2023-08-28T14:54:04-05:00 2022-12-31 135565207 KPMG LLP 200 EAST RANDOLPH DRIVE SUITE 5500 CHICAGO IL 606016436 990 2022-01-01 272552683 THE MIDWEST ALLIANCE FOR PATIENT SAFETY MIDW 6302765400 1151 E WARRENVILLE RD PO BOX 3015 NAPERVILLE IL 60563 TERRI ALLEN TREASURER 6302765400 2023-08-28 1 TERRI ALLEN XXX-XX-XXXX 0 ZELJKO POPOVIC P01795951 3126651000 2023-08-21 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ARTHUR J WILHELMI 1151 E WARRENVILLE RD PO BOX 3015 NAPERVILLE IL 60563 745475 0 X N/A X 2010 IL THE MIDWEST ALLIANCE FOR PATIENT SAFETY FOCUSES ITS EFFORTS ON IMPROVING PATIENT SAFETY AND REDUCING HARM IN HEALTH CARE. 5 4 2 4 0 0 11420 0 726900 740936 0 4539 0 0 738320 745475 0 0 0 0 212091 231481 0 0 0 421823 472406 633914 703887 104406 41588 416849 462422 607232 611217 -190383 -148795 OPERATION OF A FEDERALLY CERTIFIED PATIENT SAFETY ORGANIZATION TO PROMOTE THE ADOPTION OF BEST PRACTICES TO IMPROVE THE DELIVERY OF SAFE AND QUALITY CARE TO PATIENTS. 0 0 652577 740936 OPERATION OF A FEDERALLY CERTIFIED PATIENT SAFETY ORGANIZATION TO PROMOTE THE ADOPTION OF BEST PRACTICES TO IMPROVE THE DELIVERY OF SAFE AND QUALITY CARE TO PATIENTS. 652577 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 2 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 4 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X TERRI L ALLEN 6302765400 1151 EAST WARRENVILLE ROAD NAPERVILLE IL 60563 X ARTHUR J WILHELMI CHAIRMAN/DIRECTOR 1.25 38.75 X X 0 1305773 211165 KUMAR NATHAN MD BOARD MEMBER 1.25 0.00 X 0 0 0 RACHEL PRATHER RN BOARD MEMBER 1.25 0.00 X 0 0 0 LORI WIEGAND DNP BOARD MEMBER 1.25 0.00 X 0 0 0 BRIAN STEIN BOARD MEMBER 1.25 0.00 X 0 0 0 TERRI L ALLEN TREASURER 2.00 38.00 X 0 386373 41148 HELGA BRAKE PRESIDENT 3.00 37.00 X 0 259634 38194 KAREN HARRIS SECRETARY 2.00 38.00 X 0 433734 39430 CARRIE PINASCO DIRECTOR 40.00 0.00 X 0 126689 24142 0 2512203 354079 0 0 1 0 0 MEMBERSHIP FEES 561499 740936 740936 740936 4539 4539 745475 740936 0 4539 185440 185440 13417 13417 18610 18610 14014 14014 194149 194149 11310 11310 2459 2459 366 366 169922 169922 12 12 19768 19768 22717 22717 BAD DEBT 40000 40000 MEMBERSHIP FEES 5285 5285 BANK FEES 4687 4687 GIFTS 780 780 951 951 703887 652577 51310 0 0 0 0 0 0 0 84640 191077 0 0 0 0 0 0 0 0 5000 25916 0 0 0 0 0 0 0 0 0 0 0 0 327209 245429 416849 462422 26015 41055 581217 570162 607232 611217 X -190383 -148795 -190383 -148795 416849 462422 41588 0 X 0 1 X 1 0 X X 1 ILLINOIS HEALTH AND HOSPITAL ASSOCIATION 362352486 10 0 652577 0 1 652577 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART IV LINE 