150 207890 57966 149924 43761214 34850052 8911162 0 4440478 2594979 3251609 3251989 5499250 8138532 1079832 630308 63556 152332 4965362 4240145 726187 725217 856169 814394 15917081 16307751 5416815 6484298 1572557 1022510 3274290 524597 748491 10788259 8255299 X 3650488 6448783 1478334 1603669 5128822 8052452 15917081 16307751 2923630 0 X 0 1 X 1 1 1 X SAN FRANCISCO VETERANS AFFAIRS MEDICAL CENTER SAN FRANCISCO CA RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 999680 893131 106549 3959565 3340897 618668 6117 6117 0 725217 DUE TO SAN FRANCISCO VA 748491 748491 X 46685916 0 46685916 -1072 -1072 46684844 43762286 1072 1072 43761214 0 43761214 PART X, LINE 2: NCIRE IS A NONPROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND STATE INCOME TAX UNDER CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701D. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO NCIRE'S TAX-EXEMPT PURPOSE MAY BE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. NCIRE QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER IRC SECTION 170(B)(1)(A)(III) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(1). AS OF SEPTEMBER 30, 2021 AND 2020, NCIRE HAD NO UNRECOGNIZED TAX BENEFITS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS -1,072. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS 1,072. X X X X 0 0 0 0 0 0 0 0 0 HUBERT T KIM MD PHD VICE CHAIR 0 420402 0 0 0 0 0 0 0 0 0 420402 0 0 KENNETH R MCQUAID MD DIRECTOR 0 385193 0 0 0 0 0 0 0 0 0 385193 0 0 MICHAEL D HOPE MD DIRECTOR 0 379174 0 0 0 0 0 0 0 0 0 379174 0 0 REBECCA ROSALES CEO/EXECUTIVE DIRECTOR 303726 0 0 0 0 0 30508 0 2407 0 336641 0 0 0 THEODORA MAURO MD CHAIR 0 334567 0 0 0 0 0 0 0 0 0 334567 0 0 BRUCE OVBIAGELE MD MSC MAS MBA DIRECTOR 0 315312 0 0 0 0 0 0 0 0 0 315312 0 0 CARL GRUNFELD MD PHD DIRECTOR 0 269702 0 0 0 0 0 0 0 0 0 269702 0 0 KRISTINE YAFFE MD DIRECTOR 0 260789 0 0 0 0 0 0 0 0 0 260789 0 0 MICHAEL SHLIPAK MD MPH DIRECTOR 0 250148 0 0 0 0 0 0 0 0 0 250148 0 0 LOUISE C WALTER MD DIRECTOR 0 249896 0 0 0 0 0 0 0 0 0 249896 0 0 JOANNA ZHAO CONTROLLER, SECRETARY & TREASURER 192378 0 0 0 0 0 19862 0 31996 0 244236 0 0 0 DIANA SACREY DIRECTOR OF VAARC RESEARCH OPERATION 176505 0 0 0 0 0 18424 0 31987 0 226916 0 0 0 BONNIE S GRAHAM MBA DIRECTOR 0 201505 0 0 0 0 0 0 0 0 0 201505 0 0 DEREK FLENNIKEN CIND IT DIRECTOR 147554 0 0 0 0 0 15064 0 25941 0 188559 0 0 0 JOHN R MCQUAID PHD DIRECTOR 0 170800 0 0 0 0 0 0 0 0 0 170800 0 0 ZIN KAY CHAN DIRECTOR, INFORMATION SYSTEMS 146281 0 0 0 0 0 15076 0 8223 0 169580 0 0 0 BRIAN ROACH LAB MANAGER/PROGRAM ANALYST IV 134948 0 0 0 0 0 13330 0 18568 0 166846 0 0 0 JIAN PU ACCOUNTING MANAGER 116239 0 0 0 0 0 12398 0 31779 0 160416 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION DOES NOT HAVE "MEMBERS" BY DEFINITION OF THE BYLAWS; HOWEVER, THE FORM 990 INSTRUCTIONS ALSO DEFINE A "MEMBER" AS ANY PERSON (INCLUDING A CORPORATION OR OTHER LEGAL ENTITY) WHO, PURSUANT TO A PROVISION OF THE ORGANIZATION'S GOVERNING DOCUMENTS, HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE (INCLUDING ELECTING MEMBERS OF THE GOVERNING BODY) OR RECEIVE A SHARE OF THE ORGANIZATION'S NET ASSETS UPON DISSOLUTION. ACCORDINGLY, NCIRE HAS ONE SOLE MEMBER: THE SAN FRANCISCO VETERANS AFFAIRS MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTOR OF THE SAN FRANCISCO VETERANS AFFAIRS MEDICAL CENTER HOLDS THE AUTHORITY TO APPOINT MEMBERS OF THE BOARD (FOLLOWING NOMINATION BY THE BOARD NOMINATING COMMITTEE), REMOVE A NON-STATUTORY BOARD MEMBER, APPOINT SUCCESSOR BOARD MEMBERS IN THE EVENT OF A VACANCY, AND APPOINT THE CHAIR OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B NO AMENDMENT TO THE BYLAWS SHALL BE EFFECTIVE UNTIL APPROVED BY THE DIRECTOR OF THE SAN FRANCISCO VETERANS AFFAIRS MEDICAL CENTER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT PUBLIC ACCOUNTING WITH THE ASSISTANCE OF THE ORGANIZATION'S FINANCE AND ACCOUNTING STAFF. THE FINAL DRAFT OF THE 990 IS REVIEWED BY THE CONTROLLER AND THE EXECUTIVE DIRECTOR. A COMPLETE COPY OF THE FORM 990 IS DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL NCIRE DIRECTORS, OFFICERS, AND ANY EMPLOYEES WITH DECISION MAKING AUTHORITY ("KEY EMPLOYEES") SUBMIT A CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE AND AFFIRMATION OF COMPLIANCE ANNUALLY BY JANUARY 31ST TO THE EXECUTIVE DIRECTOR. ANY QUESTIONNAIRE WITH A DISCLOSURE WILL BE PROVIDED TO THE BOARD TO REVIEW. THE BOARD THEN DECIDES WHETHER ANY DISCLOSURES REPRESENT ACTUAL, PERCEIVED, OR POTENTIAL CONFLICTS OF INTEREST. WHENEVER THERE IS REASON TO BELIEVE THAT A POTENTIAL CONFLICT EXISTS BETWEEN THE INTERESTS OF NCIRE AND ANY BOARD MEMBER, OFFICER, OR EMPLOYEE, THE INTERESTED PARTY WILL HAVE AN OPPORTUNITY TO PROVIDE FACTUAL INFORMATION ABOUT THE PROPOSED CONFLICT AND/OR MATTER THAT PROVOKED THE POTENTIAL CONFLICT. THE INTERESTED PARTY DOES NOT PARTICIPATE IN ANY WAY, OR IS PRESENT DURING, THE DELIBERATIONS AND DECISION-MAKING VOTE OF NCIRE WITH RESPECT TO SUCH MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING THE COMPENSATION OF THE EXECUTIVE DIRECTOR AND OTHER TOP MANAGEMENT OFFICIALS IS AS FOLLOWS: TWO CUSTOM SURVEYS WERE USED AND MARKET DATA WAS GATHERED AND ANALYZED BY THE HUMAN RESOURCE DEPARTMENT. RESULTS WERE REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD AND WERE USED TO FORMALLY REVIEW AND CONFIRM THAT COMPENSATION IS APPROPRIATE. THE PROCESS WAS LAST DONE IN 2019 AND WAS CONTEMPORANEOUSLY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC VIA THE COMPANY WEBSITE. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A: FORM 990, PART VII, SECTION A ONLY REPORTS REPORTABLE COMPENSATION PAID BY A RELATED ORGANIZATION TO THE ORGANIZATION'S DIRECTORS, AS THE AMOUNT OF DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS WAS NOT AVAILABLE AT THE TIME OF FILING. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 115,958. MANAGEMENT AND GENERAL EXPENSES 100,833. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 216,791. JPA PAYROLL/FEES: PROGRAM SERVICE EXPENSES 5,126,124. MANAGEMENT AND GENERAL EXPENSES 1,558,286. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,684,410. TEMPORARY EMPLOYEE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 40,012. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 40,012. OUTSIDE RESEARCH: PROGRAM SERVICE EXPENSES 1,157,273. MANAGEMENT AND GENERAL EXPENSES 151,762. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,309,035. 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