2020-10-29T15:44:56-05:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 1301 WEST 22ND STREET SUITE 1100 OAK BROOK IL 60523 990 2019-01-01 510287258 THE ANESTHESIA PATIENT SAFETY FOUNDATION ANES 8478255586 1061 AMERICAN LANE SCHAUMBURG IL 601734973 MARK A WARNER MD PRESIDENT 8478255586 2020-10-16 1 MICHAEL R STEPHENS P01302903 6305738600 2020-10-05 67.137.57.251 2020-10-16 14:58:43 CD P 15FC16222CA11D74FA98B06BEF52F7231FC6830F D0E937DB0FF52DDC3A3C80793F76B395E8CB9D7F 2019 2021-01-29 14:40:06Z MARK A WARNER MD 1061 AMERICAN LANE SCHAUMBURG IL 601734973 7357817 0 X WWW.APSF.ORG X 1985 DE THE APSF'S MISSION IS TO IMPROVE CONTINUALLY THE SAFETY OF PATIENTS DURING ANESTHESIA CARE BY ENCOURAGING AND CONDUCTING SAFETY RESEARCH AND EDUCATION, PATIENT SAFETY PROGRAMS AND CAMPAIGNS, NATIONAL AND INTERNATIONAL EXCHANGE OF INFORMATION AND IDEAS. 20 18 0 125 0 0 1338849 1293067 0 0 681951 815275 348 1991 2021148 2110333 899178 475271 0 0 196256 202836 0 0 315097 1376101 1309697 2471535 1987804 -450387 122529 11429527 12830304 582001 635743 10847526 12194561 X THE APSF'S MISSION IS TO IMPROVE CONTINUALLY THE SAFETY OF PATIENTS DURING ANESTHESIA CARE BY ENCOURAGING AND CONDUCTING SAFETY RESEARCH AND EDUCATION, PATIENT SAFETY PROGRAMS AND CAMPAIGNS, NATIONAL AND INTERNATIONAL EXCHANGE OF INFORMATION AND IDEAS. 0 0 1411806 475271 1991 THE SPECIFIC PURPOSES OF THE FOUNDATION ARE TO FOSTER INVESTIGATIONS THAT WILL PROVIDE A BETTER UNDERSTANDING OF PREVENTABLE ANESTHETIC INJURIES, TO ENCOURAGE PROGRAMS THAT WILL REDUCE THE NUMBER OF ANESTHETIC INJURIES, AND TO PROMOTE NATIONAL AND INTERNATIONAL COMMUNICATION OF INFORMATION AND IDEAS ABOUT THE CAUSES AND PREVENTION OF ANESTHETIC INJURIES. THE APSF IS MADE UP OF INDIVIDUALS AND CORPORATIONS INVOLVED IN ALL ASPECTS OF ANESTHESIA, AND IS A MAJOR SOURCE OF GRANTS FOR RESEARCH. THE FOUNDATION'S NEWSLETTER IS PUBLISHED THREE TIMES A YEAR AND IS DISTRIBUTED WITHOUT CHARGE TO ANESTHESOLOGSTS, NURSE ANESTHETISTS, ANESTHESIOLOGIST ASSISTANTS, AND TO THOUSANDS OF HOSPITAL ADMINISTRATORS AND GOVERNMENT OFFICIALS IN THE US, CANADA, AND OTHER VARIOUS COUNTRIES. THE APSF HAS ALSO INITIATED AND SPONSORED MANY OTHER ACTIVITIES IN FULFILLMENT OF ITS MISSION, INCLUDING SUPPORTING MEETINGS ON ANESTHESIA SAFETY AND FACILITATING DEVELOPMENT OF SIMULATORS FOR TRAINING ANESTHESIOLOGISTS IN CRISIS MANAGEMENT AS WELL AS OTHER ANESTHESIA MANAGEMENT PROBLEMS. 1411806 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 49 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 20 18 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X LISA STEININGER 8472689220 1061 AMERICAN LANE SCHAUMBURG IL 601734973 MARK A WARNER APSF PRESIDENT 25.00 0.00 X X 0 0 0 MATTHEW B WEINGER APSF SECRETARY 2.00 0.00 X X 0 1450 0 DOUG BARTLETT APSF TREASURER 1.00 0.00 X X 0 0 0 DANIEL J COLE APSF VICE PRESIDENT 2.00 1.00 X X 2200 3400 0 ALICE ROMIE DIRECTOR (AS OF SEPTEMBER 2019) 1.00 0.00 X 0 0 0 BRIAN J THOMAS DIRECTOR 1.00 0.00 X 0 0 0 DAVID M GABA DIRECTOR (UNTIL SEPTEMBER 2019) 1.00 0.00 X 600 0 0 DELLA M LIN DIRECTOR 1.00 0.00 X 2400 0 0 JASON R BYRD DIRECTOR (UNTIL SEPTEMBER 2019) 1.00 0.00 X 0 0 0 JEFFREY M FELDMAN DIRECTOR 2.00 0.00 X 1000 0 0 JENNY E FREEMAN DIRECTOR (UNTIL SEPTEMBER 2019) 1.00 0.00 X 0 0 0 JERRY A COHEN DIRECTOR (UNTIL SEPTEMBER 2019) 1.00 0.00 X 0 0 0 JOSHUA LEA DIRECTOR (AS OF SEPTEMBER 2019) 1.00 0.00 X 400 0 0 LINDA GROAH DIRECTOR 