1 WHILE THE MIDWEST ALLIANCE FOR PATIENT SAFETY'S (MAPS) ARTICLES OF INCORPORATION DO NOT SPECIFY ILLINOIS HEALTH AND HOSPITAL ASSOCIATION (IHA) BY NAME AS ITS SUPPORTED ORGANIZATION, MAPS ACTIVITIES SUPPORT ITS CHARITABLE PURPOSE OF IMPROVING, SUSTAINING AND PROTECTING PATIENT SAFETY AND HEALTHCARE DELIVERY, WHICH IS WITHIN THE MISSION OF IHA TO ADVOCATE FOR HOSPITALS AND HEALTH SYSTEMS AND TO PROMOTE HEALTHCARE COMMUNITIES. FURTHER, IHA AND MAPS SHARE A CONTINUING AND HISTORICAL RELATIONSHIP, IN THAT IHA PARTICIPATED IN THE FORMATION OF MAPS, BECAME THE SOLE MEMBER OF MAPS IN 2014 AND HAS CONTROLLED APPOINTMENTS TO THE MAPS BOARD AND SET ITS STRATEGIC AND OPERATIONAL PRIORITIES. PART IV LINE 3B TREAS. REG. 1.509(A)-4(K)(1) PROVIDES, IN PERTINENT PART, THAT FOR PURPOSES OF IRC 509(A)(3), AN ORGANIZATION WHICH IS OPERATED IN CONJUNCTION WITH AN ORGANIZATION DESCRIBED IN IRC 501(C)(6) SHALL, IF IT OTHERWISE MEETS THE REQUIREMENTS OF IRC 509(A)(3), BE CONSIDERED AN ORGANIZATION DESCRIBED IN IRC 509(A)(3) IF SUCH IRC 501(C)(6) ORGANIZATION WOULD BE DESCRIBED IN IRC 509(A)(2) IF IT WERE AN ORGANIZATION DESCRIBED IN IRC 501(C)(3). THE IRC 501(C)(6) ORGANIZATION, WHICH THE SUPPORTING ORGANIZATION IS OPERATING IN CONJUNCTION WITH, MUST THEREFORE MEET THE ONE-THIRD TESTS OF A PUBLICLY SUPPORTED ORGANIZATION SET FORTH IN IRC 509(A)(2). MAPS PROVIDES SUPPORT TO IHA, AN IRC 501(C)(6) ORGANIZATION. MAPS IS OPERATED, SUPERVISED AND CONTROLLED BY IHA AND AS A RESULT OF THIS RELATIONSHIP, MAPS WAS ABLE TO CONFIRM THAT IHA MET THE IRC 509(A)(2) TEST IN 2022. THIS CALCULATION IS PERFORMED ON A YEARLY BASIS TO CONFIRM THAT IHA RECEIVES AT LEAST 33 1/3 PERCENT OF PUBLIC SUPPORT. PART IV LINE 3C MAPS IS OPERATED, SUPERVISED AND CONTROLLED BY IHA. TREAS. REGS. 1.509(A)-4(E) STATES THAT A SUPPORTING ORGANIZATION WILL BE REGARDED AS "OPERATED EXCLUSIVELY" TO SUPPORT ONE OR MORE SPECIFIED PUBLICLY SUPPORTED ORGANIZATIONS ONLY IF IT ENGAGES SOLELY IN ACTIVITIES WHICH SUPPORT OR BENEFIT THE SPECIFIED PUBLICLY SUPPORTED ORGANIZATIONS. MAPS SUPPORT TO IHA CONSISTS OF EDUCATING PROVIDERS TO IMPROVE PATIENT SAFETY AND REDUCE HARM AND PROVIDING A MECHANISM FOR REPORTING SAFETY ISSUES UNDER A GOVERNMENT PROGRAM. THESE ACTIVITIES HELP TO SUPPORT IHA'S STATED MISSION TO ADVOCATE FOR AND SUPPORT HOSPITAL OPERATIONS FOR THE SUPPORT OF HEALTHIER COMMUNITIES. THEREFORE, IT IS ABLE TO CONFIRM THAT THE SUPPORT PROVIDED TO IHA WAS USED EXCLUSIVELY FOR IRC 170(C)(2)(B) PURPOSES. 