2018-08-24T10:57:43-05:00 2017-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL SUITE 201 PITTSFORD NY 14534 990 2017-01-01 205244339 AMERICAN THROMBOSIS AND HEMOSTASIS NETWORK INC AMER 5852817301 67 RED ROCK CIRCLE ROCHESTER NY 14626 CRYSTAL WATSON CEO 5852817301 2018-08-21 1 MICHAEL VOLLMER P01322902 5853811000 2017 2022-09-23 18:48:47Z CRYSTAL WATSON 67 RED ROCK CIRCLE ROCHESTER NY 14626 10712963 0 X WWW.ATHN.ORG X 2006 GA NON-PROFIT ORGANIZATION DEDICATED TO ADVANCE AND IMPROVE THE CARE OF INDIVIDUALS WITH BLEEDING AND CLOTTING DISORDERS. 15 12 29 12 0 0 10560928 10578309 0 0 16827 96219 127 38435 10577882 10712963 4936234 4867436 0 0 2499661 3058892 0 0 36088 3188207 2969677 10624102 10896005 -46220 -183042 8482471 8864673 2470606 2834142 6011865 6030531 ATHN PROVIDES STEWARDSHIP OF A SECURE NATIONAL DATABASE, ADHERENT TO ALL PRIVACY GUIDELINES, WHICH WILL BE USED TO SUPPORT CLINICAL OUTCOMES ANALYSIS, RESEARCH, ADVOCACY AND PUBLIC HEALTH REPORTING IN THE HEMOSTASIS AND THROMBOSIS COMMUNITY. 0 0 4187792 3722134 CDC SURVEILLANCE - THIS CENTER FOR DISEASE CONTROL COOPERATIVE AGREEMENT FUNDS THE COMMUNITY COUNTS CDC PUBLIC HEALTH SURVEILLANCE PROJECT TO CREATE A UNIFORM SET OF DEMOGRAPHIC AND HEALTH SERVICES UTILIZATION DATA CHARACTERIZING THE POPULATION WITH BLEEDING AND CLOTTING DISORDERS AND TO MONITOR HEALTH INDICATORS OF THESE POPULATIONS. COMMUNITY COUNTS CONSISTS OF THREE PARTS, HTC POPULATION PROFILE, MORTALITY REPORTING, AND THE REGISTRY FOR BLEEDING DISORDERS SURVEILLANCE. MORE THAN 66,000 PATIENTS ARE INVOLVED IN THE CDC SURVEILLANCE PROJECT. 1431833 ATHN SYSTEMS - THIS PROGRAM COMPRISES THE SOFTWARE SYSTEMS AND CAPABILITIES REQUIRED AS A STEWARD OF A SECURE NATIONAL DATABASE USED TO SUPPORT CLINICAL OUTCOMES ANALYSIS, RESEARCH, AND PUBLIC HEALTH WITH REPORTING BY OVER 135 TREATMENT CENTERS, GOVERNMENT ENTITIES, AND RESEARCHERS. 925015 81417 HRSA MCHB - THIS NATIONAL HEMOPHILIA PROGRAM IS A COOPERATIVE AGREEMENT WHICH FUNDS THE FIRST NATIONAL HEMOPHILIA PROGRAM COORDINATING CENTER. THE PROJECT CREATES A NATIONAL NETWORK TO OPTIMIZE THE CARE FOR PATIENTS WITH BLEEDING AND THROMBOTIC DISORDERS OVER THEIR LIFETIME AND ACROSS GENERATIONS AND EXTENDS ATHN'S LEADERSHIP FROM THE HTCS AND REGIONS TO A BROADER GROUP OF STAKEHOLDERS SUCH AS PROFESSIONAL ORGANIZATIONS, PATIENT ADVOCACY GROUPS, PAYERS, AND GOVERNMENT PARTNERS. 