2021-05-27T15:36:21-05:00 2020-09-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2019-10-01 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 2021-05-27 1 MICHAEL LUMSDEN P01262236 4159561500 2021-05-26 2019 2022-09-23 18:48:47Z REBECCA A ROSALES 4150 CLEMENT STREET 151NC SAN FRANCISCO CA 941211563 44689842 0 X WWW.NCIRE.ORG X 1988 CA MEDICAL RESEARCH TO FIND NEW AND IMPROVED WAYS TO COMBAT DISEASE AND IMPAIRMENTS OF MAN. 18 6 304 0 0 0 42745781 39219620 5584653 5447650 42732 21954 2528 618 48375694 44689842 0 0 0 0 16724003 17337866 0 0 0 30007825 27372295 46731828 44710161 1643866 -20319 14819377 15917081 9670236 10788259 5149141 5128822 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 36174624 0 5447650 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. 36174624 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 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 41 0 1 304 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 START 1/2020 1.00 40.00 X X 0 401574 0 KENNETH R MCQUAID MD DIRECTOR 1.00 40.00 X 0 385949 0 MICHAEL D HOPE MD DIRECTOR 1.00 40.00 X 0 385765 0 BRUCE OVBIAGELE MD MSC MAS MBA DIRECTOR 1.00 40.00 X 0 377500 0 THEODORA MAURO MD CHAIR START 1/2020 8.00 40.00 X X 0 338255 0 REBECCA A ROSALES CEO/EXECUTIVE DIRECTOR 40.00 0.00 X 265789 0 22347 RAYMOND A SWANSON MD CHAIR THROUGH 12/2019 8.00 40.00 X X 0 284542 0 CARL GRUNFELD MD PHD DIRECTOR 1.00 40.00 X 0 267792 0 MICHAEL SHLIPAK MD MPH DIRECTOR 1.00 40.00 X 0 243954 0 JOANNA ZHAO CONTROLLER, SECRETARY & TREASURER 40.00 0.00 X 181870 0 49140 JOHN R MCQUAID PHD DIRECTOR 1.00 40.00 X 0 207499 0 BONNIE S GRAHAM MBA DIRECTOR 1.00 40.00 X 0 202871 0 DIANA SACREY LABORATORY MANAGER 40.00 0.00 X 145055 0 45655 ZIN KAY CHAN DIRECTOR, INFORMATION SYSTEMS 40.00 0.00 X 146575 0 26189 KATHLEEN STANLEY ADMINISTRATIVE NURSE III 40.00 0.00 X 132942 0 33738 DEREK FLENNIKEN CIND IT MANAGER 40.00 0.00 X 127668 0 37870 BRIAN ROACH PROGRAM ANALYST IV 40.00 0.00 X 127367 0 30821 SHIRA MAGUEN PHD DIRECTOR THROUGH 12/2019 1.00 40.00 X 0 134280 0 KRISTINE YAFFE MD DIRECTOR 1.00 40.00 X 0 129017 0 LOUISE C WALTER MD DIRECTOR 1.00 40.00 X 0 124197 0 RAQUEL GARDNER MD DIRECTOR EFFECTIVE 1/2020 1.00 40.00 X 0 23144 0 NEAL COHEN MD MPH MS DIRECTOR 1.00 0.00 X 0 0 0 HAROLD 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 EFFECTIVE 1/2020 1.00 0.00 X 0 0 0 1127266 3506339 245760 21 0 1 0 THE ULTIMATE SOFTWARE GROUP INC PO BOX 930953 ATLANTA GA 31193 PAYROLL AND HR SERVICES PROVIDER 159614 1 38083618 1136002 39219620 PERSONNEL REIMBURSEMENTS - SFVA 541700 3677046 3677046 CLINICAL RESEARCH REVENUE 541700 1744735 1744735 SERVICE REVENUE 541700 25869 25869 5447650 21954 21954 OTHER REVENUE 900099 618 618 618 44689842 5447650 0 22572 X 575938 575938 12962151 10174095 2788056 970185 443281 526904 1802368 873253 929115 1027224 513433 513791 63574 100 63474 91560 91560 7541722 5785631 1756091 264569 80298 184271 158622 30465 128157 375940 78624 297316 166351 76953 89398 44255 12072 32183 