2021-08-24T10:10:11-05:00 2020-12-31 410746749 CLIFTONLARSONALLEN LLP 1301 WEST 22ND STREET SUITE 1100 OAK BROOK IL 60523 990 2020-01-01 270383913 OMEGA MEDICAL GRANTS ASSOCIATION OMEG 8473187482 9400 W HIGGINS ROAD NO 205 ROSEMONT IL 60018 KEVIN P BLACK MD PRESIDENT 8473187482 2021-08-04 1 KEVIN BLACK MD 999009999 JAMES R THOMAS P00095586 6305738600 2021-08-04 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z KEVIN P BLACK MD 9400 W HIGGINS ROAD NO 205 ROSEMONT IL 60018 10095451 0 X WWW.OMEGAMEDICALGRANTS.ORG X 2010 IL OMEGA MEDICAL GRANTS ASSOCIATION AWARDS AND ADMINISTERS GRANTS FOR GRADUATE ORTHOPAEDIC MEDICAL EDUCATION. 8 8 0 22 0 0 2068160 9179750 345560 908633 3861 7068 0 0 2417581 10095451 2205860 7752208 0 0 378758 401491 0 0 0 75592 69404 2660210 8223103 -242629 1872348 2309415 7030259 1235431 4083927 1073984 2946332 OMEGA MEDICAL GRANTS ASSOCIATION AWARDS AND ADMINISTERS GRANTS FOR GRADUATE ORTHOPAEDIC MEDICAL EDUCATION THROUGH AN OPEN, ACCESSIBLE PROCESS DESIGNED TO SAFEGUARD AGAINST POTENTIAL CONFLICTS OF INTEREST AND TO ENSURE TRANSPARENCY IN THE ALLOCATION OF RESOURCES. 0 0 8176650 7752208 908633 FINANCIAL SUPPORT OF ORTHOPAEDIC FELLOWSHIPS. THE PROGRAM WAS SUPPORTED ALSO BY GRANTS RECEIVED TOTALING $9,125,750 IN 2020. 8176650 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 2 0 1 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 IL X KRISTIN OLDS GLAVIN 8473187335 9400 W HIGGINS ROAD NO 205 ROSEMONT IL 60018 KEVIN P BLACK MD PRESIDENT 1.00 X X 0 0 0 RICHARD J D'ASCOLI MD TREASURER 1.00 X X 0 0 0 LANGDON A HARTSOCK MD SECRETARY 1.00 X X 0 0 0 JOHN A GLASER MD DIRECTOR 1.00 X 0 0 0 R DALE BLASIER MD DIRECTOR 1.00 X 0 0 0 JOHN C ELFAR MD DIRECTOR 1.00 X 0 0 0 REX C HAYDON MD DIRECTOR 1.00 X 0 0 0 WAYNE J SEBASTIANELLI MD DIRECTOR 1.00 X 0 0 0 KRISTIN OLDS GLAVIN ESQ EXECUTIVE DIRECTOR 5.00 37.50 X 34023 372369 59917 RHONDA TAIRA MANAGING DIRECTOR 37.50 X 173881 0 18095 207904 372369 78012 1 0 1 0 0 54000 9125750 9179750 ADMINISTRATIVE & APPLICATION FEES 611710 908633 908633 908633 7068 7068 10095451 908633 0 7068 7752208 7752208 229401 229401 122838 115840 6998 12482 11882 600 14394 14394 22376 21846 530 19496 19496 1890 1890 3991 3991 9810 9810 31079 31079 45 45 492 492 864 864 1737 1737 8223103 8176650 46453 0 1245877 6776572 1050000 250000 10765 1778 6524 4615 2773 1909 2309415 7030259 124456 93837 1110975 3990090 1235431 4083927 X 160641 659447 