2677224 1063885 38435 2677224 1063885 38435 9221864 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 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 0 0 0 0 1 7 0 29 1 0 0 0 0 0 0 0 0 0 0 X 15 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X LINDA MAGLIOCCO 5852817301 67 REDROCK CIRCLE ROCHESTER NY 14626 REBECKA DUDLEY INTERIM CEO OF GOVERNMENT AND COMMUNITY PROJECTS 1.00 X X 161718 0 8737 ROBERT SIDONIO MD BOARD MEMBER 1.00 X 0 0 0 PAM BETZ TREASURER 1.00 X X 0 0 0 SARAH O'BRIEN MD BOARD MEMBER 1.00 X 0 0 0 MARK W SKINNER JD BOARD MEMBER 1.00 X 0 0 0 VANESSA BYAMS MPH BOARD MEMBER (NON-VOTING) 1.00 X 0 0 0 LESLIE RAFFINI MD BOARD MEMBER 1.00 X 0 0 0 MICHAEL RECHT 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501(C)(3) 309926 CDC SURVEILLANCE GRANT AND RENAL DISEASE EXTENSION, MLOF, DATA MANAGEMENT CAPACITY RESEARCH HEMOPHILIA OF GEORGIA INC 8800 ROSWELL RD SUITE 170 ATLANTA GA 30350 581175625 501(C)(3) 314321 CDC SURVEILLANCE GRANT HEMOPHILIA FOUNDATION OF MICHIGAN 1921 W MICHIGAN AVE YPSILANTI MI 48197 381905673 501(C)(3) 536561 CDC SURVEILLANCE GRANT GREAT LAKES HEMOPHILIA FOUNDATION 638 N 18TH ST SUITE 108 MILWAUKEE WI 53233 237367636 501(C)(3) 373152 CDC SURVEILLANCE GRANT UNIVERSITY OF COLORADO DENVER 13001 E 17TH PLACE AURORA CO 80045 841179794 501(C)(3) 5110 ATHN2, DATA MANAGEMENT CAPACITY RESEARCH THE CENTER FOR COMPREHENSIVE CARE & DIAGNOSIS OF INHERITED BLOOD DISORDERS 1310 W STEWART DR SUITE 606 ORANGE CA 92868 270179192 501(C)(3) 471918 CDC SURVEILLANCE GRANT, MLOF, DATA MANAGEMENT CAPACITY RESEARCH OREGON HEALTH AND SCIENCE UNIVERSITY 0690 BANCROFT ST L106SPA PORTLAND OR 97239 931176109 501(C)(3) 312812 CDC SURVEILLANCE GRANT, ATHN2, MLOF, DATA MANAGEMENT CAPACITY ALBANY MEDICAL CENTER 47 NEW SCOTLAND AVENUE ALBANY NY 12208 141338310 501(C)(3) 22000 DATA MANAGEMENT CAPACITY RESEARCH REGENTS UNIVERSITY OF MICHIGAN 3003 S STATE ST RM 1054 ANN ARBOR MI 48109 386006309 501(C)(3) 11000 THROMBOSIS GRANT, ATHN2, DATA MANAGEMENT CAPACITY RESEARCH EAST TENESEE COMPREHENSIVE HEMOPHILIA CENTER 1928 ALCOA HIGHWAY SUITE B-214 KNOXVILLE TN 37920 311626179 501(C)(3) 9150 DATA MANAGEMENT CAPACITY RESEARCH UT SOUTHWESTERN MEDICAL CENTER 5323 HARRY HINES BVD DALLAS TX 75390 756002868 501(C)(3) 31958 THROMBOSIS GRANT, ATHN2, MLOF, DATA MANAGEMENT CAPACITY RESEARCH OHIO STATE UNIVERSITY 1960 KENNY ROAD COLUMBUS OH 43210 316025986 501(C)(3) 21750 DATA MANAGEMENT CAPACITY RESEARCH AND THROMBOSIS GRANT PROMEDICA TOLEDO CHILDREN'S HOSPITAL 3949 SUN FOREST COURT SUITE 203 TOLEDO OH 43623 344428256 501(C)(3) 22070 DATA MANAGEMENT CAPACITY RESEARCH REGENTS UNIVERSITY OF CALIFORNIA 9500 GILMAN DRIVE LA JOLLA CA 92093 956006144 501(C)(3) 31500 DATA MANAGEMENT CAPACITY RESEARCH ST JOSEPH'S CHILDREN'S HOSPITAL TAMPA 4600 NORTH HABANA AVENUE SUITE 23 TAMPA FL 33614 590774199 501(C)(3) 26088 THROMBOSIS GRANT, ATHN2, MLOF, DATA MANAGEMENT CAPACITY RESEARCH ST LOUIS UNIVERSITY 3700 WEST PINE MALL ROOM 368 ST LOUIS MO 63108 430654872 501(C)(3) 13250 DATA MANAGEMENT CAPACITY RESEARCH UNIVERSITY OF ARIZONA PO BOX 