2019-06-11T13:55:13-05:00 2018-09-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2017-10-01 943084159 NORTHERN CALIFORNIA INSTITUTE FOR RESEARCH AND EDUCATION INC NORT 4157506954 4150 CLEMENT STREET 151NC SAN FRANCISCO CA 94121 REBECCA A ROSALES CHIEF EXECUTIVE OFFICER 4157506954 2019-05-28 1 LAUREN A HAVERLOCK P00545829 4159561500 2019-05-28 12.129.7.100 2019-05-28 13:01:03 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 32BFBF1104AA8EEBC72962A0CCB0C2C16BC479E3 2017 2019-02-21 02:37:17Z REBECCA A ROSALES 4150 CLEMENT STREET 151NC SAN FRANCISCO CA 94121 47212751 0 X WWW.NCIRE.ORG X 1988 CA MEDICAL RESEARCH TO FIND NEW AND IMPROVED WAYS TO COMBAT DISEASE AND IMPAIRMENTS OF MAN. 18 2 295 0 0 19829 34836192 43800228 2118366 3366889 21314 25228 23990 20406 36999862 47212751 0 0 0 0 14770983 16803355 0 0 240 22186600 29396071 36957583 46199426 42279 1013325 13324294 11327406 10832344 7822131 2491950 3505275 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 37475408 3366889 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, SUSBSECTION 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. 37475408 1 1 0 1 0 0 0 0 0 0 1 0 0 0 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 63 0 1 295 1 1 1 0 0 0 0 0 0 0 0 0 X 18 2 0 0 0 0 0 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 94121 X RAYMOND A SWANSON MD CHAIR 8.00 40.00 X 0 272388 0 HUBERT KIM MD PHD VICE CHAIR THROUGH 7/2019 / DIRECTOR 1.00 40.00 X 0 143038 0 THEODORA MAURO MD VICE CHAIR EFFECTIVE 7/2019 1.00 40.00 X 0 149018 0 NEAL H COHEN MD MPH MS DIRECTOR 1.00 0.00 X 0 0 0 STEVE COUNTOURIOTIS DIRECTOR 1.00 0.00 X 0 0 0 BONNIE S GRAHAM DIRECTOR 1.00 40.00 X 0 188402 0 JENNIFER GRANDIS MD DIRECTOR EFFECTIVE 1/1/2018 1.00 0.00 X 0 0 0 CARL GRUNFELD MD PHD DIRECTOR 1.00 40.00 X 0 153843 0 SHIRA MAGUEN MD DIRECTOR 1.00 40.00 X 0 127097 0 JOHN R MCQUAID PHD DIRECTOR 1.00 40.00 X 0 161900 0 KENNETH R MCQUAID MD DIRECTOR 1.00 40.00 X 0 381435 0 BRUCE OVBIAGELE MD MSC MAS MBA DIRECTOR EFFECTIVE 8/20/2018 1.00 40.00 X 0 0 0 STEPHEN PEARY JD LLM DIRECTOR 1.00 0.00 X 0 0 0 CARMEN PERALTA MD MAS DIRECTOR EFFECTIVE 1/1/2018 1.00 0.00 X 0 0 0 RINA SHAH MD DIRECTOR 1.00 40.00 X 0 137956 0 MICHAEL SHLIPAK MD MPH DIRECTOR 1.00 40.00 X 0 133250 0 LOUISE C WALTER MD DIRECTOR 1.00 15.00 X 0 129978 0 KEITH R YAMAMOTO PHD DIRECTOR 1.00 0.00 X 0 0 0 REBECCA A ROSALES EXECUTIVE DIRECTOR 40.00 0.00 X 218267 0 2363 STEPHEN MORANGE CFO THROUGH 5/2018 40.00 0.00 X 221672 0 47293 JOANNA ZHAO CONTROLLER/SECR & TREAS START 6/2018 40.00 0.00 X 125968 0 41272 DIANA SACREY LABORATORY MANAGER 40.00 0.00 X 131838 0 42058 ZIN KAY CHAN DIRECTOR OF INFORMATION SYSTEMS 40.00 0.00 X 128476 0 16269 KATHLEEN STANLEY ADMINISTRATIVE NURSE III 40.00 0.00 X 126059 0 37872 BRIAN ROACH PROGRAM ANALYST IV 40.00 0.00 X 122806 0 35721 MAOQIANG MAN RESEARCH SCIENTIST 40.00 0.00 X 125055 0 12905 1200141 1978305 235753 15 0 1 0 THE ULTIMATE SOFTWARE GROUP INC PO BOX 930953 ATLANTA GA 31193 PAYROLL SERVICES 124942 GFK CUSTOM RESEARCH LLC 120 EAGLE ROCK AVE SUITE 200 EAST HANOVER NJ 07936 SURVEY DATA SERVICE 113308 2 2591961 40690193 518074 43800228 CLINICAL RESEARCH REVENUE 541700 3313404 3313404 SERVICE REVENUE 541900 53485 53485 3366889 25228 25228 OTHER REVENUE 900099 20406 20406 20406 47212751 3366889 0 45634 X 637121 637121 12709028 9681057 3027971 580885 250190 330695 1843531 944876 898655 1032790 553213 