1.00 0.00 X 0 0 0 LYNN REEDE DIRECTOR 1.00 0.00 X 1200 0 0 MARIA VAN PELT DIRECTOR-AT-LARGE 2.00 0.00 X 2200 0 0 MARJORIE P STIEGLER DIRECTOR 5.00 0.00 X 20800 0 0 MAY CM PIAN-SMITH DIRECTOR 1.00 0.00 X 1800 0 0 MEGHAN LANE-FALL DIRECTOR 1.00 0.00 X 7600 0 0 PATTY MULLEN REILLY DIRECTOR 1.00 0.00 X 0 0 0 RANDALL MOORE II DIRECTOR (UNTIL SEPTEMBER 2019) 1.00 0.00 X 0 0 0 RICHARD C PRIELIPP DIRECTOR 1.00 0.00 X 2600 0 0 SHANE C ANGUS DIRECTOR 1.00 0.00 X 1600 0 0 STEVE SANFORD DIRECTOR (UNTIL SEPTEMBER 2019) 1.00 0.00 X 1400 0 0 STEVEN B GREENBERG DIRECTOR 10.00 0.00 X 22000 0 0 STEVEN K HOWARD DIRECTOR 2.00 0.00 X 800 0 0 T FORCHT DAGI DIRECTOR (UNTIL SEPTEMBER 2019) 1.00 0.00 X 0 0 0 68600 4850 0 0 0 0 0 ASSOCIATES INTERNATIONAL INC 100 ROGERS ROAD WILMINGTON DE 19801 MAILING AND DISTRIBUTION SERVICES 246328 EDENS WORK INC 409 23RD AVENUE SW ROCHESTER MN 55902 WEBSITE HOSTING AND CONSULTING SERVICES 117217 MOSER STRATEGY GROUP 640 WELSH PARTRIDGE CIR BILTMORE LAKE NC 28715 FUNDRAISING SERVICES 111751 3 425000 868067 1293067 214443 214443 5848316 5247484 600832 600832 600832 MISCELLANEOUS INCOME 900099 1991 1991 1991 2110333 1991 0 815275 X 470271 470271 5000 5000 68200 47058 7502 13640 134636 55777 52499 26360 16000 16000 3430 1921 137 1372 14165 7932 567 5666 106257 106257 502466 346584 9406 146476 103621 58028 4145 41448 21800 17462 3752 586 176998 99119 7080 70799 231913 194807 32468 4638 124220 103347 16761 4112 SPEAKER FEES 4500 4500 CREDIT CARD FEES 4327 4327 1987804 1411806 260901 315097 396200 166203 107822 724494 2250 70000 115000 10855505 11822357 11429527 12830304 25952 51406 450000 425000 50000 0 56049 159337 582001 635743 X 10622499 12177567 225027 16994 10847526 12194561 11429527 12830304 122529 1224506 0 X X 0 1 X 1 0 X 1247427 1422855 1058817 1338849 1293067 6361015 1247427 1422855 1058817 1338849 1293067 6361015 1978630 4382385 181534 170818 180633 202604 214443 950032 4175 840 107 348 1991 7461 7318508 0.59880 0.60260 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2015 AMOUNT: $ 4,175. 2016 AMOUNT: $ 840. 2017 AMOUNT: $ 107. 2018 AMOUNT: $ 348. 2019 AMOUNT: $ 1,991. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO ASA 159337 159337 X 3228582 1224506 1224506 2004076 106257 106257 2110333 1881547 0 1881547 106257 106257 1987804 PART X, LINE 2: THE FOUNDATION IS EXEMPT FROM INCOME TAX UNDER PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3). ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FOUNDATION AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2019, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. 1 WFSA (WORLD FEDERATION OF SOCIETIES OF ANAESTHESIOLOGISTS) 52 HORSEFERRY ROAD LONDON UK SW1P2AF 133211128 501(C)(3) 131322 RESEARCH GRANT WAKE FOREST SCHOOL OF MEDICINE MEDICAL CENTER BOULEVARD WINSTONSALEM NC 27157 510190238 501(C)(3) 150000 RESEARCH AWARD UNIVERSITY HEALTH NETWORK 1056-700 UNIVERSITY AVENUE TORONTO ON CA M5G1Z5 986000971 501(C)(3) 137449 RESEARCH GRANT UNIVERSITY OF SOUTHERN CALIFORNIA 3500 S FIGUEROA STREET SUITE 102 LOS ANGELES CA 90089 951642394 501(C)(3) 50000 CURRICULUM AWARD 4 0 MERIT AWARD 1 5000 0 PART I, LINE 2: THE GRANTS FUNDED BY THE SCIENTIFIC EVALUATION COMMITTEE (SEC) UNDERGO A RIGOROUS REVIEW PROCESS. THE APPLICATIONS HAVE TO DESCRIBE IN DETAIL THE LINE-ITEMIZED BUDGET, WHICH IS REVIEWED BY SEC MEMBERS ON AT LEAST THREE DIFFERENT OCCASIONS. FOR MANY OF THE