210158 TUSCON AZ 85721 742652689 501(C)(3) 13700 DATA MANAGEMENT CAPACITY RESEARCH UNIVERSITY OF IOWA 85 JESSUP HALL IOWA CITY IA 52242 426004813 501(C)(3) 31750 DATA MANAGEMENT CAPACITY RESEARCH AND THROMBOSIS GRANT THE RESEARCH INSTITUTE AT NATIONWIDE CHILDREN'S HOSPITAL 700 CHILDRENS DRIVE COLUMBUS OH 432052664 316056230 501(C)(3) 21050 DATA MANAGEMENT CAPACITY RESEARCH ST JUDE CHILDREN'S RESEARCH HOSPITAL INC 262 DANNY THOMAS PLACE MEMPHIS TN 381053678 620646012 501(C)(3) 33200 DATA MANAGEMENT CAPACITY RESEARCH WASHINGTON UNIVERSITY SCHOOL OF MEDICINE 700 ROSE DALE AVENUE CB 1034 ST LOUIS MO 63112 430653611 501(C)(3) 6300 DATA MANAGEMENT CAPACITY RESEARCH CHILDREN'S HOSPITAL OF LOS ANGELES 4650 SUNSET BLVD 54 LOS ANGELES CA 90027 951690977 501(C)(3) 14150 DATA MANAGEMENT CAPACITY RESEARCH AND THROMBOSIS GRANT WEILL MEDICAL COLLEGE- CORNELL UNIVERSITY 525 EAST 68TH ST RM P-695 NEW YORK NY 10065 131623978 501(C)(3) 16330 THROMBOSIS GRANT, MLOF, ATHN2, DATA MANAGEMENT CAPACITY RESEARCH CHILDREN'S HOSPITAL OF MICHIGAN 3901 BEAUBIEN BLVD3RD FLOOR CARLS BUILDING DETROIT MI 48201 383336414 501(C)(3) 7550 THROMBOSIS GRANT, MLOF, DATA MANAGEMENT CAPACITY RESEARCH DARTMOUTH COLLEGE ONE MEDICAL CENTER DRIVE LEBANON NH 03756 222715483 501(C)(3) 11626 THROMBOSIS GRANT, MLOF, ATHN2, DATA MANAGEMENT CAPACITY RESEARCH VERMONT REGIONAL HEMOPHELIA CENTER 111 COLCHESTER AVENUE BURLINGTON VT 05401 030219309 501(C)(3) 7500 THROMBOSIS GRANT EMORY 550 PEACHTREE STREET NE ALTANTA GA 30308 582137993 501(C)(3) 54058 THROMBOSIS GRANT, MCHB, ATHN2, MLOF, DATA MANAGEMENT CAPACITY RESEARCH MONTEFIORE MEDICAL CENTER 110 EAST 210TH ST BRONX NY 10467 131740114 501(C)(3) 11150 THROMBOSIS GRANT, DQC, DATA MANAGEMENT CAPACITY RESEARCH VIRGINIA COMMONWEALTH UNIVERSITY 1000 E MARSHALL ST 3RD FLOOR ROOM 324 RICHMOND VA 23298 546001758 501(C)(3) 15700 DATA MANAGEMENT CAPACTITY RESEACH BRODY SCHOOL OF MEDICINE AT EAST CAROLINA UNIVERSITY 600 MOYE BLV MA SUITE 333 GREENVILLE NC 27834 560000403 501(C)(3) 6250 DATA MANAGEMENT CAPACITY RESEARCH CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS 601 CHILDRENS LANE NORFOLK VA 23507 540506321 501(C)(3) 12500 DATA MANAGEMENT CAPACITY RESEARCH CHILDREN'S NATIONAL MEDICAL CENTER 111 MICHIGAN AVENUENW WASHINGTON DC 20010 521654453 501(C)(3) 9850 DATA MANAGEMENT CAPACITY RESEARCH HEMOPHILIA OUTREACH CENTER 2060 BELLEVUE STREET GREEN BAY WI 54311 391858104 501(C)(3) 24450 DATA MANAGEMENT CAPACITY RESEARCH PHOENIX CHILDREN'S HOSPITAL FOUNDATION 1919 E THOMAS ROAD BUILDING B PHOENIX AZ 85016 860422559 501(C)(3) 7450 DATA MANAGEMENT CAPACITY RESEARCH VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 941294954 501(C)(3) 32600 DATA MANAGEMENT CAPACITY RESEARCH BECKMAN