479577 66107 2600 63507 80500 80500 5500 5500 6657474 4977703 1679771 187527 33171 154356 137061 48296 88765 360350 77376 282974 412716 223531 189185 69911 7033 62878 267886 179197 88689 64022 64022 SUBCONTRACTS 18043878 18043878 OUTSIDE RESEARCH 1293683 978763 314920 LAB SUPPLIES 1007648 946159 61489 SUBJECT COSTS 321161 305696 15465 420647 222669 197738 240 46199426 37475408 8723778 240 1233124 463375 2847873 3651453 6831791 5143740 914773 733761 111999 118325 4736982 4018379 877784 718603 506950 498149 13324294 11327406 5705882 4270427 5126462 3551704 10832344 7822131 X 1380385 2360345 1111565 1144930 2491950 3505275 13324294 11327406 1013325 0 X 0 1 X 1 1 1 X US DEPARTMENT VETERANS AFFAIRS MEDICAL CENTER SAN FRANCISCO CA 0 0 0 0 0 0 1 5500 0 0 5500 0 PART II-B, LINE 1: GOVERNMENT RELATIONS FIRMS WERE RETAINED TO MONITOR, PROMOTE, AND ADVOCATE ON BEHALF OF NCIRE IN REGARDS TO FEDERAL LEGISLATION, REGULATIONS, AND PROGRAMS THAT COULD HAVE AN EFFECT ON NCIRE. 999680 798270 201410 3711076 3201657 509419 26226 18452 7774 718603 X 47212751 0 47212751 0 47212751 46199426 0 46199426 0 46199426 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, 2018, 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 0 0 0 0 0 0 0 0 0 RAYMOND A SWANSON MD CHAIR 0 272388 0 0 0 0 0 0 0 0 0 272388 0 0 BONNIE S GRAHAM DIRECTOR 0 188402 0 0 0 0 0 0 0 0 0 188402 0 0 CARL GRUNFELD MD PHD DIRECTOR 0 153843 0 0 0 0 0 0 0 0 0 153843 0 0 JOHN R MCQUAID PHD DIRECTOR 0 161900 0 0 0 0 0 0 0 0 0 161900 0 0 KENNETH R MCQUAID MD DIRECTOR 0 381435 0 0 0 0 0 0 0 0 0 381435 0 0 REBECCA A ROSALES EXECUTIVE DIRECTOR 218267 0 0 0 0 0 0 0 2363 0 220630 0 0 0 STEPHEN MORANGE CFO THROUGH 5/2018 221672 0 0 0 0 0 22152 0 25141 0 268965 0 0 0 JOANNA ZHAO CONTROLLER/SECR & TREAS START 6/2018 125968 0 0 0 0 0 13205 0 28067 0 167240 0 0 0 DIANA SACREY LABORATORY MANAGER 131838 0 0 0 0 0 13962 0 28096 0 173896 0 0 0 KATHLEEN STANLEY ADMINISTRATIVE NURSE III 126059 0 0 0 0 0 12875 0 24997 0 163931 0 0 0 BRIAN ROACH PROGRAM ANALYST IV 122806 0 0 0 0 0 12204 0 23517 0 158527 0 0 0 FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTOR OF THE SAN FRANCISCO VA 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 DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM BASED ON AUDITED FINANCIAL STATEMENTS AND 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. THE BOARD RECEIVES THE FINAL VERSION OF THE FORM 990 PRIOR TO FILING. 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 AUDIT AND RISK MANAGEMENT COMMITTEE OF THE BOARD AND WERE USED TO FORMALLY REVIEW AND CONFIRM THAT COMPENSATION IS APPROPRIATE. THE PROCESS WAS LAST DONE IN 2017 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 THIS RETURN. FORM 990, PART IX, LINE 11G CONSULTANTS/OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 95,177. MANAGEMENT AND GENERAL EXPENSES 129,573. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 224,750. JPA PAYROLL/FEES: PROGRAM SERVICE EXPENSES 4,882,526. MANAGEMENT AND GENERAL EXPENSES 1,504,541. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,387,067. TEMPORARY EMPLOYEE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 45,657. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 45,657. SAN FRANCISCO VA HEALTH CARE SYSTEM 4150 CLEMENT STREET SAN FRANCISCO CA 94121 941160824 HEALTH CARE BENEFITS AND SERVICES CA N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0