913343 2286885 1073984 2946332 2309415 7030259 1872348 0 X X 0 1 X 1 0 X 3259772 2446337 2396410 2068160 9179750 19350429 3259772 2446337 2396410 2068160 9179750 19350429 17140732 2209697 100 569 4157 3861 7068 15755 19366184 0.11410 0.11810 X THIS STATEMENT IS ATTACHED IN ACCORDANCE WITH THE INSTRUCTIONS FOR SCHEDULE A (FORM 990) REGARDING AN ORGANIZATION THAT BELIEVES IT IS PUBLICLY SUPPORTED ACCORDING TO APPLICABLE REGULATIONS. TREAS. REG. SEC. 1.170A-9(F)(3) PROVIDES THAT AN ORGANIZATION MAY BE TREATED AS "PUBLICLY SUPPORTED" UNDER THE FACTS AND CIRCUMSTANCES TEST EVEN IF IT FAILS TO MEET THE 33 1/3 PERCENT MECHANICAL TEST. UNDER THE FACTS AND CIRCUMSTANCES TEST, AN ORGANIZATION WILL BE TREATED AS PUBLICLY SUPPORTED IF IT NORMALLY RECEIVES A SUBSTANTIAL PART OF ITS SUPPORT FROMGOVERNMENTAL UNITS, FROM DIRECT OR INDIRECT CONTRIBUTIONS FROM THE GENERAL PUBLIC, OR FROM A COMBINATION OF THESE SOURCES, AND MEETS CERTAIN OTHER REQUIREMENTS. THE PERTINENT FACTORS SET FORTH IN THE REGULATIONS ARE DISCUSSED BELOW:I) ATTRACTION OF PUBLIC SUPPORTOMEGA MEDICAL GRANTS ASSOCIATION ("OMEGA") IS ORGANIZED AND OPERATED TO ATTRACT NEW AND ADDITIONAL PUBLIC SUPPORT ON A CONTINUOUS BASIS. OMEGA MAINTAINS A CONTINUOUS AND BONA FIDE PROGRAM FOR SOLICITATION OF FUNDS FROM THE GENERAL PUBLIC INCLUDING CORPORATE CONTRIBUTORS IN THE AREAS OF MEDICAL TECHNOLOGY, PHARMACEUTICAL AND BIOTECHNOLOGY PRODUCTS.II) PERCENTAGE OF FINANCIAL SUPPORTUNDER THE REGULATIONS, THE HIGHER THE PERCENTAGE OF SUPPORT ABOVE THE 10% REQUIREMENT FROM PUBLIC SOURCES THE LESSER WILL BE THE BURDEN OF ESTABLISHING THE PUBLICLY SUPPORTED NATURE OF THE ORGANIZATION THROUGH OTHER FACTORS. THE PERCENTAGE OF SUPPORT RECEIVED FROM THE GENERAL PUBLIC FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019 IS 11.14% AND 11.81%, RESPECTIVELY.III) SOURCES OF SUPPORTOMEGA EXCEEDS THE 10% MINIMUM THRESHOLD BY DERIVING SUPPORT FROM NUMEROUS UNRELATED CORPORATE CONTRIBUTORS, RATHER THAN RECEIVING ALMOST ALL OF ITS SUPPORT FROM THE MEMBERS OF A SINGLE FAMILY. OMEGA'S ACTIVITIES APPEAL TO A BROAD CROSS-SECTION OF PERSONS NATIONWIDE WHO ARE INTERESTED IN SUPPORTING THE ORTHOPAEDIC FELLOWSHIP PROGRAM, THE FOUNDATIONAL COMPONENTS OF ORTHOPAEDIC PRACTICE AND PROFESSIONALISM. OMEGA DOES NOT LIMIT ITS ACTIVITIES TO A PARTICULAR COMMUNITY, LIMITED GROUP, OR REGION AND MAINTAINS A TRANSPARENT, CONFLICT-FREE, ARMS-LENGTH PROCESS FOR DETERMINING