Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
NEW HAMPSHIRE MEDICAL SOCIETY |
020223176 | 501(C)(6) | Yes | 0 | 0 | |
| (B)
MEDICAL SOCIETY OF NORTHERN VIRGINIA |
540739279 | 501(C)(6) | Yes | 0 | 0 | |
| (C)
DENTON COUNTY MEDICAL SOCIETY |
751676014 | 501(C)(6) | Yes | 0 | 0 | |
| (D)
CONNECTICUT STATE MEDICAL SOCIETY PHYSICIANS HEAL |
060665164 | 501(C)(6) | Yes | 0 | 0 | |
| (E)
FLORIDA MEDICAL ASSOCIATION |
590559672 | 501(C)(6) | Yes | 0 | 0 | |
| (F)
HAWAII MEDICAL ASSOCIATION |
990067306 | 501(C)(6) | Yes | 0 | 0 | |
| (G)
NORTH CAROLINA MEDICAL ASSOCIATION |
560320130 | 501(C)(6) | Yes | 0 | 0 | |
| (H)
NEBRASKA MEDICAL ASSOCIATION |
470372108 | 501(C)(6) | Yes | 0 | 0 | |
| (I)
MEDICAL SOCIETY OF NEW JERSEY |
210601684 | 501(C)(6) | Yes | 0 | 0 | |
| (J)
MEDICAL SOCIETY OF NEW YORK |
131030760 | 501(C)(6) | Yes | 0 | 0 | |
| (K)
SOUTH CAROLINA MEDICAL ASSOCIATION |
570248750 | 501(C)(6) | Yes | 0 | 0 | |
| (L)
TEXAS MEDICAL ASSOCIATION |
741078510 | 501(C)(6) | Yes | 0 | 0 | |
| (M)
VERMONT MEDICAL SOCIETY |
030164911 | 501(C)(6) | Yes | 0 | 0 | |
| (N)
LOUISIANA STATE MEDICAL SOCIETY |
720386637 | 501(C)(6) | Yes | 0 | 0 | |
| (O)
CALIFORNIA MEDICAL ASSOCIATION |
940359340 | 501(C)(6) | Yes | 0 | 0 | |
| (P)
MEDICAL ASSOCIATION OF GEORGIA |
580605267 | 501(C)(6) | Yes | 0 | 0 | |
| (Q)
TENNESSEE MEDICAL ASSOCIATION |
620382010 | 501(C)(6) | Yes | 0 | 0 | |
| (R)
WASHINGTON STATE MEDICAL ASSOCIATION |
910462170 | 501(C)(6) | Yes | 0 | 0 | |
| (S)
ALASKA STATE MEDICAL ASSOCIATION |
926002176 | 501(C)(6) | Yes | 0 | 0 | |
| (T)
EL PASO COUNTY MEDICAL SOCIETY |
741238007 | 501(C)(6) | Yes | 0 | 0 | |
| (U)
AMERICAN COLLEGE OF RADIOLOGY FOUNDATION |
366125578 | 501(C)(3) | No | 75,000 | 0 | |
| (V)
KENTUCKY FOUNDATION FOR MEDICAL CARE INC |
237181728 | 501(C)(3) | No | 74,590 | 0 | |
| (W)
MEDICAL EDUCATIONAL AND SCIENTIFIC FOUNDATION OF NEW YORK |
112780360 | 501(C)(3) | No | 69,016 | 0 | |
| (X)
MISSISSIPPI STATE MEDICAL ASSOCIATION FOUNDATION |
570906060 | 501(C)(3) | No | 75,000 | 0 | |
| (Y)
PHYSICIAN HEALTH SERVICES |
223234975 | 501(C)(3) | No | 50,000 | 0 | |
| (Z)
UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL |
043167352 | 501(C)(3) | No | 75,000 | 0 | |
| (AA)
UTAH MEDICAL ASSOCIATION FOUNDATION |
876122299 | 501(C)(3) | No | 75,000 | 0 | |
| (AB)
WASHINGTON STATE MEDICAL ASSOCIATION FOUNDATION FOR HEALTH CARE IMPROVEMENT |
916074463 | 501(C)(3) | No | 75,000 | 0 | |
| (AC)
WISCONSIN MEDICAL SOCIETY FOUNDATION |
396045649 | 501(C)(3) | No | 72,300 | 0 | |
| (AD)
THE DANIEL HANLEY CENTER FOR HEALTH LEADERSHIP |
204271488 | 501(C)(3) | No | 75,000 | 0 | |
| (AE)
