COALITION TO TRANSFORM ADVANCED CARE: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- COALITION TO TRANSFORM ADVANCED CARE (EIN 45-2604332)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-10-15
- IRS object ID
- 201922889349302312
- Schema version
- 2018v3.1
- Note
- A later return for the same period supersedes this one.
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-10-15T16:56:52-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 814319449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALDWELL & ASSOCIATES LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8120 WOODMONT AVENUE 400 | AddressLine1Txt |
| City | BETHESDA | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20814 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452604332 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COALITION TO TRANSFORM ADVANCED CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COAL | BusinessNameControlTxt |
| Phone | 2029092865 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1299 PENNSYLVANIA AVENUE NW NO 1175 | AddressLine1Txt |
| City | WASHINGTON | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20004 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JON BROYLES | PersonNm |
| Person Title | CO-CHAIR | PersonTitleTxt |
| Phone | 2029092865 | PhoneNum |
| Signature | 2019-10-15 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WILLIAM J CALDWELL CPA | PreparerPersonNm |
| PTIN | P00187908 | PTIN |
| Phone | 3019418090 | PhoneNum |
| Preparation | 2019-10-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 100.36.241.138 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-10-15 | IPDt |
| IP Tm | 16:56:48 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 10F2674B3BD84EB02783F770BF0BD95D9E4F6B2E | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN T KOUTSOUMPAS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1299 PENNSYLVANIA AVENUE NW NO 1175 | AddressLine1Txt |
| City | WASHINGTON | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,753,844 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.THECTAC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | DC | LegalDomicileStateCd |
| Activity Or Mission | COALITION TO TRANSFORM ADVANCED CARE (C-TAC) IS A NON-PARTISAN GROUP OFPATIENT AND CONSUMER ADVOCACY GROUPS, HEALTH CARE PROFESSIONALS ANDPROVIDERS, PRIVATE SECTOR STAKEHOLDERS, FAITH-BASED ORGANIZATIONS, AND HEALTHCARE PAYERS. OUR VISION IS THAT ALL AMERICANS WITH ADVANCED ILLNESS, ESPECIALLY THE SICKEST AND THE MOST VULNERABLE, WILL RECEIVE COMPREHENSIVE, HIGH-QUALITY CARE THAT IS CONSISTENT WITH THEIR GOALS AND VALUES AND HONORS THEIR DIGNITY. THE C-TAC MISSION IS TO TRANSFORM ADVANCED ILLNESS CARE BY EMPOWERING CONSUMERS, CHANGING THE HEALTH CARE DELIVERY SYSTEM, IMPROVING PUBLIC AND PRIVATE POLICIES, AND ENHANCING PROVIDER CAPACITY. C-TAC OPERATES AS A VOLUNTEER-DRIVEN ORGANIZATION THROUGH WORKGROUPS AND COMMITTEES TO ACCOMPLISH ITS OVERARCHING GOALS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 8 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,828,112 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,753,844 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,828,112 | PYTotalRevenueAmt |
| CY Total Revenue | $2,753,844 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $459,712 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $445,896 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $397,543 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,994,411 | PYOtherExpensesAmt |
| CY Other Expenses | $1,816,152 | CYOtherExpensesAmt |
| PY Total Expenses | $2,454,123 | PYTotalExpensesAmt |
| CY Total Expenses | $2,262,048 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $373,989 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $491,796 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,620,697 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,093,914 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $137,572 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $118,993 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,483,125 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,974,921 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES COALITION TO TRANSFORM ADVANCED CARE (C-TAC) IS A NON-PARTISAN GROUP OF PATIENT AND CONSUMER ADVOCACY GROUPS, HEALTH CARE PROFESSIONALS AND PROVIDERS, PRIVATE SECTOR STAKEHOLDERS, FAITH-BASED ORGANIZATIONS, AND HEALTHCARE PAYERS. OUR VISION IS THAT ALL AMERICANS WITH ADVANCED ILLNESS, ESPECIALLY THE SICKEST AND THE MOST VULNERABLE, WILL RECEIVE COMPREHENSIVE, HIGH-QUALITY CARE THAT IS CONSISTENT WITH THEIR GOALS AND VALUES AND HONORS THEIR DIGNITY. THE C-TAC MISSION IS TO TRANSFORM ADVANCED ILLNESS CARE BY EMPOWERING CONSUMERS, CHANGING THE HEALTH CAREDELIVERY SYSTEM, IMPROVING PUBLIC AND PRIVATE POLICIES, AND ENHANCING PROVIDER CAPACITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $294,799 | ExpenseAmt |
| Revenue | $766,275 | RevenueAmt |
| Desc | SUMMIT: THE C-TAC NATIONAL SUMMIT ON ADVANCED ILLNESS CARE IS AN ANNUAL EVENT TO CONVENE PARTICIPANTS FROM MANY DISCIPLINES AND ORGANIZATIONS, REPRESENTING PATIENTS, FAMILIES, POLICY MAKERS, FAITH COMMUNITIES, MEDIA, AND HEALTH CARE PROFESSIONALS GATHERED TO LEARN AND DISCUSS THE NEEDED CHANGES IN OUR NATION'S CARE SYSTEM TO ASSURE THAT PEOPLE WITH ADVANCED ILLNESSES RECEIVE CARE CONSISTENT WITH THEIR VALUES AND WISHES. THE CONFERENCE HAS TWO GOALS: (1) TO CREATE A COMMON UNDERSTANDING AMONG PARTICIPANTS OF THE ISSUES, CHALLENGES, AND RANGE OF POSSIBLE SOLUTIONS; (2) TO CREATE A SHARED SENSE OF MISSION AND ACTION STEPS FOR ACHIEVING HIGH-QUALITY, ADVANCED ILLNESS CARE.PLEASE SEE OUR WEBSITE FOR A FULL POST SUMMIT REPORT. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $336,657 | ExpenseAmt |
