Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (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 | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 636,198 | 905,360 | 1,284,280 | 1,350,401 | 2,603,712 | 6,779,951 |
| 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 | 618,042 | 1,555,461 | 2,863,783 | 3,364,243 | 4,161,829 | 12,563,358 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 343,286 | 66,193 | 409,479 | |||
| 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 | 1,597,526 | 2,527,014 | 4,148,063 | 4,714,644 | 6,765,541 | 19,752,788 |
| 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.) | 19,752,788 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 1,597,526 | 2,527,014 | 4,148,063 | 4,714,644 | 6,765,541 | 19,752,788 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 73 | 284 | 14,261 | 2,182 | 55,672 | 72,472 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 73 | 284 | 14,261 | 2,182 | 55,672 | 72,472 |
| 11 | Net income from unrelated business activities not included on 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.) .. | 81,257 | 932 | 173 | 5,917 | 138,036 | 226,315 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 1,678,856 | 2,528,230 | 4,162,497 | 4,722,743 | 6,959,249 | 20,051,575 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 0.015 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 0.035 | 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 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART III, LINE 12 | 226,315 |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | ADVANCING THE FIELD OF LIFESTYLE MEDICINE THROUGH RESEARCH, ADVOCACY, PARTNERSHIPS, AND, FOREMOST, THROUGH FILLING THE GAPING VOID OF LIFESTYLE MEDICINE, INCLUDING USING FOOD AS MEDICINE, IN MEDICAL EDUCATION, FROM UME AND GME TO CME, WHILE ALSO SUPPORTING INTEGRATION OF LIFESTYLE MEDICINE INTO CLINICAL PRACTICE FOR THE BENEFIT OF PROVIDERS AND ALL PATIENTS. |
| FORM 990, PAGE 2, PART III, LINE 4A | MAJOR STRIDES TOWARD FILLING THE GAPING VOID OF LIFESTYLE MEDICINE IN MEDICAL EDUCATION ACROSS THE CONTINUUM IS ACLM'S FOREMOST ACHIEVEMENT, FROM UNDERGRADUATE MEDICAL EDUCATION (UME) AND GRADUATE MEDICAL EDUCATION (GME), THROUGH CONTINUING MEDICAL EDUCATION (CME). THIS INCLUDES MAKING AVAILABLE AS A COMPLIMENTARY RESOURCE THE LIFESTLEMEDICINE 101 CURRICULUM AND THE CULINARY MEDICINE CURRICULUM, WITH THESE COMPREHENSIVE COURSES DOWNLOADED THOUSANDS OF TIMES BY PHYSICIANS, MEDICAL PROFESSIONALS AND EDUCATORS. THE LIFESTYLE MEDICINE RESIDENCY CURRICULUM, IN ONLY ITS SECOND YEAR, IS LICENSED INTO MORE THAN 80 RESIDENCY PROGRAMS, A NUMBER EXPECTED TO DOUBLE IN THE COMING YEAR. ACLM NOW SUPPORTS LIFESTYLE MEDICINE INTEREST GROUPS ON MORE THAN 60 (AND GROWING) CAMPUSES ACROSS THE COUNTRY. THIS YEAR SAW PUBLICATION OF WHITE PAPERS ON ADVANCING LIFESTYLE MEDICINE ACROSS THE MEDICAL EDUCATION CONTINUUM, INCLUDING ONE ENTITLED UNDERGRADUATE MEDICAL EDUCATION: LIFESTYLE MEDICINE CURRICULUM IMPLEMENTATION STANDARDS. |
