2020-09-01T15:21:08-05:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 1301 WEST 22ND STREET SUITE 1100 OAK BROOK IL 60523 990 2019-01-01 270383913 OMEGA MEDICAL GRANTS ASSOCIATION OMEG 8473187482 9400 W HIGGINS ROAD NO 205 ROSEMONT IL 60018 KEVIN P BLACK MD PRESIDENT 8473187482 2020-08-20 1 JAMES R THOMAS P00095586 6305738600 2020-08-19 67.137.57.251 2020-08-20 11:24:25 CD P EA1A32499A0D1F25B9B4EBEAB70BC401AE8DEE75 8A84A6FA9340272F3455BE20DA9A7FE385B25F7F 2019 2020-11-06 18:47:13Z KEVIN P BLACK MD 9400 W HIGGINS ROAD NO 205 ROSEMONT IL 60018 2417581 0 X WWW.OMEGAMEDICALGRANTS.ORG X 2010 IL OMEGA MEDICAL GRANTS ASSOCIATION AWARDS AND ADMINISTERS GRANTS FOR GRADUATE ORTHOPAEDIC MEDICAL EDUCATION. 8 8 0 20 0 0 2396410 2068160 404437 345560 4157 3861 0 0 2805004 2417581 2496531 2205860 0 0 350409 378758 0 0 0 83692 75592 2930632 2660210 -125628 -242629 2662972 2309415 1346359 1235431 1316613 1073984 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 2606030 2205860 345560 FINANCIAL SUPPORT OF ORTHOPAEDIC FELLOWSHIP. THE MEDICAL GRANTS PROGRAM WAS SUPPORTED ALSO BY GRANTS RECEIVED TOTALING $2,068,160 IN 2019. 2606030 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 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 REX C HAYDON MD PRESIDENT 2.00 0.00 X X 0 0 0 JULIE Y BISHOP MD TREASURER 2.00 0.00 X X 0 0 0 LANGDON A HARSTOCK MD SECRETARY 2.00 0.00 X X 0 0 0 KEVIN P BLACK MD DIRECTOR 2.00 0.00 X 0 0 0 R DALE BLASIER MD DIRECTOR 2.00 0.00 X 0 0 0 JOHN C ELFAR MD DIRECTOR 2.00 0.00 X 0 0 0 RICHARD J D'ASCOLI MD DIRECTOR 2.00 0.00 X 0 0 0 WAYNE J SEBASTIANELLI MD DIRECTOR 2.00 0.00 X 0 0 0 KRISTIN OLDS GLAVIN ESQ EXECUTIVE DIRECTOR 5.00 37.50 X 31487 347314 62399 RHONDA TAIRA MANAGING DIRECTOR 37.50 0.00 X 161845 0 16829 193332 347314 79228 1 0 1 0 0 2068160 2068160 ADMINISTRATIVE & APPLI 611710 345560 345560 345560 3861 3861 2417581 345560 0 3861 2205860 2205860 213310 208830 4480 117613 115143 2470 8721 8538 183 17149 16807 342 21965 21504 461 17498 17498 1894 1894 5799 5799 8783 8783 29348 29348 7115 7115 2212 2212 1250 1250 1693 1693 2660210 2606030 54180 0 1592292 1245877 1050000 1050000 16657 10765 6524 3751 4023 2773 2662972 2309415 84769 124456 1261590 1110975 1346359 1235431 X 265570 160641 1051043 913343 1316613 1073984 2662972 2309415 -242629 0 X X 0 1 X 1 0 X 1065516 3259772 2446337 2396410 2068160 11236195 1065516 3259772 2446337 2396410 2068160 11236195 9908093 1328102 111 100 569 4157 3861 8798 11244993 0.11810 0.13270 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, 2019 AND 2018 IS 11.81% AND 13.27%, 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 3751 2773 2773 X 2417581 0 2417581 0 2417581 2660210 0 2660210 0 2660210 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) 