2021-11-13T18:52:33-06:00 2020-12-31 420714325 RSM US LLP 2021 L STREET NW SUITE 400 WASHINGTON DC 20036 990 2020-01-01 860307698 AMBULATORY SURGERY FOUNDATION AMBU 7038368808 1012 CAMERON ST ALEXANDRIA VA 22314 WILLIAM PRENTICE CHIEF EXECUTIVE OFFICER 7038368808 2021-11-12 1 WILLIAM PRENTICE 999009999 FREDERICK LONGWOOD P00439715 2022932200 2021-11-12 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z ASCA FOUNDATION WILLIAM PRENTICE 1012 CAMERON ST ALEXANDRIA VA 22314 2635430 0 X WWW.ASCASSOCIATION.ORG X 2006 AZ TO PROVIDE EDUCATION AND TRAINING FOR AMBULATORY SURGERY CENTER PROFESSIONALS. 16 16 24 96 0 0 0 0 3279092 1405597 11496 -3677 764578 746761 4055166 2148681 0 0 0 0 1147442 1051951 0 0 0 2581312 1066557 3728754 2118508 326412 30173 6148251 5893368 1643166 1188317 4505085 4705051 X THE ASCA FOUNDATION IS AN EDUCATIONAL ORGANIZATION THAT:- PROMOTES THE HIGHEST STANDARDS FOR ASCS.- CONDUCTS EDUCATIONAL PROGRAMS.- PRODUCES PUBLICATIONS TO EDUCATE ASC PROFESSIONALS AND THE PUBLIC. 0 1 788370 896044 ANNUAL CONFERENCE: CONDUCTS AN ANNUAL CONFERENCE FOR THE AMBULATORY SURGERY CENTER COMMUNITY WITH WORKSHOPS AND VARIOUS OTHER INFORMATIVE EDUCATIONAL SESSIONS, EVENTS AND EXHIBITS. 429975 493739 SEMINARS AND WEBINARS: EDUCATIONAL SEMINARS, WEBINARS AND ONLINE TRAINING SERIES PROVIDED TO THE AMBULATORY SURGERY COMMUNITY TO ASSIST IN THEIR ABILITY TO PROVIDE QUALITY AMBULATORY SURGERY SERVICES IN A COST-EFFECTIVE MANNER. 67279 0 OUTREACH. COMMUNICATES INFORMATION ABOUT DEVELOPMENTS AFFECTING AMBULATORY SURGERY CENTERS (ASC) TO THE ASC COMMUNITY AND PUBLIC. 20718 15804 PUBLICATIONS AND SURVERYS. PROIDES THE ASC COMMUNITY WITH A VARIETY OF DIGITAL AND PRINT PUBLICATIONS. 20718 15804 1306342 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 17 0 1 24 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 X THE ORGANIZATION 7038368808 1012 CAMERON ST ALEXANDRIA VA 22314 LARRY TAYLOR IMMEDIATE PAST PRESIDENT 2.00 2.00 X X 0 0 0 KECIA NORLING VICE PRESIDENT (UNTIL 5/20) 0.50 0.50 X X 0 0 0 ANN SHIMEK SECRETARY (UNTIL 11/20) 0.50 0.50 X X 0 0 0 REBECCA CRAIG IMMEDIATE PAST PRESIDENT (UNTIL 5/20) 1.00 1.00 X X 0 0 0 LISA AUSTIN SECRETARY 1.50 1.50 X X 0 0 0 JANIE KINSEY VICE PRESIDENT 1.00 1.00 X X 0 0 0 MICHAEL J PATTERSON PRESIDENT 1.00 1.00 X X 0 0 0 MARK WAINNER TREASURER 0.50 0.50 X X 0 0 0 LINDA NASH BOARD MEMBER 1.00 1.00 X 0 0 0 JOLEEN HARRISON BOARD MEMBER (AS OF 5/20) 1.00 1.00 X 0 0 0 GARY A RICHBERG BOARD MEMBER (AS OF 5/20) 1.00 1.00 X 0 0 0 SANDY BERRETH BOARD MEMBER (UNTIL 5/20) 0.50 0.50 X 0 0 0 LAWRENCE BRUNO BOARD MEMBER (UNTIL 1/2020) 0.30 0.30 X 0 0 0 TOM DEAS JR BOARD MEMBER (UNTIL 5/20) 0.80 0.80 X 0 0 0 MARIE EDLER BOARD MEMBER 1.00 1.00 X 0 0 0 DAVID SHAPIRO BOARD MEMBER (AS OF 5/20) 1.00 1.00 X 0 0 0 AMANDA HAWKINS BOARD MEMBER 