APPLICATIONS, CHANGES AND/OR CORRECTIONS TO THE BUDGET ARE REQUESTED BY THE MEMBERS OF THE SEC, SUCH THAT THE FINAL GRANT, IF APPROVED, DETAILS SPECIFICALLY HOW THE GRANT MONEY WILL BE USED. A COPY OF THE APPLICATION, INCLUDING THE BUDGET, IS ALSO SENT TO THE OFFICE OF SPONSORED RESEARCH AT THE APPLICANT'S INSTITUTION, AND THE INSTITUTIONAL GRANTS AND CONTRACTS OFFICER IS THEN SENT THE GRANT MONEY FOR DISTRIBUTION TO THE APPLICANT. IN ADDITION, THE APPLICANT'S DEPARTMENTAL CHAIR HAS TO WRITE A LETTER OF SUPPORT ON BEHALF OF THE APPLICANT, AND THE CHAIR CONFIRMS THAT THE APPLICANT WILL PERFORM THE STUDY AS PROPOSED, AND THAT ANY MONEY NOT USED AT THE END OF THE FUNDED PERIOD WILL BE RETURNED TO THE APSF. FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION UTILIZES THE MANAGEMENT OF AMERICAN SOCIETY OF ANESTHESIOLOGISTS,INC (ASA) TO PROVIDE CERTAIN PROGRAM AND ADMINISTRATIVE SERVICES. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION RETAINS THE SERVICES OF AN INDEPENDENT CPA FIRM TO PREPARE THE ORGANIZATION'S FORM 990. MANAGEMENT REVIEWS THE COMPLETED FORM 990 AND PROVIDES A COPY TO EACH MEMBER OF THE GOVERNING BODY PRIOR TO FILING. THE GOVERNING BODY IS GIVEN A CHANCE TO COMMENT AND/OR ASK QUESTIONS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES EVERY BOARD AND COMMITTEE MEMBER TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ON AN ANNUAL BASIS. A CONFLICT OF INTEREST MAY NOT DISQUALIFY THE MEMBER FROM SERVING, BUT MAY NECESSITATE DISCLOSURE OF THE CONFLICT OR APPARENT CONFLICT SO THAT THE WORDS OR DEEDS OF THE APSF MEMBER CAN BE EVALUATED BY OTHERS. FORM 990, PART VI, SECTION B, LINE 15 MANAGEMENT DUTIES NORMALLY PERFORMED BY CEO,EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL ARE PERFORMED BY BOARD MEMBERS. BOARD MEMBER STIPENDS ARE DETERMINED ANNUALLY BY THE EXECUTIVE COMMITTEE WHILE APPROVING THE BUDGET. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE THROUGH APPLICABLE GOVERNMENTAL AGENCIES. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 346,584. MANAGEMENT AND GENERAL EXPENSES 9,406. FUNDRAISING EXPENSES 146,476. TOTAL EXPENSES 502,466. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS IS RESPONSIBLE FOR OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT CPA FIRM. AMERICAN SOCIETY OF ANESHTHESIOLOGISTS 1061 AMERICAN LANE SCHAUMBURG IL 60173 362181944 ADVANCE THE SPECIALTY OF ANESTHESIA NY 501(C)(6) 0 WOOD LIBRARY-MUSEUM OF ANESTHESIOLOGY 1061 AMERICAN LANE SCHAUMBURG IL 60173 363573324 COLLECTION OF ANESTHESIA LITERATURE IL 501(C)(3) LINE 12A, I AMERICAN SOCIETY OF ANESTHESIOLOGISTS 1 FOUNDATION FOR ANESTHESIA EDUCATION AND RESEARCH 1061 AMERICAN LANE SCHAUMBURG IL 60173 521494164 ANESTHESIA CARE EDUCATION AND RESEARCH DE 501(C)(3) LINE 7 AMERICAN SOCIETY OF ANESTHESIOLOGISTS 1 ANESTHESIA QUALITY INSTITUTE 1061 AMERICAN LANE SCHAUMBURG IL 60173 263848288 ADVANCES IN QUALITY OF CARE MEASUREMENT AND DELIVERY IN ANESTHESIA DC 501(C)(3) LINE 12A, I AMERICAN SOCIETY OF ANESTHESIOLOGISTS 1 ASA CHARITABLE FOUNDATION 1061 AMERICAN LANE SCHAUMBURG IL 60173 454946512 IMPROVE HEALTH AND MEDICAL CARE IN UNDER-SERVICED COMMUNITIES IL 501(C)(3) LINE 12A, I AMERICAN SOCIETY OF ANESTHESIOLOGISTS 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 AMERICAN SOCIETY OF ANESHTHESIOLOGISTS C 425000 FMV AMERICAN SOCIETY OF ANESHTHESIOLOGISTS P 264895 FMV FOUNDATION FOR ANESTHESIA EDUCATION AND RESEARCH R 75000 FMV