86550 FELLOWSHIPS BRIGHAM AND WOMEN'S HOSPITAL 75 FRANCIS ST BOSTON MA 02115 042312909 501(C)(3) 54000 FELLOWSHIPS ORTHOPEDIC CLINICAL ASSOCIATES INC 91 PARKER HILL AVE BOSTON MA 02120 042562362 501(C)(3) 24000 FELLOWSHIPS BOSTON CHILDREN'S HOSPITAL (PEDIATRICS) 300 LONGWOOD AVE BOSTON MA 02115 042943146 501(C)(3) 15000 FELLOWSHIPS BOSTON CHILDREN'S HOSPITAL-DIVISION OF SPORTS MEDICINE 401 PARK DRIVE SUITE 602 BOSTON MA 02215 042970129 501(C)(3) 17500 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) 154830 FELLOWSHIPS SLOAN-KETTERING INSTITUTE FOR CANCER RESEARCH 1275 YORK AVENUE NEW YORK NY 10065 131624182 501(C)(3) 20000 FELLOWSHIPS NYU SCHOOL OF MEDICINE PO BOX 415026 BOSTON MA 02241 135562308 501(C)(3) 99425 FELLOWSHIPS TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NY (AR) P O BOX 29789 NEW YORK NY 10087 135598093 501(C)(3) 37000 FELLOWSHIPS ICAHN SCHOOL OF MEDICINE 5 EAST 98TH STREET 9TH FLOOR BOX 1188 NEW YORK NY 10029 136171197 501(C)(3) 30200 FELLOWSHIPS UNIVERSITY OF ROCHESTER DEPARTMENT OF ORTHOPAEDIC SURGERY 601 ELMWOOD AVE BOX 665 ROSHESTER NY 14642 160743209 501(C)(3) 15000 FELLOWSHIPS TRIA ORTHOPAEDIC CENTER 8100 NORTHLAND DRIVE BLOOMINGTON MN 55431 200033919 501(C)(3) 16500 FELLOWSHIPS THE ORTHOPAEDIC FOUNDATION (THE ROTHMAN INSTITUTE) 125 S 9TH STREET SHERIDAN BUILDING SUITE 1000 PHILADELPHIA PA 19107 222620085 501(C)(3) 58330 FELLOWSHIPS HAND REHABILITATION FOUNDATION 120 HUNTINGDON PIKE SUITE 100 ROCKLEDGE PA 19046 232000134 501(C)(3) 17665 FELLOWSHIPS PENN STATE UNIVERSITY COLLEGE OF MEDICINE (F&A AND TRAUMA) 500 UNIVERSITY DRIVE MC230 HERSHEY PA 17033 246000376 501(C)(3) 30500 FELLOWSHIPS CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER 3333 BURNET AVE CINCINNATI OH 45229 310833936 501(C)(3) 20400 FELLOWSHIPS THE OHIO STATE UNIVERSITY FDN 376 W 10TH AVE COLUMBUS OH 43210 311145986 501(C)(3) 24300 FELLOWSHIPS ORTHOPAEDIC SPECIALTY INSTITUTE (HOAG HOSPITAL FOUNDATION) (AR & SPINE) 280 S MAIN STREET ORANGE CA 92686 330905995 501(C)(3) 24000 FELLOWSHIPS CLEVELAND CLINIC FOUNDATION 9500 EUCLID AVE CLEVELAND OH 44195 340714585 501(C)(3) 31000 FELLOWSHIPS VANDERBILT UNIVERSITY MED CTR DEPT 1236 PO BOX 121236 DALLAS TX 75312 352528741 501(C)(3) 65950 FELLOWSHIPS INDIANA UNIVERSITY LOWER EXTREMITY ADULT RECONSTRUCTION FELLOWSHIP PO BOX 66057 INDIANAPOLIS IN 46266 356001673 501(C)(3) 33700 FELLOWSHIPS NORTHSHORE UNIVERSITY HEALTHSYSTEM 1033 UNIVERSITY PLACE SUITE 450 EVANSTON IL 60201 362167060 501(C)(3) 17000 FELLOWSHIPS RUSH UNIVERSITY MEDICAL CENTER (AR) 1700 W VAN BUREN CHICAGO IL 60657 362174823 501(C)(3) 37000 FELLOWSHIPS WILLIAM BEAUMONT HOSPITAL 3535 W 13 MILE ROAD SUITE 744 ROYAL OAK MI 48073 381459362 501(C)(3) 18000 FELLOWSHIPS REGENTS OF THE