GRANT RECIPIENTS BASED UPON A MERIT-BASED APPROACH.IV) REPRESENTATIVE GOVERNING BODYOMEGA HAS A GOVERNING BODY REPRESENTATIVE OF THE BROAD INTERESTS OF THE PUBLIC, HAVING SPECIAL KNOWLEDGE OR EXPERTISE IN THE PARTICULAR FIELD IN WHICH THE ORGANIZATION OPERATES.V) AVAILABILITY OF PUBLIC FACILITIES OR SERVICES; PUBLIC PARTICIPATIONIN PROGRAMS OR POLICIESOMEGA PROVIDES SERVICES DIRECTLY FOR THE BENEFIT OF THE GENERAL PUBLIC ON A CONTINUING BASIS, INCLUDING AWARDING AND ADMINISTERING GRANTS FOR GRADUATE ORTHOPAEDIC MEDICAL EDUCATION THROUGH AN OPEN, ACCESSIBLE PROCESS DESIGNED TO SAFEGUARD AGAINST POTENTIAL CONFLICTS OF INTEREST AND TO ENSURE TRANSPARENCY IN THE ALLOCATION OF RESOURCES. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6524 4615 1909 1909 X 10095451 0 10095451 0 10095451 8223103 0 8223103 0 8223103 PART X, LINE 2: THE ASSOCIATION IS RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX BY THE INTERNAL REVENUE SERVICE (IRS) PURSUANT TO THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3). THE ASSOCIATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A)(VI) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(1). THE ASSOCIATION CONTINUES TO OPERATE IN COMPLIANCE WITH ITS TAX EXEMPT PURPOSE. THE ASSOCIATION HAS DETERMINED THAT IT DOES NOT HAVE UNCERTAIN TAX POSITIONS AND, THEREFORE, HAS NOT RECORDED A LIABILITY FOR ANY UNRECOGNIZED TAX BENEFITS. 1 MASSACHUSETTS GENERAL HOSPITAL 55 FRUIT ST YAWKEY 3B BOSTON MA 02114 041564655 501(C)(3) 440000 FELLOWSHIPS BRIGHAM AND WOMEN'S HOSPITAL 75 FRANCIS ST BOSTON MA 02115 042312909 501(C)(3) 100000 FELLOWSHIPS ORTHOPEDIC CLINICAL ASSOCIATES INC 91 PARKER HILL AVE BOSTON MA 02120 042562362 501(C)(3) 70000 FELLOWSHIPS BOSTON CHILDREN'S HOSPITAL (PEDIATRICS) 300 LONGWOOD AVE BOSTON MA 02115 042943146 501(C)(3) 38000 FELLOWSHIPS BOSTON CHILDREN'S HOSPITAL-DIVISION OF SPORTS MEDICINE 401 PARK DRIVE SUITE 602 BOSTON MA 02215 042970129 501(C)(3) 52000 FELLOWSHIPS NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING THE HOSP 535 EAST 70TH STREET NEW YORK NY 10021 131624135 501(C)(3) 467400 FELLOWSHIPS SLOAN-KETTERING INSTITUTE FOR CANCER RESEARCH 1275 YORK AVENUE NEW YORK NY 10065 131624182 501(C)(3) 75000 FELLOWSHIPS NYU SCHOOL OF MEDICINE PO BOX 415026 BOSTON MA 02241 135562308 501(C)(3) 312400 FELLOWSHIPS ICAHN SCHOOL OF MEDICINE 5 EAST 98TH STREET 9TH FLOOR BOX 1188 NEW YORK NY 10029 136171197 501(C)(3) 