CONNECTICUT STATE MEDICAL SOCIETY PHEF |
061425205 | 501(C)(3) | No | 58,833 | 0 | |
| (AF)
BRANDEIS UNIVERSITY |
042103552 | 501(C)(3) | No | 102,660 | 0 | |
| (AG)
COLORADO ACADEMY OF FAMILY PHYSICIANS |
841150631 | 501(C)(3) | No | 50,000 | 0 | |
| (AH)
THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL |
566001393 | 501(C)(3) | No | 504,078 | 0 | |
| (AI)
AMERICAN ASSOCIATION OF MEDICAL SOCIETY EXECUTIVES |
362915937 | 501(C)(3) | No | 5,000 | 0 | |
| (AJ)
FOUNDATION OF THE AMERICAN ASSOCIATION OF MEDICAL SOCIETY |
363790660 | 501(C)(3) | No | 10,000 | 0 | |
| (AK)
WISCONSIN MEDICAL SOCIETY FOUNDATION INC |
396045649 | 501(C)(3) | No | 10,000 | 0 | |
Total 37
|
1,456,477 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PAGE 4, PART IV, SECTION A, LINE 1: | AS EXPLAINED IN THE FOUNDATION'S APPLICATION FOR EXEMPTION, THE SUPPORTED ORGANIZATIONS ARE DESIGNATED IN THE GOVERNING DOCUMENTS BY CLASS OR PURPOSE: "TO SUPPORT, BENEFIT OR CARRY OUT THE CHARITABLE PURPOSES OF PUBLICLY SUPPORTED ORGANIZATIONS WHOSE PURPOSES INCLUDE PROMOTING HIGH QUALITY MEDICAL CARE, INCLUDING, WITHOUT LIMITATION, ASSISTING PHYSICIANS AND THE PUBLIC TO IMPROVE THE QUALITY OF CARE RECEIVED BY PATIENTS IN THE EVOLVING HEALTHCARE ENVIRONMENT, IN A MANNER THAT CONSTITUTES CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE CODE." |
| PAGE 4, PART IV, SECTION A, LINE 2: | IN SUPPORT OF ITS APPLICATION FOR EXEMPT STATUS IN 2006, THE FOUNDATION DETERMINED THAT EACH OF ITS NAMED SUPPORTED ORGANIZATIONS WAS DEEMED TO BE DESCRIBED IN SECTION 509(A)(2) BECAUSE ITS MEMBERSHIP DUES CONSTITUTED MORE THAN ONE THIRD OF THEIR SUPPORT AND NO MORE THAN ONE THIRD OF THEIR SUPPORT CAME FROM GROSS INVESTMENT INCOME AND NET UNRELATED BUSINESS TAXABLE INCOME. |
| PAGE 4, PART IV, SECTION A, LINE 3B: | IN ITS RECORDS, THE FOUNDATION MAINTAINS A COPY OF THE DETERMININATION LETTER FOR EACH SUPPORTED ORGANIZATION THAT QUALIFIES UNDER SECTION 501(C)(6) ALONG WITH AN ANNUALLY-UPDATED SCHEDULE DEMONSTRATING THE ORGANIZATION'S COMPLIANCE WITH THE SECTION 509(A)(2) PUBLIC SUPPORT TEST. |
| PAGE 4, PART IV, SECTION A, LINE 3C: | TO ENSURE THAT ITS ASSETS ARE USED FOR CHARITABLE PURPOSES, THE FOUNDATION MAKES GRANTS ONLY TO 501(C)(3) ORGANIZATIONS AND ONLY FOR PROJECTS THAT ARE APPROVED AFTER A RIGOROUS APPLICATION PROCESS. GRANTS ARE MADE SUBJECT TO A WRITTEN AGREEMENT REQUIRING PERIODIC AND FINAL FINANCIAL AND NARRATIVE REPORTS AND PROVIDING THAT THE FOUNDATION MAY WITHHOLD FUTURE PAYMENTS AND DEMAND CORRECTION OF MISUSE OF FUNDS SHOULD THE FOUNDATION DETERMINE FUNDS HAVE NOT BEEN USED FOR APPROVED PURPOSES. |