1.00 1.00 X 0 0 0 JULIE LEWIS BOARD MEMBER 0.50 0.50 X 0 0 0 GREG MILLER BOARD MEMBER 0.50 0.50 X 0 0 0 STANFORD R PLAVIN BOARD MEMBER 0.25 0.25 X 0 0 0 STUART B SIMON BOARD MEMBER 0.75 0.75 X 0 0 0 DAVID WEINSTEIN BOARD MEMBER 0.50 0.50 X 0 0 0 JOHN GREENWICH CHIEF FINACIAL OFFICER 12.00 28.00 X 110331 257440 13583 WILLIAM PRENTICE CHIEF EXECUTIVE OFFICER 4.00 36.00 X 69497 625473 31996 GINA THORNEBERRY DIRECTOR OF EDU. & CLINICA 30.50 9.50 X 130146 40537 8686 KAY TUCKER DIRECTOR OF COMMUNICATIONS 0.50 39.50 X 2520 199062 12684 SHAWN BRYANT DIRECTOR OF MEETINGS 40.00 X 108984 0 8686 421478 1122512 75635 10 0 1 0 BLUE HOUSE SALES GROUP LLC 1835 7TH STREET NW 210 WASHINGTON DC 20001 SALES COMMISSION 188749 FREEMAN PO BOX 734596 DALLAS TX 75373 PLATFORM SERVICES 128455 2 ANNUAL CONFERENCE 896044 526691 369353 SEMINARS 900099 493749 493749 PUBLICATION SALES 900099 15804 15804 1405597 28326 28326 114312 114312 177600 49537 128063 128063 128063 405209 437212 -32003 -32003 -32003 MANAGEMENT SERVICES 561000 495922 495922 MISCELLANEOUS INCOME 900099 8464 8464 504386 2148681 1532166 0 616515 326549 326549 540071 540071 62879 62879 66707 66707 55745 55745 1119 1119 56133 56133 10569 10569 86252 46868 39384 9598 5408 4190 73016 20120 52896 27626 15567 12059 1648 1648 65792 10994 54798 30184 18416 11768 205031 200423 4608 5212 5212 179949 101399 78550 17410 877 16533 COMMISSIONS 172923 172923 OTHER EXPENSES 93637 81255 12382 HONORARIA 22350 22350 TAXES AND FEES 5467 5467 2641 608094 -605453 2118508 1306342 812166 0 86654 126674 1417315 494819 43964 39234 194427 556334 3881413 1615947 2410510 2265466 794280 1193404 1201101 1217437 6148251 5893368 548459 497247 953226 615144 141481 75926 1643166 1188317 X 4505085 4705051 4505085 4705051 6148251 5893368 30173 169793 0 X X 0 1 X 1 0 X 201 17697 17898 3039293 3404874 3399096 3808894 1901519 15553676 3039494 3404874 3416793 3808894 1901519 15571574 0 0 0 15571574 181309 263763 289655 308947 320238 1363912 181309 263763 289655 308947 320238 1363912 3733 4245 5865 19692 8464 41999 3224536 3672882 3712313 4137533 2230221 16977485 0.91720 0.93090 0.08030 0.06710 X 383713 383713 2174374 849365 1325009 802922 360276 442646 241011 214587 26424 279393 191719 87674 2265466 DUE FROM ASC ASSOCIATION 991844 ORGANIZATIONAL COST 100 DEFERRED 457(B) PLAN ASSET 219036 DUE FROM ASC QUALITY COLLABORATION 3976 DUE FROM BOARD OF AMBULATORY SURGER 2481 1217437 2357442 169793 49537 219330 2138112 10569 10569 2148681 2157476 49537 49537 2107939 10569 10569 2118508 PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED WITH REVENUE 49,537. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NETTED WITH REVENUE 49,537. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 WILLIAM PRENTICE CHIEF EXECUTIVE OFFICER 55547 499925 0 0 13950 125548 0 0 3200 28796 72697 654269 0 0 JOHN GREENWICH CHIEF FINACIAL OFFICER 101971 237932 1536 3584 6824 15924 0 0 4075 9508 114406 266948 0 0 KAY TUCKER DIRECTOR OF COMMUNICATIONS 2236 176661 19 1503 265 20898 0 0 159 12525 2679 211587 0 0 GINA THORNEBERRY DIRECTOR OF EDU. & CLINICA 128710 40090 1161 361 275 86 0 0 6623 2063 136769 42600 0 0 PART I, LINE 4B WILLIAM PRENTICE $117,905 457(F) DEFERRED COMPENSATION DISTRIBUTION; STEVE MILLER $89,133.39 457(B) DEFERRED COMPENSATION DISTRIBUTION FORM 990, PART I, ITEM C DBA: ASCA FOUNDATION FORM 990, PART III, LINE 3 DUE TO COVID-19 PANDEMIC, THE ASC FOUNDATION SWITCHED FROM AN IN-PERSON ANNUAL CONFERNECE TO A VIRTUAL ANNUAL CONFERENCE. FORM 990, PART VI, SECTION A, LINE 7A ALL MEMBERS OF THE FOUNDATION'S BOARD OF DIRECTORS ARE APPOINTED BY THE AMBULATORY SURGERY CENTER ASSOCIATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOUNDATION'S BYLAWS, AND ANY PROPOSED AMENDMENTS THERETO, ARE SUBJECT TO THE APPROVAL OF THE AMBULATORY SURGERY CENTER ASSOCIATION'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT THOROUGHLY REVIEWS THE DRAFT 990, AND IS REQUIRED TO PROVIDE THE BOARD OF DIRECTORS WITH A COMPLETE COPY OF THE 990 AT LEAST FIVE DAYS PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS REVIEW AND SIGN A DISCLOSURE OF CONFLICT DOCUMENT AT THE ANNUAL CONFERENCE. FORM 990, PART VI, SECTION B, LINE 15A A CUSTOMIZED SALARY AND BENEFITS REPORT WAS PREPARED BY CEO UPDATE IN MAY 2020. THE FOUNDATION BOARD OF DIRECTORS APPROVED THE SALARY AND BENEFITS OF THE CHIEF EXECUTIVE OFFICER FOR 2021-2026 AFTER REVIEWING INFORMATION ON OTHER SIMILARLY SITUATED ASSOCIATION EXECUTIVES, PERFORMANCE DATA, AND INPUT FROM A COMPENSATION COMMITTEE MADE UP OF THE OFFICERS OF THE FOUNDATION'S BOARD AND THE BOARD OF DIRECTORS OF THE AMBULATORY SURGERY CENTER ASSOCIATION, WHICH SHARES EMPLOYEES WITH THE FOUNDATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: IN 2011, THE FOUNDATION ESTABLISHED AN AUDIT COMMITTEE TO OVERSEE THE AUDIT PROCESS AND RESULTS. THE AUDIT COMMITTEE IS COMPRISED OF THREE BOARD MEMBERS. 1012 CAMERON LLC 1012 CAMERON STREET ALEXANDRIA VA 22314 TITLE HOLDER - LEASES BUILDING TO FOUNDATION. VA 177600 2352074 AMBULATORY SURGERY FOUNDATION AMBULATORY SURGERY CENTER ASSOCIATION 1012 CAMERON STREET ALEXANDRIA VA 22314 202266365 TO ASSIST AMBULATORY SURGERY CENTERS IN DELIV- ERING HIGH-QUALITY CARE VA 501(C)(6) N/A 0 AMBULATORY SURGERY CENTER ASSOCIATION POLITICAL ACTION COMMITTEE 1012 CAMERON STREET ALEXANDRIA VA 22314 TO PROMOTE THE LEGISLATIVE INTERESTS OF AMBULATORY SURGERY CENTERS VA 527 ASCA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 AMBULATORY SURGERY CENTER ASSOCIATION N 263766 CASH AMBULATORY SURGERY CENTER ASSOCIATION O 2654707 CASH AMBULATORY SURGERY CENTER ASSOCIATION Q 522411 CASH