55000 FELLOWSHIPS UNIVERSITY OF ROCHESTER DEPARTMENT OF ORTHOPAEDIC SURGERY 601 ELMWOOD AVE BOX 665 ROSHESTER NY 14642 160743209 501(C)(3) 75000 FELLOWSHIPS TRIA ORTHOPAEDIC CENTER 8100 NORTHLAND DRIVE BLOOMINGTON MN 55431 200033919 501(C)(3) 52000 FELLOWSHIPS THE ORTHOPAEDIC FOUNDATION (THE ROTHMAN INSTITUTE) 125 S 9TH STREET SHERIDAN BUILDING SUITE 1000 PHILADELPHIA PA 19107 222620085 501(C)(3) 210000 FELLOWSHIPS HAND REHABILITATION FOUNDATION 120 HUNTINGDON PIKE SUITE 100 ROCKLEDGE PA 19046 232000134 501(C)(3) 60000 FELLOWSHIPS PENN STATE UNIVERSITY COLLEGE OF MEDICINE (F&A AND TRAUMA) 500 UNIVERSITY DRIVE MC230 HERSHEY PA 17033 246000376 501(C)(3) 110000 FELLOWSHIPS CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER 3333 BURNET AVE CINCINNATI OH 45229 310833936 501(C)(3) 32000 FELLOWSHIPS THE OHIO STATE UNIVERSITY FDN 376 W 10TH AVE COLUMBUS OH 43210 311145986 501(C)(3) 85750 FELLOWSHIPS ORTHOPAEDIC SPECIALTY INSTITUTE (HOAG HOSPITAL FOUNDATION) (AR & SPINE) 280 S MAIN STREET ORANGE CA 92686 330905995 501(C)(3) 58000 FELLOWSHIPS CLEVELAND CLINIC FOUNDATION 9500 EUCLID AVE CLEVELAND OH 44195 340714585 501(C)(3) 115000 FELLOWSHIPS VANDERBILT UNIVERSITY MED CTR DEPT 1236 PO BOX 121236 DALLAS TX 75312 352528741 501(C)(3) 293000 FELLOWSHIPS INDIANA UNIVERSITY LOWER EXTREMITY ADULT RECONSTRUCTION FELLOWSHIP PO BOX 66057 INDIANAPOLIS IN 46266 356001673 501(C)(3) 70000 FELLOWSHIPS NORTHSHORE UNIVERSITY HEALTHSYSTEM 1033 UNIVERSITY PLACE SUITE 450 EVANSTON IL 60201 362167060 501(C)(3) 48000 FELLOWSHIPS RUSH UNIVERSITY MEDICAL CENTER (AR) 1700 W VAN BUREN CHICAGO IL 60657 362174823 501(C)(3) 135000 FELLOWSHIPS BEAUMONT HEALTH FOUNDATION 3535 W 13 MILE ROAD SUITE 744 ROYAL OAK MI 48073 364852171 501(C)(3) 70000 FELLOWSHIPS REGENTS OF THE UNIVERSITY OF MINNESOTA 200 OAK ST SE MINNEAPOLIS MI 55455 416007513 501(C)(3) 188000 FELLOWSHIPS MAYO CLINIC ROCHESTER 200 FIRST STREET SW ROCHESTER MN 55905 416011702 501(C)(3) 352250 FELLOWSHIPS WASHINGTON UNIVERSITY 700 ROSEDALE AVENUE ST LOUIS MO 63112 430653611 501(C)(3) 410000 FELLOWSHIPS THE CURATORS OF THE UNIVERSITY OF MISSOURI 115 BUSINESS LOOP 70W MIZZOU NORTH ROOM 501 COLUMBIA MO 65211 436003859 501(C)(3) 110000 FELLOWSHIPS SINAI HOSPITAL OF BALTIMORE INC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 520486540 501(C)(3) 58000 FELLOWSHIPS UNION MEMORIAL HOSPITAL 201 EUNIVERSITY PKY BALTIMORE MD 21218 520591685 501(C)(3) 