| PAGE 4, PART IV, SECTION A, LINE 5A: | AS DESCRIBED IN PART IV, NUMBER 3C, THE FOUNDATION MAKES GRANTS TO 501(C)(3) ORGANIZATIONS THAT ARE INCLUDED IN THE CLASS OF ORGANIZATIONS DESIGNATED IN THE GOVERNING DOCUMENTS BY CLASS OR PURPOSE. IN 2014, THE FOUNDATION MADE NEW GRANTS TO 11 ORGANIZATIONS THAT WERE NOT LISTED ON THE 2013 FORM 990. NO PAYMENTS WERE MADE IN 2014 TO 18 ORGANIZATIONS THAT WERE LISTED ON THE 2013 FORM 990 BECAUSE THE GRANT PERIOD ENDED IN 2013. NAMES AND EINS ARE AVAILABLE ON SCHEDULE A, PART VI OF THE 2013 AND 2014 FORM 990S. |
| PAGE 5, PART IV, SECTION B, LINE 2: | IN ADDITION TO MAKING GRANTS TO 501(C)(3) ORGANIZATIONS OPERATED, SUPERVISED OR CONTROLLED BY SUPPORTED ORGANIZATIONS NAMED IN THE ORGANIZING DOCUMENTS, THE FOUNDATION ALSO GIVES GRANTS TO 501(C)(3) ORGANIZATIONS TO CARRY OUT THE FOUNDATION'S CHARITABLE PURPOSES. SEE REV. RUL. 76-401, 1976-2 C.B. 175, WHICH PROVIDES THAT THE GENERAL REQUIREMENTS OF SECTIONS 1.509(A)-4(C), (D) AND (E) OF THE REGULATIONS ARE INAPPLICABLE TO SUPPORTED SECTION 501(C)(6) ORGANIZATIONS FOR PURPOSES OF SATISFYING BOTH THE ORGANIZATIONAL AND OPERATIONAL TESTS OF SECTION 509(A)(3)(A) OF THE INTERNAL REVENUE CODE. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE FOUNDATION HAS CONTRACTS WITH INDEPENDENT CONTRACTORS WHO PROVIDE SERVICES AS CHIEF EXECUTIVE OFFICER (CEO) AND CHIEF OPERATING OFFICER (COO). THE COMPENSATION PAID TO THESE INDIVIDUALS HAS BEEN DISCLOSED ON PAGE 8, PART VII, SECTION B. |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT COPY OF FORM 990 IS REVIEWED BY THE COO WHO DISTRIBUTES A DRAFT COPY OF THE FORM TO EACH BOARD MEMBER FOR COMMENTS PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD REVIEWS THE ANNUAL DISCLOSURES SUBMITTED BY EACH MEMBER. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FOUNDATION'S ANNUAL REPORT IS AVAILABLE IN "PDF" FORMAT VIA THEIR WEBSITE AT WWW.PHYSICIANSFOUNDATION.ORG, INCLUDING MAILING INSTRUCTIONS FOR OBTAINING A COPY OF FORM 990 UPON WRITTEN REQUEST. |
| FORM 990, PART IX, LINE 24E | MEALS AND ENTERTAINMENT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 26,518. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,518. FOREIGN TAX WITHHELD: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 17,937. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,937. DUES AND SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,818. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,818. UNSPENT GRANT FUNDS REFUNDED: PROGRAM SERVICE EXPENSES -36,289. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -36,289. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| Software ID: | |
| Software Version: |