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 | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 368,547 | 161,103 | 44,009 | 98,007 | 365,398 | 1,037,064 |
| 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 | 5,535,884 | 6,135,184 | 7,466,564 | 8,039,685 | 8,262,860 | 35,440,177 |
| 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 | 5,904,431 | 6,296,287 | 7,510,573 | 8,137,692 | 8,628,258 | 36,477,241 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 36,477,241 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 5,904,431 | 6,296,287 | 7,510,573 | 8,137,692 | 8,628,258 | 36,477,241 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 605,428 | 766,046 | 973,547 | 892,214 | 918,224 | 4,155,459 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 34,714 | 47,624 | 54,420 | 51,675 | 51,615 | 240,048 |
| c | Add lines 10a and 10b. | 640,142 | 813,670 | 1,027,967 | 943,889 | 969,839 | 4,395,507 |
| 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.) .. | 35,846 | 66,258 | 77,101 | 76,797 | 113,957 | 369,959 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 6,580,419 | 7,176,215 | 8,615,641 | 9,158,378 | 9,712,054 | 41,242,707 |
| 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 2024 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-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, 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 2024. 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 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | INCOME FROM ACTIVITIES NOT REGULARLY CARRIED ON |
| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
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| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS: THE CORPORATION SHALL HAVE MEMBERS. THE CHARACTERISTICS, QUALIFICATIONS, RIGHTS, LIMITATIONS AND OBLIGATIONS ATTACHING TO EACH OR ANY CLASS OF MEMBERS SHALL BE DETERMINED BY THE BOARD OF DIRECTORS; PROVIDED, HOWEVER, THAT ONLY TWO (2) CLASSES OF MEMBERS, PROVIDER MEMBERS AND PROSPECTIVE PROVIDER MEMBERS, SHALL HAVE THE RIGHT TO VOTE AND HOLD OFFICE IN THE CORPORATION. MEMBERSHIP CLASSIFICATIONS AND QUALIFICATIONS: THE BOARD OF DIRECTORS SHALL DETERMINE THE CHARACTERISTICS, QUALIFICATIONS, RIGHTS, LIMITATIONS AND OBLIGATIONS ATTACHING TO EACH OR ANY CLASS OF THE MEMBERS. APPLICATION FOR MEMBERSHIP IN THE CORPORATION SHALL BE MADE PURSUANT TO PROCEDURES ESTABLISHED BY THE BOARD OF DIRECTORS. MEMBERSHIP ELIGIBILITY QUALIFICATIONS SHALL BE DETERMINED BY THE BOARD OF DIRECTORS IN ITS SOLE DISCRETION. |
| FORM 990, PART VI, SECTION A, LINE 7A | PROVIDER MEMBERS SHALL BE: (1) ENTITIES THAT OPERATE PACE PROGRAMS UNDER SECTIONS 1894 AND 1934 OF THE SOCIAL SECURITY ACT, (2) ENTITIES THAT OPERATE PACE PROGRAMS UNDER DUAL MEDICARE AND MEDICAID WAIVERS, (3) ORGANIZATIONS OPERATING UNDER DUAL MEDICARE AND MEDICAID CAPITATION THAT PREDOMINANTLY SERVE THE FRAIL ELDERLY, OR (4) PRE-PACE PROGRAMS, OR THOSE ORGANIZATIONS OPERATING UNDER MEDICAID CAPITATION ONLY. PROVIDER MEMBERS MAY BE NOT-FOR-PROFIT CORPORATIONS OPERATING UNDER 501(C)(3) TAX STATUS OR FOR-PROFIT CORPORATIONS. PROVIDER MEMBERS SHALL MAINTAIN A MEMBERSHIP IN THEIR RESPECTIVE NPA-CHARTERED STATE PACE ASSOCIATION (IF ONE IS AVAILABLE IN THEIR STATE). IF A PROVIDER ORGANIZATION IS RELATED TO A PARENT ORGANIZATION THAT HAS MULTIPLE PROVIDER OR PROSPECTIVE PROVIDER ORGANIZATIONS, ALL OF THE ORGANIZATIONS MUST BE A MEMBER IN ORDER FOR ANY ONE OF THE ORGANIZATIONS TO BE A MEMBER. PROVIDER MEMBERS SHALL HAVE THE FOLLOWING RIGHTS AND PRIVILEGES: (1)THE RIGHT TO NOMINATE ONE EMPLOYEE OF ANY CURRENT PROVIDER MEMBER, OR AN EMPLOYEE OF ANY PROVIDER MEMBER'S SPONSORING ORGANIZATION, TO SERVE ON THE CORPORATION'S BOARD OF DIRECTORS; (2)THE RIGHT TO VOTE IN EACH ANNUAL ELECTION TO FILL OPEN SEATS ON THE BOARD OF DIRECTORS, OR VOTE ON ANY MATTER SUBMITTED TO A VOTE OF THE MEMBERS OF THE CORPORATION; (3)THE RIGHT TO HAVE EITHER THE MEDICAL DIRECTOR (OR EQUIVALENT) OR A PRIMARY CARE PROFESSIONAL OF THE PROVIDER MEMBER SERVE ON THE PRIMARY CARE COMMITTEE; (4)THE PRIVILEGE TO HAVE SPECIFIC PERSONS ASSOCIATED WITH THE PROVIDER MEMBER SERVE ON STANDING AND WORKING