| Desc | ADVANCED CARE MODEL: THE ADVANCED CARE MODEL IS A PARTNERSHIP BETWEEN C-TAC, IHSS, TRINITY HEALTH, INOVA HEALTH AND CARE OREGON. IT IS BUILDING ON THE PROGRESS FIRST REALIZED WITH THE ADVANCED CARE PROJECT. IT IS A PROVEN SERVICE DELIVERY MODEL AND PROPOSED NEW ADVANCED ALTERNATIVE PAYMENT MODEL (AAPM) TO IMPROVE QUALITY AND COST OUTCOMES FOR ADVANCED ILLNESS BENEFICIARIES. THE ACM IS SPECIFICALLY DESIGNED TO MEET THESE NEEDS BY "BREAKING DOWN A RANGE OF SILOS BETWEEN 'CURATIVE AND PALLIATIVE CARE, BETWEEN PROFESSIONAL GROUPS TO FOSTER INTERDISCIPLINARY PRACTICE, AND BETWEEN TRADITIONAL MEDICAL AND SOCIAL SERVICES" (IOM REPORT: DYING IN AMERICA). THE ACM AAPM PAYMENT CAN OPERATE AS A STAND-ALONE APM AND OR IN CONJUNCTION WITH EXISTING APMS TO ENSURE ALL MEDICARE FFS BENEFICIARIES CAN ACCESS THE NEEDED ACM SERVICES. FURTHERMORE, THE ACM SUPPORTS PRIMARY CARE AND/OR SPECIALTY PROVIDER PARTICIPATION. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $191,859 | ExpenseAmt |
| Desc | SERIOUS ILLNESS PROGRAM: THE SERIOUS ILLNESS PROGRAM IS A PARTNERSHIP BETWEEN C-TAC, HEALTHSPERIEN, THE BETTY IRENE MOORE SCHOOL OF NURSING AT UC DAVIS, THE PETRIE-FLOM CENTER FOR HEALTH LAW POLICY, BIOTECHNOLOGY, AND BIOETHICS AT HARVARD LAW SCHOOL AND THE GORDON AND BETTY MOORE FOUNDATION. THE PROGRAM IS DESIGNED TO IMPROVE AND EQUALIZE HEALTH CARE FOR THE ELDERLY AND THOSE WHO ARE CHRONICALLY ILL. THE HAVE DEVELOPED A FRAMEWORK THAT HAS INFORMED PROGRAM DEVELOPMENT, REPLICATION, AND SCALING, INTEGRATED WITH CARE MODEL PAYMENT DESIGN, INFORMED CARE MODEL AND PROFORMA SIMULATOR DEVELOPMENT AND INFORMED OTHER ASPECTS OF DESIGN AND DEVELOPMENT SUCH AS POLICY, STANDARDIZED MEASUREMENTS, AND REGULATORY ANALYSIS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $722,309 | ExpenseAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $722,309 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $1,545,624 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 8 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALDWELL & COMPANY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3019418090 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8120 WOODMONT AVE SUITE 400 | AddressLine1Txt |
| City | BETHESDA | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20814 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| J THOMAS KOUTSOUMPAS | ||||||
| CO-CHAIR | 15.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| WILLIAM NOVELLI | ||||||
| CO-CHAIR | 20.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ALEXANDRA DRANE | ||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | |
| LUCY KALANITHI | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JEFFREY BURNICH | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| RICHARD UMBDENSTOCK | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MARK GANZ | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| BJ MILLER | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| NANCY BROWN | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID E LONGNECKER MD | ||||||
| SECRETARY - TREASURER | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| REV DR YVONNE V DELK | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| JONATHAN A BROYLES | ||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $152,514 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $152,514 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHSPERIEN LLC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1299 PENNSYLVANIA AVE NW SUITE 11 | AddressLine1Txt |
| City | WASHINGTON | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MEDICAL CONSULTING | ServicesDesc |
| Compensation | $127,379 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $707,900 | MembershipDuesAmt |
| All Other Contributions | $2,045,944 | AllOtherContributionsAmt |
| Total Contributions | $2,753,844 | TotalContributionsAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,753,844 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $396,584 | TotalAmt |
| Program Services | $254,518 | ProgramServicesAmt |
| Management And General | $89,131 | ManagementAndGeneralAmt |
| Fundraising | $52,935 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,868 | TotalAmt |
| Program Services | $11,467 | ProgramServicesAmt |
| Management And General | $4,016 | ManagementAndGeneralAmt |
| Fundraising | $2,385 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,444 | TotalAmt |
| Program Services | $20,180 | ProgramServicesAmt |
| Management And General | $7,067 | ManagementAndGeneralAmt |
| Fundraising | $4,197 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $668,195 | TotalAmt |
| Program Services | $219,013 | ProgramServicesAmt |
| Management And General | $147,544 | ManagementAndGeneralAmt |
| Fundraising | $301,638 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,506 | TotalAmt |
| Program Services | $2,892 | ProgramServicesAmt |
| Management And General | $1,013 | ManagementAndGeneralAmt |
| Fundraising | $601 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,134 | TotalAmt |
| Program Services | $20,623 | ProgramServicesAmt |
| Management And General | $7,222 | ManagementAndGeneralAmt |
| Fundraising | $4,289 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $958,230 | TotalAmt |
| Program Services | $951,167 | ProgramServicesAmt |