0 RECEIVABLE FROM RELATED ENTITY 245429 245429 X PART X, LINE 2: THE MIDWEST ALLIANCE FOR PATIENT SAFETY (MAPS) HAS RECEIVED A FAVORABLE DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) STATING THAT IT IS EXEMPT FROM TAXATION ON INCOME RELATED TO THEIR EXEMPT PURPOSES UNDER SECTION 501(A) OF THE CODE AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3). AS AN EXEMPT ORGANIZATION, MAPS IS SUBJECT TO FEDERAL AND STATE INCOME TAXES ON INCOME DETERMINED TO BE UNRELATED BUSINESS TAXABLE INCOME. MAPS ACCOUNTS FOR INCOME TAXES USING THE PROVISIONS OF ASC TOPIC 740. UNDER ASC TOPIC 740, DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THEIR RESPECTIVE TAX BASES, OPERATING LOSS, AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES AND LAWS EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT ON DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN INCOME IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. A VALUATION ALLOWANCE IS PROVIDED WHEN IT IS MORE LIKELY THAN NOT THAT SOME PORTION OF DEFERRED TAX ASSETS WILL NOT BE REALIZED. AS OF DECEMBER 31, 2022 AND 2021, MAPS DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS. 0 1 0 0 0 0 0 0 0 ARTHUR J WILHELMI CHAIRMAN/DIRECTOR 0 975413 0 307165 0 23195 0 174209 0 36956 0 1516938 0 242521 KAREN HARRIS SECRETARY 0 342998 0 68166 0 22570 0 24965 0 14465 0 473164 0 0 TERRI L ALLEN TREASURER 0 320639 0 41670 0 24064 0 25925 0 15223 0 427521 0 0 HELGA BRAKE PRESIDENT 0 227733 0 28337 0 3564 0 22004 0 16190 0 297828 0 0 CARRIE PINASCO DIRECTOR 0 119258 0 4917 0 2514 0 10831 0 13311 0 150831 0 0 PART I, LINE 4B FORM 990, SCH J, PART I, LINE 4B THE FOLLOWING AMOUNTS WERE CONTRIBUTED TO A NONQUALIFIED RETIREMENT PLAN: AJ WILHELMI: $148,284 THE FOLLOWING AMOUNTS WERE DISTRIBUTED DURING THE YEAR FROM THE NONQUALIFIED RETIREMENT PLAN (CODA): AJ WILHELMI: $242,521 FORM 990, SCHEDULE J, PART II ALL COMPENSATION LISTED IN SCHEDULE J, PART II IS FROM THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION. NO TRUSTEE RECEIVED COMPENSATION FROM THE FILING ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 2 ILLINOIS HEALTH AND HOSPITAL ASSOCIATION, A RELATED ENTITY, IS THE EMPLOYER OF THE FOLLOWING OFFICERS AND DIRECTORS OF THE ENTITY: TERRI ALLEN, HELGA BRAKE, KAREN HARRIS, AND A.J. WILHELMI. THE ENTITY'S BOARD IS COMPRISED OF INDIVIDUALS WHO ARE NOT EMPLOYED BY THE ENTITY, BUT WHO ARE EMPLOYED BY AND/OR HOLD A BOARD AND/OR OFFICER POSITION WITH AN ILLINOIS HOSPITAL THAT CONDUCTS A TRANSACTION(S) WITH THE HOSPITAL'S BUSINESS ON THE SAME TERMS AS ARE GENERALLY OFFERED TO OTHER MEMBERS OF THE ENTITY'S PARENT, IHA. THE ENTITY'S BOARD IS COMPRISED OF INDIVIDUALS