200900 FELLOWSHIPS JOHNS HOPKINS UNIVERSITY SOM 3910 KESWICK ROAD N4327B BALTIMORE MD 21211 520595110 501(C)(3) 102200 FELLOWSHIPS UNIVERSITY OF MARYLAND MEDICAL SYSTEM FOUNDATION 110 S PACA STREET BALTIMORE MD 21201 522238893 501(C)(3) 100000 FELLOWSHIPS CARILION MEDICAL CENTER 1906 BELLEVIEW AVE ROANOKE VA 24014 540506332 501(C)(3) 97280 FELLOWSHIPS ANDERSON CLINIC POST-GRADUATE MEDICAL EDUCATION FOUNDATION PO BOX 7088 ALEXANDRIA VA 22307 541632197 501(C)(3) 65000 FELLOWSHIPS UNIVERSITY OF VIRGINIA DEPARTMENT OF ORTHOPAEDIC SURGERY FOOT AND ANKLE FEL PO BOX 400195 CHARLOTTESVILLE VA 22904 546001796 501(C)(3) 87000 FELLOWSHIPS WEST VIRGINIA UNIVERSITY RESEARCH CORPORATION PO BOX 6005 MORGANTOWN WV 26506 550665758 501(C)(3) 65000 FELLOWSHIPS DUKE UNIVERSITY (AR AND F&A) DUMC BOX 3000 DURHAM NC 27710 560532129 501(C)(3) 75000 FELLOWSHIPS ORTHOCAROLINA (AR) 2001 VAIL AVENUE CHARLOTTESVILLE NC 28207 561093722 501(C)(3) 72000 FELLOWSHIPS UNIV OF NORTH CAROLINA - CH 102 MASON FARM RD 2ND FLOOR CHAPEL HILL NC 27599 566001393 501(C)(3) 20000 FELLOWSHIPS ATRIUM HEALTH FOUNDATION PO BOX 32861 CHARLOTTESVILLE NC 28232 566060481 501(C)(3) 75000 FELLOWSHIPS EMORY UNIVERSITY 59 EXECUTIVE PARK SOUTH ATLANTA GA 30329 580566256 501(C)(3) 70000 FELLOWSHIPS THE HUGHSTON FOUNDATION INC PO BOX 9517 COLUMBUS GA 31908 581354127 501(C)(3) 35000 FELLOWSHIPS UNIVERSITY OF MIAMI 1120 NW 14TH ST SUITE 1259 MIAMI FL 33136 590624458 501(C)(3) 58000 FELLOWSHIPS FOUNDATION FOR ORTHOPAEDIC RESEARCH AND EDUCATION (AR) 13020 N TELECOM PARKWAY TAMPA FL 33637 593555349 501(C)(3) 55000 FELLOWSHIPS UNIVERSITY OF FLORIDA 207 GRINTER HALL PO BOX 115500 GAINESVILLE FL 32611 596002052 501(C)(3) 235000 FELLOWSHIPS UNIVERSITY OF LOUISVILLE (FOUNDATION) DEPARTMENT OF ORTHOPAEDIC SURGERY 550 S JACKSON ST- ACB LOUISVILLE KY 40292 611029626 501(C)(3) 65000 FELLOWSHIPS THE CAMPBELL FOUNDATION 1400 S GERMANTOWN ROAD GERMANTOWN TN 38138 620548038 501(C)(3) 147000 FELLOWSHIPS UNIVERSITY OF ALABAMA AT BIRMINGHAM (F&A) 1313 13TH STREET SOUTH BIRMINGHAM AL 35205 636005396 501(C)(3) 60000 FELLOWSHIPS UTHEALTH (UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON) (TRAUMA) P O BOX 301418 DALLAS TX 75303 741761309 501(C)(3) 195000 FELLOWSHIPS TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN 2222 WELBORN STREET DALLAS TX 75219 750818178 501(C)(3) 32000 FELLOWSHIPS BAYLOR HEALTH CARE SYSTEM FOUNDATION (F&A) 3600 GASTON AVE