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RHODE ISLAND MEDICAL SOCIETY FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
RHODE ISLAND MEDICAL SOCIETY FOUNDATION (EIN 05-0401176)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-05-22
IRS object ID
201341429349300739
Schema version
2012v2.0
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

FieldValueIRS element (for citing)
Timestamp2013-05-22T15:53:26-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CALIRI MANCINI & BARBIERI PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11 WORTHINGTON RDAddressLine1
CityCRANSTONCity
StateRIState
ZIP Code02920ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN050401176EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1RHODE ISLAND MEDICAL SOCIETY FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlRHODNameControl
Phone4013313207Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1235 PROMENADE STREETAddressLine1
CityPROVIDENCECity
StateRIState
ZIP Code02908ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameNEWELL E WARDE PHDName
TitleEXECUTIVE DIRECTORTitle
Phone4013313207Phone
Date Signed2013-05-22DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameNANCY L MANCINI CPAName
Phone4012317736Phone
Date Prepared2013-05-22DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1NEWELL E WARDE PHDBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1235 PROMENADE ST STE 500AddressLine1
CityPROVIDENCECity
StateRIState
ZIP Code02908ZIPCode
FieldValueIRS element (for citing)
Gross Receipts391913GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitehttp://www.rimed.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1983YearFormation
State Legal DomicileRIStateLegalDomicile
Activity Or Mission DescriptionPromote the betterment of public health by engaging in educational and charitable activities related to the field of medicine, and to support peer review activities relating to health care services in the State of Rhode IslandActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers70TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year157587ContributionsGrantsPriorYear
Contributions Grants Current Year148015ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year17541InvestmentIncomePriorYear
Investment Income Current Year36579InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year175128TotalRevenuePriorYear
Total Revenue Current Year184594TotalRevenueCurrentYear
Grants And Similar Amnts CY32586GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year177185OtherExpensePriorYear
Other Expenses Current Year188641OtherExpensesCurrentYear
Total Expenses Prior Year177185TotalExpensesPriorYear
Total Expenses Current Year221227TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2057RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-36633RevenuesLessExpensesCY
Total Assets BOY565108TotalAssetsBOY
Total Assets EOY526391TotalAssetsEOY
Total Liabilities BOY29696TotalLiabilitiesBOY
Total Liabilities EOY35786TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY535412NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY490605NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPromote the betterment of publicMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense162260Expense
DescriptionPHYSICIANS HEALTH PROGRAM ESTABLISHED TO SUPPORT THE COST OF EMPLOYING PROFESSIONALS WHO PROVIDES SERVICES PERTAINING TO THE HEALTH OF PHYSICIANS AND CERTAIN OTHER MEDICAL PROFESSIONALS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense31500Expense
Grants31500Grants
DescriptionHEALTH PROFESSIONAL WORKFORCE OF THE FUTURE FUND WAS ESTABLISHED TO ENCOURAGE AND SUPPORT INDIVIDUALS EARLY IN THEIR CAREERS WHO ARE COMMITTED TO WORKING IN HEALTH CARE, ESPECIALLY IN THE PRACTICE OF MEDICINE. THE FUND WAS INITIATED BY THE PROVIDENCE MEDICAL ASSOCIATION AND SUPPORTED BY PHYSICIANS THROUGHOUT RHODE ISLAND IN THE INTEREST OF RHODE ISLAND PATIENTS OF THE FUTURE.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense6120Expense
DescriptionBIKE SAFETY PROGRAM HAS PROVIDED MORE THAN 5,600 SAFETY MATERIALS OVER THE PAST 13 YEARS.Description

Activity Other ActivityOther (2 entries)