RESEARCH INSTITUTE OF THE CITY OF HOPE 1500 E DURATE RD DUARTE CA 91010 953432210 501(C)(3) 6600 DATA MANAGEMENT CAPACITY RESEARCH BOSTON CHILDREN'S HOSPITAL 300 LONGWOOD AVE BOSTON MA 02115 042774441 501(C)(3) 10630 DATA MANAGEMENT CAPACITY RESEARCH CHILDREN'S HOPITAL NEW ORLEANS 200 HENRY CLAY AVE STE 3201 NEW ORLEANS LA 70118 720467503 501(C)(3) 6050 DATA MANAGEMENT CAPACITY RESEARCH CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER 3333 BURNET AVE ML 4006 CINCINNATI OH 45229 310833936 501(C)(3) 19100 DATA MANAGEMENT CAPACITY RESEARCH COOK CHILDREN'S MEDICAL CENTER 801 SEVENTH AVE FORT WORTH TX 76104 752051646 501(C)(3) 11700 DATA MANAGEMENT CAPACITY RESEARCH HEMOPHILIA CENTER OF WESTERN PA 3636 BLVD OF THE ALLIES PITTSBURGH PA 15213 251562716 501(C)(3) 17094 DATA MANAGEMENT RESEARCH CAPACITY HEMOPHILIA TREATMENT CENTER OF NEVADA 3121 S MARYLAND PARKWAY STE 206 LAS VEGAS NV 89109 205354255 501(C)(3) 5476 DATA MANAGEMENT CAPACITY RESEARCH IHC HEALTH SERVICES INC 100 N MARIO CAPECCHI DR SALT LAKE CITY UT 84113 942854057 501(C)(3) 8650 DATA MANAGEMENT CAPACITY RESEARCH INDIANA HEMOPHILIA & THROMBOSIS 8326 NAAB ROAD INDIANAPOLIS IN 46260 352047838 501(C)(3) 25652 DATA MANAGEMENT CAPACITY RESEARCH AND THROMBOSIS GRANT INTERMOUNTAIN HEMOPHILIA AND THROMBOSIS P O BOX 57828 SALT LAKE CITY UT 84157 876000525 501(C)(3) 8250 DATA MANAGEMENT CAPACITY RESEARCH JOHN HOPKINS U MEDICAL CENTER 720 RUTLAND AVE BALTIMORE MD 21205 520595110 501(C)(3) 7854 DATA MANAGEMENT CAPACITY RESEARCH MAINE HEMOPHILIA AND THROMBOSIS CENTER 81 RESEARCH DR SCARBOROUGH ME 04074 010357684 501(C)(3) 10330 DATA MANAGEMENT CAPACITY RESEARCH MICHIGAN STATE UNIVERSITY 426 AUDITORIUM RD ROOM 2 EAST LANSING MI 48824 386005984 501(C)(3) 48367 DATA MANAGEMENT CAPACITY RESEARCH AND MCHB REGENTS OF THE UNIV OF COLORADO 13199 E MONTVIEW BLVD 100 AURORA CO 80045 846000555 501(C)(3) 9800 DATA MANAGEMENT CAPACITY RESEARCH AND THROMBOSIS GRANT RUSH UNIVERSITY MEDICAL CENTER 75 REMITTANCE DR STE 6807 CHICAGO IL 60675 362174823 501(C)(3) 13375 DATA MANAGEMENT CAPACITY RESEARCH ST LUKE'S HEMOPHILIA CENTER 100 E IDAHO STREET BOISE ID 83712 272050459 501(C)(3) 8400 DATA MANAGEMENT CAPACITY RESEARCH THE CHILDREN'S MERCY HOSPITAL 2401 GILLHAM ROAD KANSAS CITY MO 64108 440605373 501(C)(3) 7800 DATA MANAGEMENT CAPACITY RESEARCH AND THROMBOSIS GRANT UNC HEMOPHILIA AND THROMBOSIS CENTER 6340 QUADRANGLE DR STE 50 CHAPEL HILL NC 27517 566001393 501(C)(3) 5760 RENAL DISEASE EXTENSION UNIVERSITY OF CALIFORNIA SD MEDICAL CENTER 9500 GILMAN DR LA JOLLA CA 92093 956006144 501(C)(3) 11608 DATA MANAGEMENT CAPACITY RESEARCH UNIVERSITY OF PENNSYLVANIA 3451 WALNUT ST ROOM P-221 PHILADELPHIA PA 19104 231352685 501(C)(3) 9650 DATA MANAGEMENT