2011-08-15T11:50:55-05:00 2010-12-31 CHERRY BEKAERT & HOLLAND LLP 1111 METROPOLITAN AVENUE SUITE 1000 CHARLOTTE NC 28204 990 2010-01-01 201184743 PATIENT ACCESS NETWORK FOUNDATION PATI 2023841471 900 19TH STREET NW NO 200 WASHINGTON DC 20006 PATRICK MCKERCHER 2023841471 2011-08-12 1 7043771678 2010 2016-02-24 21:20:13Z PATRICK MCKERCHER 900 19TH STREET NW SUITE 200 WASHINGTON DC 20006 75343570 0 X WWW.PANFOUNDATION.ORG X 2004 DC HELPING UNDERINSURED PATIENTS ACCESS NEEDED TREATMENTS THROUGH CO-PAYMENT ASSISTANCE. 9 9 8 0 0 0 34511711 35551233 0 0 1253183 2954255 0 0 35764894 38505488 37323252 37562665 0 0 438845 616785 0 0 399683 7117877 7003349 44879974 45182799 -9115080 -6677311 86533037 82276880 4688064 5937330 81844973 76339550 X PATIENT ACCESS NETWORK (PAN) FOUNDATION IS AN INDEPENDENT NON-PROFIT CHARITABLE ORGANIZATION THAT PROVIDES FINANCIAL ASSISTANCE TO UNDERINSURED PATIENTS FOR THEIR OUT-OF-POCKET EXPENSES FOR LIFE-SAVING MEDICATIONS. IN JUST SIX YEARS, PAN HAS HELPED OVER 120,000 PATIENTS BY PROVIDING NEARLY $165 MILLION IN FINANCIAL ASSISTANCE. THROUGH OUR ADVOCACY FOR THE GROWING UNDERINSURED POPULATION STRUGGLING WITH INCREASING OUT-OF-POCKET COSTS, PAN ALSO SERVES AS AN IMPORTANT "VOICE FOR THE UNDERINSURED."THROUGH A SIMPLE AND QUICK APPLICATION PROCESS, PAN PROVIDES CO-PAYMENT ASSISTANCE TO PATIENTS WITH INSURANCE, INCOME LEVELS BELOW 300% TO 500% OF THE FEDERAL POVERTY LEVEL, WHO LIVE IN A US STATE OR TERRITORY, AND NEED ASSISTANCE FOR MEDICATIONS RELATED TO 31 ONCOLOGY AND CHRONIC DISEASES. THESE 31 CONDITIONS INCLUDE BREAST CANCER, LUNG CANCER, PANCREATIC CANCER, MULTIPLE MYELOMA, CYSTIC FIBROSIS AND KIDNEY TRANSPLANTS. 0 0 10613929 APPROVED 2,971 RHEUMATOID ARTHRITIS PATIENTS AND PROVIDED FINANCIAL ASSISTANCE TO HELP PAY FOR MEDICATIONS. 6004047 APPROVED 2,687 NON-SMALL CELL LUNG CANCER PATIENTS AND PROVIDED FINANCIAL ASSISTANCE TO HELP PAY FOR MEDICATIONS. 16677372 APPROVED 6,810 PATIENTS WITH OTHER DISEASES AND PROVIDED FINANCIAL ASSISTANCE TO HELP PAY FOR MEDICATIONS. 5822151 APPROVED 3,233 BREAST CANCER PATIENTS AND PROVIDED FINANCIAL ASSISTANCE TO HELP PAY FOR MEDICATIONS. 3605323 APPROVED 1,035 MULTIPLE MYELOMA PATIENTS AND PROVIDED FINANCIAL ASSISTANCE TO HELP PAY FOR MEDICATIONS. 9427474 42722822 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1539 0 8 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 DC AL AK AR CA CO CT FL IL KS KY ME MD MI MA MN MS NH NJ NM NY NC ND OH OK OR PA RI SC TN UT VA WA WV WI HI AZ MO X X PATRICK MCKERCHER 2023841471 900 19TH STREET NW SUITE 200 WASHINGTON DC 20006 LYN BOOCOCK-TAYLOR 10.00 X X 9000 0 0 STEPHEN F LOEBS PHD 5.00 X X 12000 0 0 ROBERT E SMITH MD 5.00 X 9000 0 0 MICHAEL C GERALD PHD 5.00 X 10500 0 0 KIM SCHWARTZ 5.00 X 9000 0 0 ALLAN GOLDSTEIN MD 5.00 X 9000 0 0 ANITA PLOTINSKY PHD 5.00 X 9000 0 0 MICHAEL O'GRADY 5.00 X 6000 0 0 PATRICK L MCKERCHER 5.00 X 6000 0 0 JULIE E REYNES 40.00 X 256666 0 15740 DONNA ROMAN 40.00 X 34716 0 513 370882 0 16253 1 0 1 0 THE LASH GROUP INC 3735 GLEN LAKE DRIVE CHARLOTTE NC 28208 MANAGEMENT SERVICES 5472894 MILLIMAN INC 111 MONUMENT CIRCLE 601 INDIANAPOLIS IN 460245128 ACTUARIAL & CONSULTING 143500 2 35551233 35551233 2862450 2862450 36929887 