| Management And General | $1,968 | ManagementAndGeneralAmt |
| Fundraising | $5,095 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,641 | TotalAmt |
| Management And General | $8,898 | ManagementAndGeneralAmt |
| Fundraising | $12,743 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,371 | TotalAmt |
| Program Services | $11,148 | ProgramServicesAmt |
| Management And General | $3,904 | ManagementAndGeneralAmt |
| Fundraising | $2,319 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,261 | TotalAmt |
| Program Services | $44,450 | ProgramServicesAmt |
| Management And General | $15,566 | ManagementAndGeneralAmt |
| Fundraising | $9,245 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,726 | TotalAmt |
| Management And General | $25,726 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,461 | TotalAmt |
| Management And General | $1,461 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,611 | TotalAmt |
| Program Services | $1,212 | ProgramServicesAmt |
| Management And General | $2,166 | ManagementAndGeneralAmt |
| Fundraising | $233 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,064 | TotalAmt |
| Program Services | $683 | ProgramServicesAmt |
| Management And General | $239 | ManagementAndGeneralAmt |
| Fundraising | $142 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,412 | TotalAmt |
| Program Services | $7,965 | ProgramServicesAmt |
| Management And General | $2,790 | ManagementAndGeneralAmt |
| Fundraising | $1,657 | FundraisingAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISC TAXES & LICENSES | Desc |
| Total | $540 | TotalAmt |
| Program Services | $306 | ProgramServicesAmt |
| Management And General | $170 | ManagementAndGeneralAmt |
| Fundraising | $64 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,262,048 | TotalAmt |
| Program Services | $1,545,624 | ProgramServicesAmt |
| Management And General | $318,881 | ManagementAndGeneralAmt |
| Fundraising | $397,543 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $816,890 | BOYAmt |
| EOY | $1,249,686 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,079 | BOYAmt |
| EOY | $91,079 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $599,970 | BOYAmt |
| EOY | $706,850 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,318 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,083 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,299 | BOYAmt |
| EOY | $3,235 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,459 | BOYAmt |
| EOY | $43,064 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,620,697 | BOYAmt |
| EOY | $2,093,914 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,711 | BOYAmt |
| EOY | $93,035 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,861 | BOYAmt |
| EOY | $25,958 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,572 | BOYAmt |
| EOY | $118,993 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,483,125 | BOYAmt |
| EOY | $1,974,921 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,483,125 | BOYAmt |
| EOY | $1,974,921 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,620,697 | BOYAmt |
| EOY | $2,093,914 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $491,796 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $663,750 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $905,983 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,208,163 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,828,112 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,753,844 | CurrentTaxYearAmt |
| Total | $9,359,852 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $663,750 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $905,983 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,208,163 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,828,112 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,753,844 | CurrentTaxYearAmt |
| Total | $9,359,852 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $9,359,852 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $167 | CurrentTaxYearMinus4YearsAmt |
| Total | $167 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $9,360,019 | TotalSupportAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99990 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,318 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,083 | DepreciationAmt |
| Book Value | $3,235 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,235 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CREDIT CARD PAYABLE | $4,678 |
| PAYROLL TAXES PAYABLE | $21,280 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $25,958 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JONATHAN A BROYLES | PersonNm |
| Title | EXECUTIVE DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $137,514 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $15,000 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $152,514 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | COPY OF FORM 990 IS PROVIDED TO THE MEMBERS OF GOVERNING BODY FOR REVIEW BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | WHEN THERE IS A POTENTIAL CONFLICT OF INTEREST, THE ISSUE IS RAISED IN PUBLIC AND A DISCUSSION ENSUES. IN THE LIMITED CASES WHEN THAT HAS HAPPENED, THE MEMBER WITH THE POTENTIAL CONFLICT RECUSES HIMSELF FROM VOTING. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROGRAM INITIATIVE: PROGRAM SERVICE EXPENSES 943,367. MANAGEMENT AND GENERAL EXPENSES 1,968. FUNDRAISING EXPENSES 5,095. TOTAL EXPENSES 950,430. 2018 NATIONAL SUMMIT: PROGRAM SERVICE EXPENSES 7,800. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,800. |