2016-05-16T09:26:40-05:00 2015-12-31 580692043 MAULDIN & JENKINS LLC 200 GALLERIA PKWY SE STE 1700 ATLANTA GA 303395946 990 2015-01-01 581218672 NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS INC NATI 6784178100 12000 FINDLEY ROAD NO 100 JOHNS CREEK GA 30097 DAWN MORTON-RIAS EDD CEO 6784178100 2016-05-06 1 MARY JO ALEXANDER P00002534 7709558600 2016-05-06 2015 2016-12-15 16:53:06Z DAWN MORTON-RIAS EDD PA-C 12000 FINDLEY ROAD NO 100 JOHNS CREEK GA 30097 19316338 0 X WWW.NCCPA.NET X 1976 GA TO PROVIDE CERTIFICATION PROGRAMS THAT REFLECT STANDARDS FOR CLINICAL KNOWLEDGE, CLINCIAL REASONING AND OTHER MEDICAL SKILLS AND PROFESSIONAL BEHAVIORS REQUIRED UPON ENTRY INTO PRACTICE AND THROUGHOUT THEIR CAREERS AS PHYSICIAN ASSISTANTS. 18 18 80 100 0 0 0 0 15771278 16255432 529839 439830 0 0 16301117 16695262 200000 175000 0 0 4827424 5379897 0 0 0 8062649 8029230 13090073 13584127 3211044 3111135 21656010 23699904 3225315 3115641 18430695 20584263 TO PROVIDE CERTIFICATION PROGRAMS THAT REFLECT STANDARDS FOR CLINICAL KNOWLEDGE, CLINCIAL REASONING AND OTHER MEDICAL SKILLS AND PROFESSIONAL BEHAVIORS REQUIRED UPON ENTRY INTO PRACTICE AND THROUGHOUT THEIR CAREERS AS PHYSICIAN ASSISTANTS. 0 0 THE NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS, INC. SERVED APPROXIMATELY 70,175 CANDIDATES. SERVICES INCLUDED FIRST TIME EXAM APPLICANTS, RECERTIFICATION FOR EXISTING APPLICANTS, AND CERTIFICATION OF ADDED QUALIFICATIONS FOR EXISTING CANDIDATES. 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 138 0 1 80 1 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 GA X SONIA RATLIFF VP FINANCE 6784178100 12000 FINDLEY ROAD STE 100 JOHNS CREEK GA 30097 FREDERICK C BLUM BOARD MEMBER 1.00 X 0 0 0 JAMES CANNON IMMEDIATE PAST CHAIR 1.00 1.00 X X 0 0 0 CLAUDETTE E DALTON BOARD MEMBER 1.00 X 0 0 0 TIMOTHY EVANS BOARD MEMBER 1.00 X 0 0 0 WANDA C GONSALVES BOARD MEMBER 1.00 X 0 0 0 ROBIN HUNTER BUSKEY BOARD MEMBER 1.00 1.00 X 0 0 0 CYNTHIA GRIGGS-FLOURNOY BOARD MEMBER 1.00 1.00 X 0 0 0 VICTORIA KAPRIELIAN CHAIR 1.00 X X 0 0 0 JOEL KASE BOARD MEMBER 1.00 X 0 0 0 TIFFANY BILLMEIER KINDRATT BOARD MEMBER 1.00 X 0 0 0 KEVIN LOHENRY BOARD MEMBER 1.00 X 0 0 0 PAUL LOMBARDO BOARD MEMBER 1.00 X 0 0 0 JENNIFER R MADONIA SECRETARY 1.00 X X 0 0 0 VARNELL D MCDONALD-FLETCHER BOARD MEMBER 1.00 X 0 0 0 PEGGY RILEY ROBINSON BOARD MEMBER 1.00 X 0 0 0 JOHN H STUEMKY TREASURER 1.00 1.00 X X 0 0 0 MARY WARNER BOARD MEMBER 1.00 1.00 X 0 0 0 DENNI J WOODMANSEE CHAIR ELECT 1.00 1.00 X X 0 0 0 RICK BLUM BOARD MEMBER 1.00 X 0 0 0 DAWN MORTON-RIAS EDD PA-C CEO 40.00 12.00 X 334234 0 21332 RAGAN COHN VP GOVERNANCE 40.00 X 145850 0 22715 SHEILA MAULDIN VP RESEARCH AND TEST DEVELOP 40.00 X 174177 0 26682 SONIA RATLIFF VP FINANCE & HR 40.00 X 180081 0 28159 STAN GILBREATH VP TECHNOLOGY SERVICES 40.00 X 88229 0 2425 LASHARN HUGHES VP