WHO ARE ALSO ON THE BOARD(S) OR AN OFFICER OF ONE OR MORE RELATED ORGANIZATIONS: A.J. WILHELMI. THE ENTITY'S FOLLOWING OFFICERS ARE INDIVIDUALS WHO ARE ALSO ON THE BOARD(S) OR AN OFFICER OF ONE OR MORE RELATED ORGANIZATIONS: TERRI ALLEN, HELGA BRAKE, KAREN HARRIS, AND A.J. WILHELMI. FORM 990, PART VI, SECTION A, LINE 6 THE MIDWEST ALLIANCE FOR PATIENT SAFETY HAS ONE MEMBER, THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION (IHA). FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER HAS THE POWER TO APPOINT ALL DIRECTORS OF THE ORGANIZATION AND THE POWER TO REMOVE OFFICERS AND DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER SHALL INITIATE AND APPROVE THE FOLLOWING: A. APPROVE ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS; B. APPOINT AND REMOVE THE DIRECTORS OF THE CORPORATION; C. TAKE ACTION WITH REGARD TO EACH ANNUAL OPERATING AND CAPITAL BUDGET OF THE CORPORATION BEFORE EXPENDITURES MAY BE MADE FROM THE OPERATING AND CAPITAL BUDGET; D. APPROVE EACH LONG-RANGE PLAN OF THE CORPORATION BEFORE EXPENDITURES MAY BE MADE; E. APPROVE ANY INDEBTEDNESS OF THE CORPORATION WHICH WAS NOT INCLUDED IN AN ANNUAL BUDGET AND WHICH EXCEEDS 10% OF THE APPROVED BUDGET, F. APPROVE ANY EXPENDITURE OR INVESTMENT OF THE CORPORATION WHICH EXCEEDS 10% OF THE APPROVED BUDGET; G. APPROVE ANY PLAN OF MERGER OR CONSOLIDATION, H. APPROVE A VOLUNTARY PARTIAL OR TOTAL DISSOLUTION OF THE CORPORATION, I. APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION, J. APPROVE THE CREATION OF CONTROLLED OR OWNED SUBSIDIARIES OR AFFILIATES BY THE CORPORATION, K. APPROVE, INITIATE, OR IMPLEMENT THE SELECTION OR USE OF AUDITORS AND/OR LEGAL COUNSEL, ACCOUNTING POLICIES, AND COMPENSATION POLICIES, L. ESTABLISH COMPENSATION, IF ANY, OF DIRECTORS AND OFFICERS FOR SERVICES TO THE CORPORATION AS DIRECTORS AND OFFICERS, IRRESPECTIVE OF ANY PERSONAL INTEREST. FORM 990, PART VI, SECTION B, LINE 11B WITH ASSISTANCE FROM THE LEGAL DEPARTMENT OF IHA, THE INFORMATION NEEDED TO PREPARE THE MIDWEST ALLIANCE FOR PATIENT SAFETY'S (MAPS) FORM 990 IS PREPARED BY THE FINANCE STAFF OF THE MAPS PARENT, ILLINOIS HOSPITAL ASSOCIATION (IHA). THE FORM IS THEN PREPARED AND REVIEWED BY THE ASSOCIATION'S OUTSIDE TAX ADVISORS, KPMG. AFTER KPMG REVIEW, THE FORM IS THE FURTHER REVIEWED BY THE ASSOCIATION'S CHIEF ACCOUNTING OFFICER. EACH BOARD MEMBER RECEIVES A COPY OF THE FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST DISCLOSURE FORMS ARE REVIEWED, COMPLETED AND SIGNED BY BOARD MEMBERS AND OFFICERS OF THE ENTITY. THESE ARE REVIEWED BY HUMAN RESOURCES STAFF AND