36838082 91805 91805 91805 38505488 0 0 2954255 33260579 33260579 4302086 4302086 380282 380282 162232 34407 127825 10019 9400 619 28594 18377 10217 35658 24268 11390 93347 93347 83745 83745 242297 242297 908150 908150 52019 52019 30311 30311 19056 19056 89671 89671 99533 99533 3928 3928 10822 10822 FEES FOR PROGRAM OPERAT 5049785 5049785 PHARMACY CARDS 96876 96876 OUTREACH 13496 13496 210313 12700 197613 45182799 42722822 2060294 399683 11549959 7188283 5600000 373235 1538 15712 21702 15403 10346 8985 5057 69356843 74688603 86533037 82276880 4688064 5937330 4688064 5937330 X 2206775 4208137 79638198 72131413 81844973 76339550 86533037 82276880 X -6677311 1171888 X X 0 1 1 X 0 X 53185277 48197417 54511561 34511711 35551233 225957199 53185277 48197417 54511561 34511711 35551233 225957199 188182266 37774933 1560465 3112680 2653011 1258146 2862450 11446752 2852 2852 237406803 0.16000 0.18000 X PATIENT ACCESS NETWORK FOUNDATION CONTINUES TO QUALIFY AS A PUBLIC CHARITY UNDER THE FACTS AND CIRCUMSTANCES TEST. THE PUBLIC SUPPORT RECEIVED BY THE ORGANIZATION EQUALS AT LEAST 10% OF THE TOTAL SUPPORT RECEIVED BY THE ORGANIZATION. THE ORGANIZATION IS ORGANIZED AND OPERATED TO ATTRACT NEW AND ADDITIONAL PUBLIC SUPPORT ON A CONTINUOUS BASIS AND IS MAINTAINING A PROGRAM TO SOLICIT FUNDS FROM THE GENERAL PUBLIC. IN ADDITION, THE 10% TEST IS SATISFIED BY SUPPORT FROM A NUMBER OF UNRELATED DONORS (AS OPPOSED TO SUPPORT FROM MEMBERS OF A SINGLE FAMILY), THE ORGANIZATION'S GOVERNING BODY REPRESENTS THE BROAD INTERESTS OF THE PUBLIC RATHER THAN THE PERSONAL OR PRIVATE INTERESTS OF A LIMITED NUMBER OF DONORS, THE ORGANIZATION PROVIDES SERVICES DIRECTLY FOR THE BENEFIT OF THE GENERAL PUBLIC ON A CONTINUOUS BASIS AND THE ORGANIZATION MAINTAINS A DEFINITIVE PROGRAM FOR ACCOMPLISHING ITS CHARITABLE WORK IN THE COMMUNITY. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 15403 10346 5057 5057 EXCHANGE TRADED AND CLOSED END FUNDS 18160655 F MUTUAL FUNDS 15935378 F GOVERNMENT & AGENCY SECURITIES 24431896 F CORPORATE BONDS 15792510 F ACCRUED INTEREST INCOME 368164 F 74688603 38505488 45182799 -6677311 1171888 1171888 -5505423 39435079 1171888 1171888 38263191 242297 242297 38505488 44940502 0 44940502 242297 242297 45182799 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE FOUNDATION FOLLOWS THE FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE FOUNDATION'S POLICY IS TO RECORD A LIABILITY FOR ANY TAX POSITION TAKEN THAT IS BENEFICIAL TO THE FOUNDATION, INCLUDING ANY RELATED INTEREST AND PENALTIES, WHEN IT IS MORE LIKELY THAN NOT THE POSITION TAKEN BY MANAGEMENT WITH RESPECT TO A TRANSACTION OR CLASS OF TRANSACTIONS WILL BE OVERTURNED BY A TAXING AUTHORITY UPON EXAMINATION. MANAGEMENT BELIEVES THERE ARE NO SUCH POSITIONS AS OF DECEMBER 31, 2010 AND 2009 AND, ACCORDINGLY, NO LIABILITY HAS BEEN ACCRUED. 