ExpenseExpenseGrantsGrantsDescriptionDescription
40041086RHODE ISLAND CHRONIC CARE COLLABORATIVE FUND ESTABLISHED TO PROVIDE TEAMS OF HEALTHCARE PROVIDERS THE TOOLS THEY NEED TO INCREASE THEIR JOB OF HEALTHCARE PROVIDERS THE TOOLS THEY NEED TO INCREASE THEIR JOB OF HEALTHCARE PROVIDERS THE TOOLS THEY NEED TO INCREASE THEIR JOB OF HEALTHCARE PROVIDERS THE TOOLS THEY NEED TO INCREASE THEIR JOB
2957TAR WARS CAMPAIGN IS AN ANNUAL ANTI-TOBACCO EFFORT THAT REACHES THOUSANDS OF YOUNGSTERS IN RHODE ISLAND THAT REACHES THOUSANDS OF YOUNGSTERS IN RHODE ISLAND
FieldValueIRS element (for citing)
Total Of Other Program Service Exp6961TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt1086TotalOfOtherProgramServiceGrnt
Total Program Service Expense206841TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10961NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonNEWELL E WARDE PHDNamePerson
Telephone Number4013313207TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1235 PROMENADE ST SUITE 500AddressLine1
CityPROVIDENCECity
StateRIState
ZIP Code02908ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
ALYN L ADRAIN MD
TRUSTEE0.02X020000
VERA A DE PALO MD
TRUSTEE0.02X000
DIANE SIEDLECKI MD
TRUSTEE through 9/120.02X020000
GARY BUBLY MD
PRESIDENT through 9/120.10X000X
NITIN S DAMLE MD
PRESIDENT begin 9/120.10X015000X
JERALD C FINGERUT MD
SECRETARY/TREASURER0.10X000X
NEWELL E WARDE PHD
EXECUTIVE DIRECTOR0.25X015290048311X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs158400TotalReportableCompFrmRltdOrgs
Total Other Compensation48311TotalOtherCompensation
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Related Organizations11000RelatedOrganizations
All Other Contributions137015AllOtherContributions
Total Contributions148015TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column8686TotalRevenueColumn
Exclusion$8,686ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities235212Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities207319Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities27893Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column27893TotalRevenueColumn
Exclusion$27,893ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column184594TotalRevenueColumn
Exclusion$36,579ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total32586Total
Program Services32586ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6895Total
Program Services6895ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total5000Total
Program Services0ProgramServices
Management And General5000ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total5844Total
Program Services1527ProgramServices
Management And General4317ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4674Total
Program Services4674ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total15000Total
Program Services15000ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total4813Total
Program Services4813ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total4377Total
Program Services4377ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4082Total
Program Services4082ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
SHARED PERSONNEL COSTS11491411491400
RIMS MANAGEMENT FEE10000800020000
BIKE SAFETY & TAR WARS PROGRAMS9077907700
MISCELLANEOUS396589630690

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total221227Total
Program Services206841ProgramServices
Management And General14386ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY75647BOY
EOY33257EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY250264BOY
EOY213956EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY5000EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY49BOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1000BOY
EOY400EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis32593LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec15357LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY21318BOY
EOY17236EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY216830BOY
EOY256542EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY565108BOY
EOY526391EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3560BOY
EOY6451EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY5176BOY
EOY5176EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY20960BOY
EOY24159EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY29696BOY
EOY35786EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY127856BOY
EOY116729EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY407556BOY
EOY373876EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY535412BOY
EOY490605EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY565108BOY
EOY526391EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-36633ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-8174ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewtrueAccountantCompileOrReview
FS AuditedfalseFSAudited
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years264667CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years132128CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years178902CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year157587CurrentTaxYearMinus1Year
Current Tax Year148015CurrentTaxYear
Total881299Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years264667CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years132128CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years178902CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year157587CurrentTaxYearMinus1Year
Current Tax Year148015CurrentTaxYear
Total881299Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total264269AmountsSubstContributorsTotal
Public Support Total170617030PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9613CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14010CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8077CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8489CurrentTaxYearMinus1Year
Current Tax Year8686CurrentTaxYear
Total48875Total
FieldValueIRS element (for citing)
Total Support930174TotalSupport
Public Support Pertcentage1700.66330PublicSupportPertcentage170
Public Support Pertcent Prior Year0.64740PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
Public Support Total5090PublicSupportTotal509
Public Support Percentage5090PublicSupportPercentage509
Investment Income Percentage0InvestmentIncomePercentage

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtcfalseAgentTrusteeEtc
Beginning Balance5176BeginningBalance
Ending Balance5176EndingBalance
Included On FStrueIncludedOnFS

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis32593OtherCostOrOtherBasis
Depreciation15357Depreciation
Book Value17236BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings17236TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO RHODE ISLAND MEDICAL SOCIETYDescription
Amount$24,159Amount
FieldValueIRS element (for citing)
Total Of Amounts24159TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierExplanationExplanation
Pt IV Line 2bFUNDS ARE BEING HELD ON BEHALF OF THE WASHINGTON COUNTY
MEDICAL SOCIETY UNTIL THIS ENTITY BECOMES ACTIVE AGAIN.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1GIFT CASHIER BROWN UNIVBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1BOX 1877AddressLine1
CityPROVIDENCECity
StateRIState
ZIP Code02917ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient050258809EINOfRecipient
Amount Of Cash Grant31500AmountOfCashGrant
Purpose Of GrantAwards Endow.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV (10 entries)