CERTIFICATION MAINTENANCE 40.00 X 11740 0 29 ANGELA LANGA DIRECTOR OF IT 40.00 X 149107 0 18688 JOSHUA GOODMAN DIRECTOR PSYCHOMETRICS & RESEARCH 40.00 X 178124 0 2575 MATTHEW BURKE DIRECTOR TEST DEVELOPMENT 40.00 X 139347 0 320 XUEDONG WANG SR. DATA ANALYST 40.00 X 104849 0 22884 KATHERINE ADAMSON DIRECTOR MEDICAL ADVISOR 40.00 X 111810 0 12575 1617548 0 158384 10 0 1 0 NCS PEARSON INC 13036 COLLECTION CENTER DR CHICAGO IL 60693 TESTING CENTER 2783490 352 INC PO BOX 919439 ORLANDO FL 32891 IT 475000 SPRINGBIT INC 5125 SAVANNAH RUN CUMMING GA 30040 IT 425000 ARBET CONSULTING INC 1074 CLIFFS VISTA PARKWAY SIX MILE SC 29682 PSYCHOMETRIC SERVICES 346366 PILLSBURY WINTHROP SHAW PITTMAN LLP PO BOX 601240 CHARLOTTE NC 29260 LEGAL 317343 7 CERTIFICATE MAINT FEES 541900 6020010 6020010 RECERTIFICATION FEES 541900 5207900 5207900 ENTRY LEVEL APPLICATION 541900 4122525 4122525 PRACTICE EXAM FEES 541900 512855 512855 SOFTWARE DEVEL PROJECT 541900 240357 240357 151785 151785 16255432 372822 372822 2688084 2620295 781 67789 -781 67008 67008 16695262 16255432 0 439830 175000 1203448 3027077 215635 646336 287401 313033 29390 77945 256937 285833 240796 261969 576252 87055 656584 1050541 57139 EXAM COSTS 3441358 CREDIT CARD PROCESSING 328585 SOFTWARE DEVELOPMENT EX 305535 MISCELLANEOUS EXP 19310 40968 13584127 200 200 4574749 3967275 62175 90170 243072 379020 12528331 10336118 1521347 2192213 12162599 14294447 3091868 2776579 21656010 23699904 655885 701391 2569430 2414250 3225315 3115641 X 18430695 20584263 18430695 20584263 21656010 23699904 3111135 -957567 0 X X 0 1 X 1 0 83883 52152 31731 298593 259932 38661 12145855 10024034 2121821 2192213 ADVANCES TO NCCPA FOUNDATION 2000000 OTHER ASSETS 225069 A/R FROM RELATED PARTIES 44329 OTHER RECEIVABLES 507181 2776579 X 15659750 -957567 -957567 16617317 77945 77945 16695262 13506182 0 13506182 77945 77945 13584127 PART X, LINE 2: THE COMMISSION IS EXEMPT FROM INCOME TAXATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(6), AND THE FOUNDATION AND THE PA HISTORY SOCIETY ARE EXEMPT UNDER SECTION 501(C)(3). MANAGEMENT OF THE ORGANIZATION CONSIDERS THE LIKELIHOOD OF CHANGES BY TAXING AUTHORITIES IN ITS FILED INCOME TAX RETURNS AND RECOGNIZES A LIABILITY FOR OR DISCLOSES POTENTIAL SIGNIFICANT CHANGES THAT MANAGEMENT BELIEVES ARE MORE LIKELY THAN NOT TO OCCUR, INCLUDING CHANGES TO THE ENTITY'S STATUS AS A NOT-FOR-PROFIT ENTITY. MANAGEMENT BELIEVES THE ENTITIES WITHIN THE ORGANIZATION MET THE REQUIREMENTS TO MAINTAIN ITS TAX-EXEMPT STATUS AND HAVE NO INCOME SUBJECT TO UNRELATED BUSINESS INCOME TAX; THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THESE FINANCIAL STATEMENTS. THE INCOME TAX RETURNS FOR THE PAST THREE YEARS ARE SUBJECT TO EXAMINATION BY TAX AUTHORITIES, AND MAY CHANGE UPON EXAMINATION. PART X, LINE 2: THE COMMISSION IS EXEMPT FROM INCOME TAXATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(6), AND THE FOUNDATION AND THE PA HISTORY SOCIETY ARE EXEMPT UNDER SECTION 501(C)(3). MANAGEMENT OF THE ORGANIZATION CONSIDERS THE LIKELIHOOD OF CHANGES BY TAXING AUTHORITIES IN ITS FILED INCOME TAX RETURNS AND RECOGNIZES A LIABILITY FOR OR DISCLOSES POTENTIAL SIGNIFICANT CHANGES THAT MANAGEMENT BELIEVES ARE MORE LIKELY THAN NOT TO OCCUR, INCLUDING CHANGES TO THE ENTITY'S STATUS AS A NOT-FOR-PROFIT ENTITY. MANAGEMENT BELIEVES THE ENTITIES WITHIN THE ORGANIZATION MET THE REQUIREMENTS TO MAINTAIN ITS TAX-EXEMPT STATUS AND HAVE NO INCOME SUBJECT TO UNRELATED BUSINESS INCOME TAX; THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THESE FINANCIAL STATEMENTS. THE INCOME TAX RETURNS FOR THE PAST THREE YEARS ARE SUBJECT TO EXAMINATION BY TAX AUTHORITIES,AND MAY CHANGE UPON EXAMINATION. 0 SOCIETY FOR THE PRESERVATION OF PHYSICIAN ASSISTANT HISTORY INC 12000 FINDLEY ROAD SUITE 160 JOHNS CREEK GA 30097 030429253 175000 FINANCIAL SUPPORT FOR OPERATING EXPENSES 1 0 PART I, LINE 2 NCCPA GIVES ASSISTANCE TO NCCPA HEALTH FOUNDATION AND THE PA HISTORY SOCIETY FOR FINANCIAL SUPPORT AND OPERATING EXPENSES. X 1 1 X X X X X 1 0 0 DAWN MORTON-RIAS EDD PA-C CEO 256634 0 47600 0 30000 0 20966 0 366 0 355566 0 0 0 RAGAN COHN VP GOVERNANCE 114057 0 16607 0 15186 0 16705 0 6010 0 168565 0 0 0 SHEILA MAULDIN VP RESEARCH AND TEST DEVELOP 132487 0 23690 0 18000 0 19892 0 6790 0 200859 0 0 0 SONIA RATLIFF VP FINANCE & HR 137640 0 24441 0 18000 0 20383 0 7776 0 208240 0 0 0 ANGELA LANGA DIRECTOR OF IT 136756 0 12351 0 0 0 10912 0 7776 0 167795 0 0 0 JOSHUA GOODMAN DIRECTOR PSYCHOMETRICS & RESEARCH 155124 0 3000 0 20000 0 0 0 2575 0 180699 0 0 0 I, LINE 1A: ALL EMPLOYEES RECEIVE REIMBURSEMENT UP TO $1,000 PER YEAR FOR HEALTH CLUB MEMBERSHIPS SCHEDULE J PART I LINE 3 AN ALL-STAFF COMPENSATION STUDY IS CONDUCTED EVERY 3-5 YEARS BY A PROFESSIONAL CONSULTING GROUP THROUGH WHICH COMPARATIVE DATA IS GATHERED REGARDING COMPENSATION FOR SIMILAR ROLES WITHIN SIMILAR ORGANIZATIONS (NATIONWIDE) AND WITHIN SIMILARLY-SIZED ORGANIZATIONS IN THIS GEOGRAPHIC AREA. INFORMED BY THAT COMPENSATION STUDY AND THE REVIEW OF SIMILAR ORGANIZATION'S 990S, THE CEO DETERMINES OFFICER'S AND OTHER KEY EMPLOYEE'S SALARIES. SIMILARLY, EXECUTIVE COMPENSATION IS ASSESSED AGAINST NATIONAL, LOCAL, AND INDUSTRY ORGANIZATIONS WITH SIMILAR BUDGETS AND STAFF SIZE. COMPARATIVE ANALYSES ARE EVALUATED BY A COMMITTEE OF THE BOARD. FINAL CEO SALARY IS DETERMINED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS PRESENTED TO THE ENTIRE BOARD OF DIRECTORS BY THE THIRD PARTY TAX ACCOUNTANT. THE BOARD VOTES TO APPROVE THE FORM 990 BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE ASKED TO ANNUALLY SIGN A PARTICIPATION AGREEMENT. IT INCLUDES A SECTION ON CONFLICT OF INTEREST AS WELL AS THEIR DUTIES OF