| FORM 990, PAGE 2, PART III, LINE 4B | WHILE TRANSFORMING UME AND GME IS VITAL, A FOCUS ON CME IS ESSENTIAL IN ORDER TO REACH THE MILLIONS OF ALREADY PRACTICING MEDICAL PROFESSIONALS. THE TSUNAMI OF CHRONIC DISEASE IN OUR COUNTRY BEGS FOR A LIFESTYLE MEDICINE-FIRST APPROACH TO HEALTHCARE-ONE FOCUSED ON TREATING ROOT CAUSES OF DISEASE. THIS IS ACLM'S MISSION, NOW OFFERING MORE THAN 100 HOURS OF CME-ACCREDITED CONTENT THROUGH ITS LMS. NEW COURSES INTRODUCED THIS YEAR INCLUDE THE MULTI-MODULE FOOD AS MEDICINE FOR MEDICAL PROFESSIONALS COURSE AND, TO ADDRESS THE EPIDEMIC OF PHYSICIAN AND PROVIDER BURNOUT, THE PHYSICIAN AND HEALTH PROFESSIONAL WELL-BEING COURSE AND COMPANION WORKSHOP. OTHER COURSES HELPING TO FILL THE EDUCATION GAP INCLUDE REVERSING TYPE 2 DIABETES AND INSULIN RESISTANCE WITH LIFESYTLE MEDICINE AND THE FOUNDATIONS OF LIFESYTLE MEDICINE BOARD REVIEW COURSE, USED AS THE PRIMARY PREPARATORY MATERIAL FOR THE AMERICAN BOARD OF LIFESTYLE MEDICINE (ABLM) CERTIFICATION EXAM. DUE TO COVID-19, ACLM'S LM2021 CONFERENCE WAS SUCCESSFULLY PRODUCED AS A VIRTUAL EVENT IN 2021, BRINGING EXCEPTIONAL CME-ACCREDITED CONTENT TO 2,500 REGISTRANTS. |
| FORM 990, PAGE 2, PART III, LINE 4C | COVID-19 HAS SHONE A BRIGHT LIGHT ON THE URGENT NEED TO ADDRESS THE UNDERLYING CONDITIONS THAT EXACERBATED THE VIRUS' MOST HARMFUL EFFECTS, AND THE DISPROPORTIONATE IMPACT ON OUR UNDERSERVED COMMUNITIES. THROUGH ACLM'S HEALTH EQUITY ACHIEVED THROUGH LIFESTYLE MEDICINE (HEAL) INITIATIVE, THE HEAL SCHOLARSHIP FUND WAS ESTABLISHED TO AWARD TRAINING AND CERTIFICATION SCHOLARSHIPS TO UNDERREPRESENTED IN MEDICINE CLINICIANS ON THE FRONT LINES OF DELIVERING CARE IN THEIR COMMUNITIES. THE HEAL INITIATIVE IS ACTIVELY WORKING ON OUTREACH TO OUR NATION'S HBCUS AND ENGAGING IN COMMUNITY CONVERSATIONS TO EDUCATE, EQUIP AND EMPOWER PROVIDERS AND THOSE THEY SERVE ABOUT THE ROLE LIFESTYLE PLAYS IN PROTECTING HEALTH AND FIGHTING DISEASE THROUGH EVIDENCE-BASED THERAPEUTIC LIFESTYLE INTERVENTION, INCLUDING A WHOLE FOOD, PLANT-PREDOMINANT EATING PATTERN, REGULAR PHYSICAL ACTIVITY, STRESS MANAGEMENT, RESTORATIVE SLEEP, AVOIDANCE OF RISKY SUBSTANCES, AND POSITIVE SOCIAL CONNECTION WITH MEANING AND PURPOSE. |