SENIOR MANAGEMENT. WHEN A DIRECTOR OR OFFICER IS AWARE OF A CONFLICT OR POTENTIAL CONFLICT OF INTEREST FOR HIMSELF/HERSELF OR A FAMILY MEMBER, THE DIRECTOR OR OFFICER MUST DISCLOSE IT TO THE BOARD OR THE COMPLIANCE OFFICER OF ILLINOIS HEALTH AND HOSPITAL ASSOCIATION. AFTER DISCLOSURE OF A POTENTIAL CONFLICT OF INTEREST, THE REMAINING BOARD MEMBERS OR OFFICERS, AS THE CASE MAY BE, WOULD DECIDE IF A CONFLICT EXISTS. IF A CONFLICT IS DEEMED TO EXIST, THAT BOARD MEMBER OR OFFICER, AS THE CASE MAY BE, IS NOT ALLOWED TO VOTE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 FORM 990 PART VI SECTION B LINE 15A A COMPENSATION COMMITTEE, COMPRISED OF THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES, IS RESPONSIBLE FOR REVIEWING AND APPROVING THE COMPENSATION OF THE CEO, OTHER OFFICERS AND KEY EMPLOYEES. AN INDEPENDENT COMPENSATION CONSULTANT, AS WELL AS COMPENSATION STUDIES OF OTHER SIMILAR ORGANIZATIONS ARE UTILIZED IN THE PROCESS. THE COMPENSATION COMMITTEE DOCUMENTS ALL COMPENSATION DECISIONS ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 THE MIDWEST ALLIANCE FOR PATIENT SAFETY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART VII THE HIGHEST COMPENSATED EMPLOYEE (HCE) LISTED ON PART VII DEDICATES 100% OF THEIR TIME TO MAPS, BUT ARE CONSIDERED EMPLOYEES OF IHA WHO THE HCE REPORTS TO, WHO DIRECTS THE HCE'S DAY TO DAY ACTIVITIES, AND WHO SETS THE HCE'S COMPENSATION AND BENEFITS. ILLINOIS HEALTH AND HOSPITAL ASSOCIATION 1151 EAST WARRENVILLE ROAD NAPERVILLE IL 60563 362352486 TRADE ASSOC. IL 501 (C) (6) N/A 0 ILLINOIS HOSP RESEARCH & EDUC FOUND 1151 EAST WARRENVILLE ROAD NAPERVILLE IL 60563 237421930 EDUC/RESEARCH IL 501 (C) (3) SCH A LN 7 IHA 0 MCHC - CHICAGO HOSPITAL COUNCIL 1151 EAST WARRENVILLE ROAD NAPERVILLE IL 60563 362167008 HEALTHCARE SPT. IL 501 (C) (3) SCH A LN 10 IHA 0 ASSOCIATION VENTURE CORPORATION 1151 EAST WARRENVILLE ROAD NAPPERVILLE IL 60563 363507989 HOLDING COMPANY IL IHA C 0 ASSOCIATION MANAGEMENT RESOURCES 1151 EAST WARRENVILLE ROAD NAPERVILLE IL 60563 363063484 PURCH PRG & DATA IL AVC C 0 ILLINOIS RISK MANAGEMENT SERVICES 1151 EAST WARRENVILLE ROAD NAPERVILLE IL 60563 363100207 CLAIMS RISK MGT. IL AVC C 0 MEDICAL ALLIANCE INSURANCE COMPANY 1151 EAST WARRENVILLE ROAD NAPERVILLE IL 60563 320097644 PHYS PL INSURANCE IL AVC C 0 MCHC - SERVICE CORPORATION 1151 EAST WARRENVILLE ROAD NAPERVILLE IL 60563 363404171 HEALTHCARE SUPPORT IL AVC C 0 IHA HUMAN CAPITAL SERVICES INC 1151 EAST WARRENVILLE ROAD NAPERVILLE IL 60563 320541199 CONSULTING IL AVC C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0