SUITE 100 DALLAS TX 75246 751606705 501(C)(3) 68000 FELLOWSHIPS TEXAS EDUCATION & RESEARCH FOUNDATION FOR SHOULDER & ELBOW SURGERY 7401 S MAIN STREET HOUSTON TX 77030 821438713 501(C)(3) 50000 FELLOWSHIPS CINCINNATI SHOULDER & ELBOW RESEARCH & EDUCATION FOUNDATION 4701 CREEK RD 110 CINCINNATI OH 45242 822840237 501(C)(3) 35000 FELLOWSHIPS UNIVERSITY OF COLORADO DENVER PO BOX 910238 DENVER CO 80291 846000555 501(C)(3) 106000 FELLOWSHIPS UNIVERSITY OF UTAH 590 WAKARA WAY SALT LAKE CITY UT 84108 876000525 501(C)(3) 58000 FELLOWSHIPS MUSCULOSKELETAL ORGANIZATION FOR RESEARCH AND EDUCATION 555 NORTH ARLINGTON AVE RENO NV 89523 880278047 501(C)(3) 83000 FELLOWSHIPS UNIVERSITY OF WASHINGTON 12455 COLLECTIONS DRIVE CHICAGO IL 60693 916001537 501(C)(3) 110000 FELLOWSHIPS STANFORD UNIVERSITY SCHOOL OF MEDICINE 450 BROADWAY STREET REDWOOD CITY CA 94063 941156365 501(C)(3) 132000 FELLOWSHIPS SAN FRANCISCO GENERAL HOSPITAL FOUNDATION PO BOX 410836 SAN FRANCISCO CA 94141 943189424 501(C)(3) 70000 FELLOWSHIPS REGENTS OF THE UNIVERSITY OF CALIFORNIA SAN FRANCISCO (ARSPINESPORTS) 1855 FOLSOM STREET SAN FRANCISCO CA 94143 946036493 501(C)(3) 50000 FELLOWSHIPS REGENTS OF THE UNIV CA DAVIS PO BOX 989062 WEST SACRAMENTO CA 95798 946036494 501(C)(3) 100000 FELLOWSHIPS CHILDREN'S HOSPITAL LOS ANGELES 4650 SUNSET BLVD MS97 LOS ANGELES CA 90027 951690977 501(C)(3) 25100 FELLOWSHIPS CHILDREN'S SPECIALISTS OF SAN DIEGO AMGRADY CHILDREN'S HOSPITAL 3020 CHILDRENS WAY MC 5062 SAN DIEGO CA 92123 953255175 501(C)(3) 43000 FELLOWSHIPS KERLAN JOBE ORTHOPAEDIC FOUNDATION 6801 PARK TERRACE SUITE 140 LOS ANGELES CA 90045 954707606 501(C)(3) 52000 FELLOWSHIPS UNIVERSITY OF CALIFORNIA SAN DIEGO (AR AND SPINE) 200 W ARBOR DRIVE 8894 SAN DIEGO CA 92103 956006144 501(C)(3) 35000 FELLOWSHIPS MONTEFIORE MEDICAL CENTER 1250 WATERS PLACE 11TH FLOOR BRONX NY 10461 131740114 501(C)(3) 12000 FELLOWSHIPS VIRTUA W JERSEY HEALTH SYSTEM 303 LIPPINCOTT DRIVE 4TH FLOOR FOUNDATION MARLTON NJ 08053 210634532 501(C)(3) 39800 FELLOWSHIPS UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER 11100 EUCLID AVE MCCO-5062 CLEVELAND OH 44106 341567805 501(C)(3) 43000 FELLOWSHIPS BAPTIST HEALTH SOUTH FL FOUNDATION 6855 RED ROAD SUITE 600 CORAL GABLES FL 33146 591923401 501(C)(3) 65000 FELLOWSHIPS FLORIDA ORTHOPAEDIC INSTITUTE 13020 N TELECOM PARKWAY TAMPA FL 33637 592929608 501(C)(3) 130000 FELLOWSHIPS UNIVERSITY OF TEXAS AT AUSTIN 