833 833 226972 133391 93581 77949 77949 SUBCONTRACTS 16996111 16996111 LAB SUPPLIES 883944 686201 197743 SUBJECT COSTS 201987 196992 4995 REGISTRATION FEES 74063 13033 61030 203843 80691 123152 44710161 36174624 8535537 0 2278735 4440478 3724118 3251609 7005829 5499250 467105 1079832 129471 63556 4901109 4174922 812990 726187 401129 856169 14819377 15917081 7333416 5941412 2336820 1572557 3274290 9670236 10788259 X 3925781 3650488 1223360 1478334 5149141 5128822 14819377 15917081 -20319 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 861510 138170 3875204 3287905 587299 26225 25507 718 726187 DEPOSITS 57212 DUE FROM SAN FRANCISCO VA MEDICAL CENTER 798957 856169 X 44689842 0 44689842 0 44689842 44710161 0 44710161 0 44710161 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, 2020 AND 2019, 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. X X X X 0 0 0 0 0 0 0 0 0 HUBERT T KIM MD PHD VICE CHAIR START 1/2020 0 401574 0 0 0 0 0 0 0 0 0 401574 0 0 KENNETH R MCQUAID MD DIRECTOR 0 385949 0 0 0 0 0 0 0 0 0 385949 0 0 MICHAEL D HOPE MD DIRECTOR 0 385765 0 0 0 0 0 0 0 0 0 385765 0 0 BRUCE OVBIAGELE MD MSC MAS MBA DIRECTOR 0 377500 0 0 0 0 0 0 0 0 0 377500 0 0 THEODORA MAURO MD CHAIR START 1/2020 0 338255 0 0 0 0 0 0 0 0 0 338255 0 0 REBECCA A ROSALES CEO/EXECUTIVE DIRECTOR 265789 0 0 0 0 0 19948 0 2399 0 288136 0 0 0 RAYMOND A SWANSON MD CHAIR THROUGH 12/2019 0 284542 0 0 0 0 0 0 0 0 0 284542 0 0 CARL GRUNFELD MD PHD DIRECTOR 0 267792 0 0 0 0 0 0 0 0 0 267792 0 0 MICHAEL SHLIPAK MD MPH DIRECTOR 0 243954 0 0 0 0 0 0 0 0 0 243954 0 0 JOANNA ZHAO CONTROLLER, SECRETARY & TREASURER 181870 0 0 0 0 0 18193 0 30947 0 231010 0 0 0 JOHN R MCQUAID PHD DIRECTOR 0 207499 0 0 0 0 0 0 0 0 0 207499 0 0 BONNIE S GRAHAM MBA DIRECTOR 0 202871 0 0 0 0 0 0 0 0 0 202871 0 0 DIANA SACREY LABORATORY MANAGER 145055 0 0 0 0 0 14813 0 30842 0 190710 0 0 0 ZIN KAY CHAN DIRECTOR, INFORMATION SYSTEMS 146575 0 0 0 0 0 14369 0 11820 0 172764 0 0 0 KATHLEEN STANLEY ADMINISTRATIVE NURSE III 132942 0 0 0 0 0 13545 0 20193 0 166680 0 0 0 DEREK FLENNIKEN CIND IT MANAGER 127668 0 0 0 0 0 13060 0 24810 0 165538 0 0 0 BRIAN ROACH PROGRAM ANALYST IV 127367 0 0 0 0 0 12948 0 17873 0 158188 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 86,745. MANAGEMENT AND GENERAL EXPENSES 13,570. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 100,315. JPA PAYROLL/FEES: PROGRAM SERVICE EXPENSES 4,738,439. MANAGEMENT AND GENERAL EXPENSES 1,462,892. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,201,331. TEMPORARY EMPLOYEE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 54,770. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 54,770. OUTSIDE RESEARCH: PROGRAM SERVICE EXPENSES 960,447. MANAGEMENT AND GENERAL EXPENSES 224,859. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,185,306. SAN FRANCISCO VETERANS AFFAIRS MEDICAL CENTER 4150 CLEMENT STREET SAN FRANCISCO CA 94121 941160824 HEALTH CARE BENEFITS AND SERVICES CA N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0