CONFIDENTIALITY, LOYALTY, ETC. BOARD MEMBERS ARE ASKED TO DISCLOSE ANY CONFLICTS. CONFLICTS THAT DO ARISE ARE USUALLY RESOLVED BY ASKING A BOARD MEMBER TO RECUSE FROM VOTING OR SOME OTHER ARRANGEMENT DETERMINED BY THE CHAIR OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 AN ALL-STAFF COMPENSATION STUDY IS CONDUCTED EVERY 3-5 YEARS BY A PROFESSIONAL CONSULTING GROUP THROUGH WHICH COMPARATIVE DATA IS GATHERED REGARDING COMPENSATION FOR SIMILAR ROLES WITHIN SIMILAR ORGANIZATIONS (NATIONWIDE) AND WITHIN SIMILARLY-SIZED ORGANIZATIONS IN THIS GEOGRAPHIC AREA. INFORMED BY THAT COMPENSATION STUDY AND THE REVIEW OF SIMILAR ORGANIZATION'S 990S, THE CEO DETERMINES OFFICER'S AND OTHER KEY EMPLOYEE'S SALARIES. SIMILARLY, EXECUTIVE COMPENSATION IS ASSESSED AGAINST NATIONAL, LOCAL, AND INDUSTRY ORGANIZATIONS WITH SIMILAR BUDGETS AND STAFF SIZE. COMPARATIVE ANALYSES ARE EVALUATED BY A COMMITTEE OF THE BOARD. FINAL CEO SALARY IS DETERMINED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE FORM 990 IS AVAILABLE UPON REQUEST AT NCCPA. FORM 990 PART XII LINE 2C THE ORGANIZATION ISSUED A REQUEST FOR PROPOSALS FOR A FINANCIAL AUDIT AND SELECTED A FIRM. THE PROCESS FOR OVERSIGHT OF FINANCIAL STATEMENTS HAS NOT CHANGED. PART VI, LINE 13 THE ORGANIZATION'S WHISTLEBLOWER POLICY IS CONTAINED IN THE EMPLOYEE HANDBOOK IN ITS OWN DEFINED SECTION. NCCPA HEALTH FOUNDATION 12000 FINDLEY ROAD SUITE 100 JOHNS CREEK GA 30097 204381466 SUPPORTING ORGANIZATION IL 501(C)(3) LINE 11A, I NATIONAL COMMISSION OF CERTIFICATION OF PHYSICIAN ASSISTANTS INC 1 SOCIETY FOR THE PRESERVATION OF PHYSICIAN ASSISTANT HISTORY INC 12000 FINDLEY ROAD SUITE 160 JOHNS CREEK GA 30097 030429253 SUPPORTING ORGANIZATION NC 501(C)(3) LINE 11A, I NATIONAL COMMISSION OF CERTIFICATION OF PHYSICIAN ASSISTANTS INC 1 0 1 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 1 0 NCCPA HEALTH FOUNDATION L 51200 BOOK VALUE OF INKIND SERVICES NCCPA HEALTH FOUNDATION J 13800 BOOK VALUE NCCPA HEALTH FOUNDATION P 161146 PERSONNEL RELATED COSTS PA HISTORY SOCIETY P 159409 PERSONNEL RELATED COSTS PA HISTORY SOCIETY B 175000 AMOUNT CONTRIBUTED PA HISTORY SOCIETY L 26500 BOOK VALUE OF IN KIND SERVICES PART II, IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: NAME, ADDRESS, AND EIN OF RELATED ORGANIZATION: NCCPA HEALTH FOUNDATION EIN: 20-4381466 12000 FINDLEY ROAD, SUITE 100 JOHNS CREEK, GA 30097 PRIMARY ACTIVITY: SUPPORTING ORGANIZATION DIRECT CONTROLLING ENTITY: NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIANS ASSISTANTS, INC. NAME, ADDRESS, AND EIN OF RELATED ORGANIZATION: SOCIETY FOR THE PRESERVATION OF PHYSICIAN ASSISTANT HISTORY INC EIN: 03-0429253 12000 FINDLEY ROAD, SUITE 160 JOHNS CREEK, GA 30097 PRIMARY ACTIVITY: SUPPORTING ORGANIZATION DIRECT CONTROLLING ENTITY: NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIANS ASSISTANTS, INC.