1701 TRINITY STREET STOP Z0800 AUSTIN TX 78712 746000203 501(C)(3) 65000 FELLOWSHIPS PRISMA HEALTH - UPSTATE 605 GROVE ROAD GREENVILLE SC 29605 811723202 501(C)(3) 26550 FELLOWSHIPS TCO FOUNDATION 4010 WEST 65TH STREET EDINA MN 55435 830435069 501(C)(3) 30000 FELLOWSHIPS DENVER HEALTH 777 BANNOCK ST MC0188 DENVER CO 80204 841343242 501(C)(3) 35000 FELLOWSHIPS SWEDISH MEDICAL CENTER FOUNDATION 747 BROADWAY SEATTLE WA 98122 910983214 501(C)(3) 24000 FELLOWSHIPS UNIVERSITY OF SOUTHERN CALIFORNIA UNIVERSITY PARK CAMPUS UGB 102 LOS ANGELES CA 90089 951642394 501(C)(3) 50000 FELLOWSHIPS UC REGENTS 10833 LE CONTE AVENUE LOS ANGELES CA 90095 956006143 501(C)(3) 48000 FELLOWSHIPS 76 0 PART I, LINE 2: PROGRAMS THAT ARE AWARDED GRANTS THROUGH THE MERIT-BASED APPLICATION REVIEW PROCESS ARE REQUIRED TO PROVIDE OMEGA WITH THREE REPORTS REGARDING THE USE OF FUNDS PROVIDED BY OMEGA. ACCEPTANCE OF THE GRANT AND USE OF THE FUNDS IS CONDITIONAL UPON RECIPIENT'S TIMELY, ACCURATE, AND THOROUGH COMPLETION OF ALL INFORMATION FIELDS REQUESTED IN ONLINE REPORTING REQUIRED BY OMEGA. THIS REPORTING INCLUDES THE USE OF FUNDS SUMMARY, COPIES OF RECEIPTS AND A SUMMARY OF SUPPORTED ACTIVITIES INCLUDING RESEARCH, PRESENTATIONS AND PROCEDURES PERFORMED. X X X 0 0 0 0 0 0 0 0 0 KRISTIN OLDS GLAVIN ESQ EXECUTIVE DIRECTOR 34023 340226 0 32143 0 0 3402 37237 0 19278 37425 428884 0 0 RHONDA TAIRA MANAGING DIRECTOR 170381 0 3500 0 0 0 17232 0 863 0 191976 0 0 0 PART I, LINE 3 THE EXECUTIVE DIRECTOR IS AN EMPLOYEE OF THE AMERICAN ORTHOPAEDIC ASSOCATION (AOA), WHICH IS THE SOLE MEMBER OF OMEGA. COMPENSATION IS ESTABLISHED BY WRITTEN CONTRACT AND REVIEWED BY AN AOA COMPENSATION COMMITTEE (TOP ELECTED LEADERSHIP). CONTRACTUAL PARAMETERS FOR COMPENSATION HAVE BEEN REVIEWED BY OUTSIDE COUNSEL TO ASSURE COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILAR ORGANIZATIONS AND ADDITIONALLY COMPENSATION SURVEYS ARE REVIEWED ANNUALLY. COMPENSATION COMMITTEE REVIEWS AND ADJUSTS ANNUALLY BASED ON CONTRACTUAL PARAMETERS. FORM 990, PART V, LINE 2A: THE ORGANIZATION IS ADMINISTERED BY STAFF PROVIDED BY THE AMERICAN ORTHOPAEDIC ASSOCIATION, THE ORGANIZATION'S SOLE MEMBER. ALL EXPENSES RELATED TO SUCH STAFFING ARE REIMBURSED BY THE ORGANIZATION TO THE AMERICAN ORTHOPAEDIC ASSOCIATION. FORM 990, PART VI, SECTION A, LINE 6 AMERICAN ORTHOPAEDIC ASSOCIATION IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A AMERICAN ORTHOPAEDIC