UNIVERSITY OF MINNESOTA 200 OAK ST SE MINNEAPOLIS MI 55455 416007513 501(C)(3) 43500 FELLOWSHIPS MAYO CLINIC ROCHESTER 200 FIRST STREET SW ROCHESTER MN 55905 416011702 501(C)(3) 86000 FELLOWSHIPS WASHINGTON UNIVERSITY 700 ROSEDALE AVENUE ST LOUIS MO 63112 430653611 501(C)(3) 108800 FELLOWSHIPS THE CURATORS OF THE UNIVERSITY OF MISSOURI 115 BUSINESS LOOP 70W MIZZOU NORTH ROOM 501 COLUMBIA MO 65211 436003859 501(C)(3) 33500 FELLOWSHIPS SINAI HOSPITAL OF BALTIMORE INC 2401 WEST BELVEDERE AVENUE BALTIMORE MD 21215 520486540 501(C)(3) 27500 FELLOWSHIPS THE INSTITUTE FOR FOOT AND ANKLE RECONSTRUCTION AT MERCY 301 ST PAUL PLACE BALTIMORE MD 21202 520591658 501(C)(3) 15300 FELLOWSHIPS UNION MEMORIAL HOSPITAL 201 EUNIVERSITY PKY BALTIMORE MD 21218 520591685 501(C)(3) 32500 FELLOWSHIPS JOHNS HOPKINS UNIVERSITY SOM 3910 KESWICK ROAD N4327B BALTIMORE MD 21211 520595110 501(C)(3) 37000 FELLOWSHIPS UNIVERSITY OF MARYLAND MEDICAL SYSTEM FOUNDATION 110 S PACA STREET BALTIMORE MD 21201 522238893 501(C)(3) 44700 FELLOWSHIPS CARILION MEDICAL CENTER 1906 BELLEVIEW AVE ROANOKE VA 24014 540506332 501(C)(3) 33700 FELLOWSHIPS ANDERSON CLINIC POST-GRADUATE MEDICAL EDUCATION FOUNDATION PO BOX 7088 ALEXANDRIA VA 22307 541632197 501(C)(3) 24000 FELLOWSHIPS UNIVERSITY OF VIRGINIA DEPARTMENT OF ORTHOPAEDIC SURGERY FOOT AND ANKLE FEL PO BOX 400195 CHARLOTTESVILLE VA 22904 546001796 501(C)(3) 12400 FELLOWSHIPS WEST VIRGINIA UNIVERSITY RESEARCH CORPORATION PO BOX 6005 MORGANTOWN WV 26506 550665758 501(C)(3) 27500 FELLOWSHIPS DUKE UNIVERSITY (AR AND F&A) DUMC BOX 3000 DURHAM NC 27710 560532129 501(C)(3) 33700 FELLOWSHIPS ORTHOCAROLINA (AR) 2001 VAIL AVENUE CHARLOTTESVILLE NC 28207 561093722 501(C)(3) 24000 FELLOWSHIPS UNIV OF NORTH CAROLINA - CH 102 MASON FARM RD 2ND FLOOR CHAPEL HILL NC 27599 566001393 501(C)(3) 12800 FELLOWSHIPS ATRIUM HEALTH FOUNDATION PO BOX 32861 CHARLOTTESVILLE NC 28232 566060481 501(C)(3) 16000 FELLOWSHIPS EMORY UNIVERSITY 59 EXECUTIVE PARK SOUTH ATLANTA GA 30329 580566256 501(C)(3) 27500 FELLOWSHIPS GEORGIA ORTHOPAEDIC TRAUMA INSTITUTE 840 PINE STREET STE 500 MACON GA 31201 582307485 501(C)(3) 13500 FELLOWSHIPS CHILDREN'S HEALTHCARE OF ATLANTA 1600 TULLIE CIRCLE ATLANTA GA 30329 582367819 501(C)(3) 17250 FELLOWSHIPS FOUNDATION FOR ORTHOPAEDIC RESEARCH AND EDUCATION (AR) 13020 N TELECOM PARKWAY TAMPA FL 33637 593555349 501(C)(3) 38500 FELLOWSHIPS UNIVERSITY OF FLORIDA 207 GRINTER HALL PO BOX 115500 GAINESVILLE FL 32611 596002052 501(C)(3) 77700 FELLOWSHIPS UNIVERSITY OF LOUISVILLE (FOUNDATION) DEPARTMENT OF ORTHOPAEDIC SURGERY 550 S JACKSON ST- ACB LOUISVILLE KY 40292 611029626 501(C)(3) 27500 FELLOWSHIPS THE CAMPBELL FOUNDATION 1400 S GERMANTOWN ROAD GERMANTOWN TN 38138 620548038 501(C)(3) 15300 FELLOWSHIPS