COMMITTEES OF THE BOARD OF DIRECTORS UPON THE REQUEST OF THE BOARD OF DIRECTORS; AND (5)THE PRIVILEGE TO ACCESS CERTAIN MATERIALS, INCLUDING OFFICIAL PUBLICATIONS AND OTHER DOCUMENTS DISTRIBUTED BY THE CORPORATION, AS WELL AS CONFERENCES OFFERED BY THE CORPORATION. PROSPECTIVE PROVIDER MEMBERS SHALL BE: (1) ENTITIES THAT ARE EVALUATING OR PURSUING PACE DEVELOPMENT, OR (2) ENTITIES THAT ARE COMPLETING OR HAVE SUBMITTED PACE PROVIDER APPLICATIONS. PROSPECTIVE PROVIDER MEMBERS MAY BE NOT-FOR-PROFIT CORPORATIONS OPERATING UNDER 501(C)(3) TAX STATUS OR FOR-PROFIT CORPORATIONS. PROSPECTIVE PROVIDER MEMBERS SHALL MAINTAIN A MEMBERSHIP IN THEIR RESPECTIVE NPA-CHARTERED STATE PACE ASSOCIATION (IF ONE IS AVAILABLE IN THEIR STATE). IF A PROSPECTIVE PROVIDER ORGANIZATION IS RELATED TO A PARENT ORGANIZATION THAT HAS MULTIPLE PROVIDER OR PROSPECTIVE PROVIDER ORGANIZATIONS, ALL OF THE ORGANIZATIONS MUST BE A MEMBER IN ORDER FOR ANY ONE OF THE ORGANIZATIONS TO BE A MEMBER. PROSPECTIVE PROVIDER MEMBERS SHALL HAVE THE FOLLOWING RIGHTS AND PRIVILEGES: (1)THE RIGHT TO NOMINATE ONE EMPLOYEE OF ANY CURRENT PROSPECTIVE PROVIDER MEMBER, OR AN EMPLOYEE OF ANY PROSPECTIVE PROVIDER MEMBER'S SPONSORING ORGANIZATION, TO SERVE ON THE CORPORATION'S BOARD OF DIRECTORS; (2)THE RIGHT TO VOTE IN EACH ANNUAL ELECTION TO FILL OPEN SEATS ON THE BOARD OF DIRECTORS, OR VOTE ON ANY MATTER SUBMITTED TO A VOTE OF THE MEMBERS OF THE CORPORATION; (3)THE PRIVILEGE TO HAVE SPECIFIC PERSONS ASSOCIATED WITH THE PROSPECTIVE PROVIDER MEMBER SERVE ON STANDING AND WORKING COMMITTEES OF THE BOARD OF DIRECTORS UPON THE REQUEST OF THE BOARD OF DIRECTORS; AND (4)THE PRIVILEGE TO ACCESS CERTAIN MATERIALS, INCLUDING OFFICIAL PUBLICATIONS AND OTHER DOCUMENTS DISTRIBUTED BY THE CORPORATION, AS WELL AS CONFERENCES OFFERED BY THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE SENIOR VICE PRESIDENT OF FINANCE AND ADMINISTRATION. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE BOARD OF THE GOVERNING BODY BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | 1. DUTY TO DISCLOSE IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS OR HER FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. 2. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS AFTER DISCLOSURE OF THE FINANCIAL INTEREST, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. 3. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST (A)THE CHAIR OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. (B)AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER NPA CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. (C)IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN NPA'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO NPA AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. 4. VIOLATIONS OF THE CONFLICT OF INTEREST POLICY (A)IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. (B)IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. RECORDS OF PROCEEDINGS THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1. THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. 2. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION HEREWITH. ANNUAL STATEMENTS EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: (A)HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, (B)HAS READ AND UNDERSTANDS THE POLICY, (C)HAS AGREED TO COMPLY WITH THE POLICY, AND (D)UNDERSTANDS THAT NPA IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE EXECUTIVE COMMITTEE OF THE GOVERNING BODY REVIEWED THE PRESIDENT/CEO'S COMPENSATION IN APRIL AS PART OF THE ANNUAL PERFORMANCE EVALUATION PROCESS. A COMPENSATION REVIEW WAS CONDUCTED BY AN INDEPENDENT FIRM WHICH REVIEWED A MARKET ANALYSIS OF SALARIES FOR THIS POSITION. THE COMPENSATION REVIEW WAS PROVIDED TO THE EXECUTIVE COMMITTEE AS PART OF THEIR DETERMINATION PROCESS. AT THE CONCLUSION OF THE PROCESS A SALARY DETERMINATION WAS MADE BY THE EXECUTIVE COMMITTEE, DOCUMENTED IN COMPLIANCE WITH THE ORGANIZATION'S POLICIES, AND PROVIDED TO THE FINANCE DEPARTMENT FOR INCLUSION IN THE NEXT PAY CYCLE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
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| Software Version: |