| FORM 990, PAGE 2, PART III, LINE 4D | ACLM IS MAKING TREMENDOUS STRIDES IN SUPPORTING ITS MORE THAN 7,000 MEMBERS. IN RESEARCH, ADVOCACY, PRACTICE ADVANCEMENT, COMMUNICATIONS, PARTNERSHIPS AND MEMBERSHIP SUPPORT, THIS HAS INCLUDED THE ESTABLISHMENT THIS YEAR OF THE HEALTH SYSTEMS COUNCIL, AS WELL AS RESEARCH PUBLICATIONS, AND WHAT WILL BE A JANUARY 2022 PUBLICATION OF A 120-PAGE SUPPLEMENT IN THE JOURNAL OF FAMILY PRACTICE ENTITLED A FAMILY PHYSICIAN'S INTRODUCTION TO LIFESTYLE MEDICINE. CONTINUED DEVELOPMENT OF A WIDE ARRAY OF BOTH PROVIDER RESOURCES AND PATIENT-FACING EDUCATIONAL RESOURCES HAVE THIS YEAR INCLUDED THE REIMBURSEMENT ROADMAP, PEDIATRIC TOOLKIT, SHARED MEDICAL APPOINTMENT TOOLKIT, WOMEN'S HEALTH ROADMAP, AND FOODASMED.ORG SERVING TO CURATE AND MAKE AVAILABLE ACLM'S FOOD AS MEDICINE-RELATED RESOURCES AND COURSE OFFERINGS. WITH NEARLY TWO DOZEN MEMBER INTEREST GROUPS, AS WELL AS STANDING COMMITTEES AND TASK FORCES, ACLM MEMBER ENGAGEMENT IS SERVING AS THE TIP OF THE SPEAR TO TRANSFORM OUR NATION'S HEALTHCARE SYSTEM FROM ONE OF DISEASE MANAGEMENT TO ONE OF HEALTH RESTORATION. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE BOARD OF DIRECTORS REVIEWS THE TAX RETURN BEFORE IT IS SUBMITTED TO THE INTERNAL REVENUE SERVICE. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE AMERICAN COLLEGE OF LIFESTYLE MEDICINE HAS A CONFLICT OF INTEREST POLICY IN PLACE AND COVERS ALL DIRECTORS, OFFICERS, AGENTS AND EMPLOYEES OF THE ORGANIZATION. IN SHORT, A CONFLICT OF INTEREST WOULD ARISE WHEN ANY OF THE ABOVE HAS COMPETING LOYALTIES BY VIRTUE OF THE PERSON'S ROLE IN THE ORGANIZATION AND ANY DUALITY WITH OTHER BUSINESSES OR ORGANIZATIONS. IF A CONFLICT OF INTEREST IS DISCOVERED OR DISCLOSED, THE AFFECTED MEMBER IS NOT ALLOWED TO PARTICIPATE IN THE DISCUSSION OR VOTING ON THE ISSUE IN CONFLICT AND THAT MEMBER'S ATTENDANCE AT ANY MEETING UPON WHICH ACTION IS TAKEN IS NOT COUNTED TOWARDS DETERMINING A QUORUM. |
| FORM 990, PAGE 6, PART VI, LINE 15A | BASE SALARY - WILL BE REVIEWED ANNUALLY BY THE EXECUTIVE COMMITTEE AND MAY BE INCREASED BEYOND THE COST-OF-LIVING ADJUSTMENT IN THE DISCRETION OF THE EXECUTIVE COMMITTEE BASED UPON EXTRAORDINARY PERFORMANCE OF THE EXECUTIVE. THIS BASE SALARY SHALL BE PRORATED FOR ANY PARTIAL YEAR OF THE EXECUTIVES EMPLOYMENT HEREUNDER. BONUS - THE EXECUTIVE SHALL BE ELIGIBLE TO RECEIVE AN ANNUAL BONUS BASED UPON EXTRAORDINARY PERFORMANCE AGAINST A PLAN TO BE MUTUALLY AGREED UPON BY THE EXECUTIVE COMMITTEE AND THE EXECUTIVE FROM TIME TO TIME. EACH BONUS SHALL CORRESPOND TO THE CALENDAR YEAR AND SHALL BE PAID TO THE EXECUTIVE IN ONE LUMP SUM, SUBJECT TO DEDUCTIONS AND WITHHOLDING, DURING THE FIRST MONTH OF THE FOLLOWING CALENDAR YEAR. THE BONUS IS NOT ALLOWED TO EXCEED 20% OF THE BASE SALARY. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION DOES NOT MAKE PUBLIC ITS FINANCIAL STATEMENTS OR GOVERNING DOCUMENTS. |
| Software ID: | |
| Software Version: |