UNIVERSITY OF ALABAMA AT BIRMINGHAM (F&A) 1313 13TH STREET SOUTH BIRMINGHAM AL 35205 636005396 501(C)(3) 17300 FELLOWSHIPS UTHEALTH (UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON) (TRAUMA) P O BOX 301418 DALLAS TX 75303 741761309 501(C)(3) 14500 FELLOWSHIPS TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN 2222 WELBORN STREET DALLAS TX 75219 750818178 501(C)(3) 17250 FELLOWSHIPS BAYLOR HEALTH CARE SYSTEM FOUNDATION (F&A) 3600 GASTON AVE SUITE 100 DALLAS TX 75246 751606705 501(C)(3) 18500 FELLOWSHIPS TEXAS EDUCATION & RESEARCH FOUNDATION FOR SHOULDER & ELBOW SURGERY 7401 S MAIN STREET HOUSTON TX 77030 821438713 501(C)(3) 14000 FELLOWSHIPS CINCINNATI SHOULDER & ELBOW RESEARCH & EDUCATION FOUNDATION 4701 CREEK RD 110 CINCINNATI OH 45242 822840237 501(C)(3) 11000 FELLOWSHIPS UNIVERSITY OF COLORADO DENVER PO BOX 910238 DENVER CO 80291 846000555 501(C)(3) 53000 FELLOWSHIPS UNIVERSITY OF UTAH 590 WAKARA WAY SALT LAKE CITY UT 84108 876000525 501(C)(3) 24000 FELLOWSHIPS MUSCULOSKELETAL ORGANIZATION FOR RESEARCH AND EDUCATION 555 NORTH ARLINGTON AVE RENO NV 89523 880278047 501(C)(3) 27500 FELLOWSHIPS UNIVERSITY OF WASHINGTON 12455 COLLECTIONS DRIVE CHICAGO IL 60693 916001537 501(C)(3) 25500 FELLOWSHIPS STANFORD UNIVERSITY SCHOOL OF MEDICINE 450 BROADWAY STREET REDWOOD CITY CA 94063 941156365 501(C)(3) 47500 FELLOWSHIPS SAN FRANCISCO GENERAL HOSPITAL FOUNDATION PO BOX 410836 SAN FRANCISCO CA 94141 943189424 501(C)(3) 16000 FELLOWSHIPS REGENTS OF THE UNIVERSITY OF CALIFORNIA SAN FRANCISCO (ARSPINESPORTS) 1855 FOLSOM STREET SAN FRANCISCO CA 94143 946036493 501(C)(3) 15000 FELLOWSHIPS REGENTS OF THE UNIV CA DAVIS PO BOX 989062 WEST SACRAMENTO CA 95798 946036494 501(C)(3) 57500 FELLOWSHIPS CHILDREN'S HOSPITAL LOS ANGELES 4650 SUNSET BLVD MS97 LOS ANGELES CA 90027 951690977 501(C)(3) 13000 FELLOWSHIPS CHILDREN'S SPECIALISTS OF SAN DIEGO AMGRADY CHILDREN'S HOSPITAL 3020 CHILDRENS WAY MC 5062 SAN DIEGO CA 92123 953255175 501(C)(3) 20400 FELLOWSHIPS KERLAN JOBE ORTHOPAEDIC FOUNDATION 6801 PARK TERRACE SUITE 140 LOS ANGELES CA 90045 954707606 501(C)(3) 16500 FELLOWSHIPS UNIVERSITY OF CALIFORNIA SAN DIEGO (AR AND SPINE) 200 W ARBOR DRIVE 8894 SAN DIEGO CA 92103 956006144 501(C)(3) 17000 FELLOWSHIPS 66 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. 0 0 0 0 0 0 0 0 0 KRISTIN OLDS GLAVIN ESQ EXECUTIVE DIRECTOR 31487 316407 0 30907 0 0 3149 34578 0 24672 34636 406564 0 0 RHONDA TAIRA MANAGING DIRECTOR 159345 0 2500 0 0 0 16034 0 795 0 178674 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. 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 0 SCHEDULE R, PART II, COLUMN (B) ENGAGING THE ORTHOPAEDIC COMMUNITY TO DEVELOP LEADERS, STRATEGIES, AND RESOURCES TO GUIDE THE FUTURE OF MUSCULOSKELETAL CARE.