IdentifierIdentifierExplanationExplanation
Pt I Line 2THE FUNDS GRANTED TO BROWN UNIVERSITY ESTABLISHED AN ENDOWMENT TO FUND
TWO PRIZES TO STUDENTS AT BROWN UNIVERSITY'S WARREN ALPERT MEDICAL SCHOOL,
NAMELY, THE DR. AMOS THROOP PRIZE AND THE DR. HERBERT RAKATANSKY PRIZE.
THE THROOP PRIZE WILL BE AWARDED ANNUALLY TO THE GRADUATING SENIOR MEDICAL
STUDENT WHO HAS MOST DISTINGUISHED HIM/HERSELF THROUGH ENGAGEMENT WITH PUBLIC
POLICY MATTERS RELATING TO HEALTH CARE AND ADVOCACY FOR PATIENTS THROUGH
INVOLVEMENT WITH ORGANIZED MEDICINE. THE RAKATANSKY PRIZE WILL BE AWARDED
ANNUALLY TO THE GRADUATING MEDICAL STUDENT WHO HAS DONE THE MOST TO PROMOTE THE
HEALTH AND WELL-BEING OF HER/HIS FELLOW MEDICAL STUDENTS. THESE FUNDS
WILL BE MONITORED AND ADMINISTERED BY BROWN UNIVERSITY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonNEWELL E WARDE PHDNamePerson
Comp Based On Related Orgs152900CompBasedOnRelatedOrgs
Deferred Comp Related Orgs16002DeferredCompRelatedOrgs
Nontaxable Benefits Related Orgs32309NontaxableBenefitsRelatedOrgs
Total Compensation Related Orgs201211TotalCompensationRelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierExplanationExplanation
Pt VI, Line 11bA COPY OF THE FORM 990 IS PROVIDED TO THE PRESIDENT AND
THE TREASURER FOR THEIR REVIEW PRIOR TO THE EXECUTIVE
DIRECTOR'S SIGNATURE AND FILING.
Pt VI, Line 15bAT THE PRESENT TIME, NONE OF THE TOP MANAGEMENT OFFICIALS
ARE COMPENSATED BY THE FOUNDATION.
Pt VI, Line 19GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS
ARE MADE AVAILABLE UPON REQUEST.
Form 990EZ, Part I, Line 16SHARED PERSONNEL COSTS TAR WARS CAMPAIGN BIKE HELMET EXPENSE CONFERENCES & MEETINGS OFFICE EXPENSES INFORMATION TECHNOLOGY TRAVEL & ENTERTAINMENT DUES MISCELLANEOUS CONTRIBUTIONS
Form 990EZ, Part II, Line 24PREPAID EXPENSES
Form 990EZ, Part II, Line 26ACCOUNTS PAYABLE & ACCRUED EXPENSES FUNDS HELD ON BEHALF OF OTHERS DUE TO RHODE ISLAND MEDICAL SOCIETY
Form 990, Part III, Line 4dRHODE ISLAND CHRONIC CARE COLLABORATIVE FUND ESTABLISHED TO PROVIDE TEAMS 4004. 1086. 0. TAR WARS CAMPAIGN IS AN ANNUAL ANTI-TOBACCO EFFORT 2957. 0. 0.
Form 990, Part IX, Line 24fGUN SAFETY PROGRAM PRINTING & POSTAGE CONTRIBUTIONS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
RHODE ISLAND MEDICAL SOCIETY
235 PROMENADE STREET SUITE 500PROVIDENCERI02908050250010MEMBERSHIP SOCIETYRI501(c)(6)NAfalse
RI MEDICAL POLITICAL ACTION COMMITTEE
235 PROMENADE STREET SUITE 500PROVIDENCERI02908050250010POLITICAL ACTION COMMITTEERI527NAfalse
PROVIDENCE MEDICAL ASSOCIATION
235 PROMENADE STREET SUITE 500PROVIDENCERI02908050203944MEMBERSHIP ASSOC.RI501(c)(6)NAfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1RIMS INSURANCE BROKERAGE CORPORATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1235 PROMENADE STREET SUITE 500AddressLine1
CityPROVIDENCECity
StateRIState
ZIP Code02908ZIPCode
FieldValueIRS element (for citing)
EIN050391461EIN
Primary ActivityINSURANCE BROKERAGEPrimaryActivity
Legal Domicile StateRILegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Percentage Ownership0.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1RHODE ISLAND MEDICAL SOCIETYBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypenTransactionType
Method Of Amt DeterminationAllocated TimeMethodOfAmtDetermination