1 ASHEVILLE ARTHRITIS CENTER PA 445 BILTMORE CENTER 306 ASHEVILLE NC 28801 561426545 5004 CO-PAYMENT ASSISTANCE FOR MEDICATIONS FOR UNDERINSURED PATIENTS IN NEED US BIOSERVICES- NASHVILLE 13105 COLLECTIONS CENTRE DR CHICAGO IL 60693 043734758 5017 CO-PAYMENT ASSISTANCE FOR MEDICATIONS FOR UNDERINSURED PATIENTS IN NEED RETINA VITREOUS ASSOC 2213 CHERRY ST 400 TOLEDO OH 43608 341196311 5025 CO-PAYMENT ASSISTANCE FOR MEDICATIONS FOR UNDERINSURED PATIENTS IN NEED WEST COAST RETINA MEDICAL GROUP INC 185 BERRY ST 130 SAN FRANCISCO CA 94107 942275625 5051 CO-PAYMENT ASSISTANCE FOR MEDICATIONS FOR UNDERINSURED PATIENTS IN NEED REGIONAL WEST PHYSICIAN CLINIC PO BOX 1248 SCOTTSBLUFF NE 69363 363314159 5054 CO-PAYMENT ASSISTANCE FOR MEDICATIONS FOR UNDERINSURED PATIENTS IN NEED GENTIVA CARECENTRIX PO BOX 277947 ATLANTA GA 30384 113454103 5057 CO-PAYMENT ASSISTANCE FOR 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THE PATIENT'S GRANT WILL PROVIDE ASSISTANCE FOR THEIR RESPONSIBILITY (DEDUCTIBLE, CO-PAYMENT, OR COINSURANCE) FOR COVERED MEDICATION SERVICES AFTER PAYMENT FROM THE PRIMARY INSURANCE OR THE AMOUNT AVAILABLE TO EACH PATIENT IS LIMITED BY A CAP SET BY THE BOARD. FUNDS ARE DISBURSED TO THE PHARMACY OR PHYSICIAN'S OFFICE WHEN POSSIBLE, SINCE WE WANT TO ENSURE THAT THE PATIENT DOES NOT NEED TO PROVIDE FUNDS OUT-OF-POCKET FOR THEIR MEDICATIONS. X X X 0 0 0 0 0 0 0 0 0 JULIE E REYNES 256666 0 0 0 0 0 9400 0 6340 0 272406 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 IS MAILED TO ALL DIRECTORS FOR THEIR REVIEW. THEIR COMMENTS ARE THEN INCORPORATED INTO THE FORM. THE FINAL 990 IS SUBMITTED UNDER THE SECRETARY/TREASURER SIGNATORY. FORM 990, PART VI, SECTION B, LINE 12C AS POTENTIAL BOARD MEMBERS OR OFFICERS ARE RECRUITED THEY ARE ASKED ABOUT POSSIBLE CONFLICTS OF INTEREST. ONCE THEY JOIN PAN, OR ANNUALLY, THEY WILL READ THE CONFLICT OF INTEREST POLICY AND FILL OUT AND SIGN THE FORM. IF ANY CONFLICTS ARE NOTED ON THE FORM, MORE INFORMATION WILL BE GATHERED AND IT WILL BE DETERMINED IF THE ISSUE IS MATERIAL. IF IT IS MATERIAL WE INVOLVE LEGAL COUNSEL AND A DETAILED FOLLOW UP AND RESOLUTION WILL OCCUR. FORM 990, PART VI, SECTION B, LINE 15 THE GOVERNING, NOMINATING AND COMPENSATION (GNC) COMMITTEE OF THE BOARD GATHERED COMPENSATION DATA FOR PRESIDENTS OF CO-PAYMENT ASSISTANCE ORGANIZATIONS AND NONPROFITS. THE GNC COMMITTEE CHAIR THEN PRESENTED THIS INFORMATION ALONG WITH THE PAN PRESIDENT'S PERFORMANCE EVALUATION RATING AND COMMENTS TO THE WHOLE BOARD IN EXECUTIVE SESSION. THE RESULTING COMPENSATION INCREASE WAS THEN DOCUMENTED ON THE PRESIDENT'S PERFORMANCE EVALUATION AND REFLECTED IN THE ORGANIZATION'S MINUTES. A SUBSEQUENT DISCUSSION WAS THEN HELD BETWEEN THE BOARD CHAIR AND THE PRESIDENT TO REVIEW THE PERFORMANCE AND SALARY INCREASE. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS, LIST OF BOARD MEMBERS AND THE ANNUAL REPORT ARE POSTED ON THE ORGANIZATION'S WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 1,171,888. AUDIT COMMITTEE FORM 990, PART XII, LINE 2C THE AUDIT AND FINANCE COMMITTEE'S PURPOSE IS TO ASSIST THE BOARD IN ITS OVERSIGHT OF THE FOUNDATION'S FINANCIAL AFFAIRS, INCLUDING THE AUDIT PROCESS. IT IS THE COMMITTEE'S RESPONSIBILITY TO SELECT AND DISCHARGE INDEPENDENT AUDITORS AND SUPERVISE AND EVALUATE THE PERFORMANCE OF THE AUDITORS. BOOKS & RECORDS PAGE 6, SECTION C, DISCLOSURE THE ORGANIZATION'S BOOKS ARE LOCATED IN CHARLOTTE, NORTH CAROLINA IN CARE OF DENISE BADGETT AT LASH GROUP, INC, 3735 GLEN LAKE DRIVE, CHARLOTTE, NC 28208, 704-357-3071. THE RECORDS ARE LOCATED AS STATED ON PAGE 6, SECTION C.