ASSOCIATION EXECUTIVE COMMITTEE APPOINTS THE BOARD OF DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE FULL BOARD OF DIRECTORS BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST FORMS ARE COMPLETED ANNUALLY. IN ADDITION, STAFF ANNUALLY CHECKS DISCLOSURE BY CONTRIBUTING ORGANIZATIONS AND FOLLOWS UP WITH ANY INDIVIDUALS FOR FURTHER EXPLANATIONS, AS NECESSARY. FORM 990, PART VI, SECTION B, LINE 15A AMERICAN ORTHOPAEDIC ASSOCIATION, A RELATED PARTY, DETERMINES COMPENSATION USING THE FOLLOWING METHOD. COMPENSATION PROCESS FOR TOP OFFICIAL IS ESTABLISHED BY WRITTEN CONTRACT AND REVIEWED BY COMPENSATION COMMITTEE (TOP ELECTED LEADERSHIP). CONTRACTUAL PARAMETERS FOR COMPENSATION REVIEWED BY OUTSIDE COUNSEL TO ASSURE COMPARABLE COMPENSATION FOR SIMILIARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITION AT SIMILAR ORGANIZATIONS. COMPENSATION COMMITTEE REVIEWS AND ADJUSTS ANNUALLY BASED ON CONTRACTUAL PARAMETERS. OMEGA UTILIZIES THIS COMPENSATION DETERMINATION PROCESS BY AGREEING TO PAY A PERCENTAGE OF THE TOTAL COMPENSATION AS DETERMINED BY AMERICAN ORTHOPAEDIC ASSOCIATION, FOR WORK DONE FOR OMEGA. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S OFFICE. PAGE 12, FORM 990, PART XII, LINE 2C THE ORGANIZATION'S BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT ACCOUNTANT AND THE OVERSIGHT OF ITS ANNUAL AUDIT. THIS PROCESS WAS NOT CHANGED DURING THE YEAR. FORM 990, PART VIII, LINE 1D DURING 2020, THE AMERICAN ORTHOPAEDIC ASSOCIATION (AOA) RECEIVED A LOAN THAT WAS FORGIVEN THROUGH THE PAYCHECK PROTECTION PROGRAM (PPP). OF THIS AMOUNT, $54,000 WAS ALLOCATED TO OMEGA TO COVER THE PROPORTIONATE SHARE OF RELATED PAYROLL COSTS THAT ARE ELIGIBLE UNDER THE PROGRAM. AMERICAN ORTHOPAEDIC ASSOCIATION 9400 W HIGGINS RD STE 205 ROSEMONT IL 60018 136118458 SEE PART VII IL 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 THE AMERICAN ORTHOPAEDIC ASSOCIATION S 54000 FMV SCHEDULE R, PART II, COLUMN (B) ENGAGING THE ORTHOPAEDIC COMMUNITY TO DEVELOP LEADERS, STRATEGIES, AND RESOURCES TO GUIDE THE FUTURE OF MUSCULOSKELETAL CARE. SCHEDULE R, PART V, LINE 2 (1) DURING 2020, AOA RECEIVED A LOAN THAT WAS FORGIVEN THROUGH THE PAYCHECK PROTECTION PROGRAM (PPP). OF THIS AMOUNT, $54,000 WAS ALLOCATED TO OMEGA TO COVER THE PROPORTIONATE SHARE OF RELATED PAYROLL COSTS THAT ARE ELIGIBLE UNDER THE PROGRAM. AOA ADMINISTERS THE ELIGIBLE PAYROLL AND BENEFIT COSTS FOR OMEGA STAFF.