CAPACITY RESEARCH UNIVERSITY OF PITTSBURGH 500 ROSS STREET 154-0455 PITTSBURGH PA 15262 250965591 501(C)(3) 7250 DATA MANAGEMENT CAPACITY RESEARCH WASHINGTON UNIVERSITY 660 S EUCLID AVE ST LOUIS MO 63110 430653611 501(C)(3) 11950 DATA MANAGEMENT CAPACITY RESEARCH AND THROMBOSIS GRANT YALE UNIV SCHOOL OF MEDICINE 333 CEDAR STREET NEW HAVEN CT 06520 060646973 501(C)(3) 7300 DATA MANAGEMENT CAPACITY RESEARCH HENRY FORD HEALTH SYSTEM 2799 W GRAND BLVD DETROIT MI 48202 381357020 501(C)(3) 5350 DATA MANAGEMENT CAPACITY RESEARCH PART I, LINE 2: ATHN HAS A FORMAL PROCESS FOR APPLYING, SELECTING, AWARDING, SUBSTANTIATING THE AMOUNTS OF GRANTS AWARDED AND TRACKING ACHIEVEMENT OF MILESTONES FUNDED BY THE GRANTS. THE ATHNDATA.QUALITY.COUNTS APPLICATION PROCESS IS AN ONLINE SUBMISSION PROCESS USING A STANDARD APPLICATION TEMPLATE, WITH SPECIFIC FUNDING REQUIREMENTS AND SUBMISSION DEADLINES ANNOUNCED TO ALL ATHN AFFILIATES. PROPOSALS ARE REVIEWED BY A MULTI-DISCIPLINARY GRANT REVIEW PANEL. EACH PROPOSAL IS WEIGHTED BASED ON CRITERIA ESTABLISHED FOR THAT ROUND OF FUNDING AND APPROPRIATENESS OF FINANCIAL REQUEST. UPON SELECTION OF THE SUBSET OF WINNING PROPOSALS, THE PROPOSED AWARDEES AND AMOUNTS OF EACH AWARD ARE REVIEWED BY THE DATA QUALITY COUNTS COMMITTEE FOR REASONABLENESS AND CONSISTENCY WITH BUDGET, AND APPROVED BY THE ATHN BOARD. LETTER AGREEMENTS CONFIRMING THE AWARDED AMOUNT AND REQUIREMENTS ARE PROVIDED AND EXECUTED BY EACH AWARDEE. PAYMENTS ARE ISSUED IN THREE PARTS: $2,500 UPFRONT AND THE REMAINING PAYMENTS MADE EVERY SUBSEQUENT SIX MONTHS UPON SUBMISSION INTERIM PROJECT REPORTS AND FINAL PROJECT REPORTS AT A RATE OF $50 OR $100 FOR UPDATING CORE DATA ELEMENTS PER PATIENT. X X X 0 0 0 0 0 0 0 0 0 REBECKA DUDLEY INTERIM CEO OF GOVERNMENT AND COMMUN 145619 0 16099 0 0 0 8737 0 0 0 170455 0 0 0 CRYSTAL WATSON INTERIM CEO OF RESEARCH AND TECH SER 168861 0 19501 0 0 0 10903 0 0 0 199265 0 0 0 LINDA MAGLIOCCO INTERIM CEO OF FINANCE AND ADMINISTR 148685 0 16686 0 0 0 9815 0 0 0 175186 0 0 0 DIANE J ASCHMAN MS PRESIDENT AND CEO 263967 0 40706 0 0 0 8324 0 0 0 312997 0 0 0 ELLEN MCCARTHY CLINICAL RESEARCH PROJECT LEAD 125835 0 17250 0 0 0 7638 0 0 0 150723 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS EMAILED TO ALL BOARD MEMBERS FOR THEIR REVIEW PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C ATHN REQUIRES ALL BOARD MEMBERS AND OFFICERS TO COMPLETE CONFLICT OF INTEREST STATEMENTS ON A YEARLY BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO'S COMPENSATION IS REVIEWED BY THE EXECUTIVE COMMITTEE AND APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 ALL REQUIRED PUBLIC DISCLOSURE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST DURING NORMAL BUSINESS HOURS.