2024-11-14T14:05:49-06:00 2023-12-31 872525370 CITRIN COOPERMAN ADVISORS LLC 30 BRAINTREE HL OFFICE PARK STE 300 BRAINTREE MA 02184 990 2023-01-01 205244339 AMERICAN THROMBOSIS AND HEMOSTASIS NETWORK INC AMER 9145883550 217 MAIN STREET CORNWALL NY 12518 CRYSTAL WATSON PRESIDENT & CEO 9145883550 2024-11-05 1 0 AMANDA ADAMS P00748038 7813562000 2024-11-05 2023 2024-10-15 13:58:12Z X CRYSTAL WATSON 217 MAIN STREET CORNWALL NY 12518 15786032 0 X N/A X 2006 GA THE AMERICAN THROMBOSIS AND HEMOSTASIS NETWORK (ATHN) IS A NONPROFIT ORGANIZATION DEDICATED TO IMPROVING THE LIVES OF PEOPLE AFFECTED BY BLEEDING AND CLOTTING DISORDERS. WE'RE USING TECHNOLOGY TO SECURE DATA, ADVANCE KNOWLEDGE, TRANSFORM CARE--AND ULTIMATELY IMPROVE LIVES. 7 7 55 7 0 0 13465526 12829029 0 0 101383 740677 28311 4193 13595220 13573899 5395276 4715723 0 0 6993690 8029734 0 0 0 2145875 3688164 14534841 16433621 -939621 -2859722 8367265 5433549 3104627 808004 5262638 4625545 X THE AMERICAN THROMBOSIS AND HEMOSTASIS NETWORK (ATHN) IS A NONPROFIT ORGANIZATION DEDICATED TO IMPROVING THE LIVES OF PEOPLE AFFECTED BY BLEEDING AND CLOTTING DISORDERS. WE'RE USING TECHNOLOGY TO SECURE DATA, ADVANCE KNOWLEDGE, TRANSFORM CARE--AND ULTIMATELY IMPROVE LIVES. 0 0 4376851 ATHN SYSTEMS:THIS PROGRAM COMPRISES THE SOFTWARE SYSTEMS AND CAPABILITIES REQUIRED AS A STEWARD OF A SECURE NATIONAL DATABASE USED TO SUPPORT CLINICAL OUTCOMES ANALYSIS, RESEARCH, AND PUBLIC HEALTH WITH REPORTING BY OVER 140 TREATMENT CENTERS, GOVERNMENT ENTITIES, AND RESEARCHERS. 4066902 3510008 COMMUNITY COUNTS CDC PUBLIC HEALTH SURVEILLANCE PROJECT (CDC):THIS FEDERAL PROJECT IS LED BY ATHN IN PARTNERSHIP WITH THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) AND THE U.S. HEMOPHILIA TREATMENT CENTER NETWORK. ITS AIM IS TO COLLECT DATA ON PEOPLE WITH BLEEDING AND CLOTTING DISORDERS AND INCREASE KNOWLEDGE, MONITOR TRENDS, IDENTIFY RISK FACTORS, AND MORE. IN 2020, THE CDC RENEWED ATHN'S 5-YEAR COOPERATIVE AGREEMENT TO CONTINUE THE COMMUNITY COUNTS PROJECT AND:- STRENGTHEN COLLABORATION WITH TREATMENT CENTERS - CONTINUE DATA AND SPECIMEN COLLECTION AND TRANSFER- EVALUATE DATA QUALITY AND IMPROVEMENT- SHARE INFORMATION WITH THE COMMUNITYUSING ATHN SYSTEMS, OVER 453,000 SURVEILLANCE FORMS HAVE BEEN SUBMITTED TO CDC FOR MORE THAN 141,000 UNIQUE PATIENTS. 3536429 1190705 ATHN RESEARCH PROGRAMS:ATHN, IN CONJUNCTION WITH OUR 140+ HEMOPHILIA TREATMENT CENTERS (HTCS) ACROSS THE UNITED STATES, LEADS OR SUPPORTS A NUMBER OF PROGRAMS THAT LEVERAGE OUR STAFF EXPERTISE AND INFRASTRUCTURE.OUR LEADING 2023 RESEARCH PROGRAMS INCLUDE:ATHN TRANSCENDS - THE WORLD'S LARGEST NATURAL HISTORY STUDY OF PEOPLE AFFECTED BY NON-NEOPLASTIC HEMATOLOGIC CONDITIONS, WAS CREATED IN RESPONSE TO THE NATIONAL HEART, LUNG, AND BLOOD INSTITUTE'S (NHLBI) BLUEPRINT FOR FACTOR VIII INHIBITOR CLINICAL TRIALS. WITH THE PRIMARY AIM OF DETERMINING THE SAFETY OF ALL THERAPIES UTILIZED IN THIS POPULATION.ATHN TRANSCENDS PLANS TO ENROLL PARTICIPANTS INTO VARIOUS COHORTS BASED ON DIAGNOSIS. ATHN TRANSCENDS' STUDY ARCHITECTURE IS DESIGNED TO ENCOURAGE THE CREATION OF MODULES EXPLORING SPECIFIC SAFETY AND EFFECTIVENESS ENDPOINTS. IN ADDITION, THE ATHN RESEARCH BIOREPOSITORY, LOCATED AT VERSITI, BLOOD CENTER OF WISCONSIN, WILL STORE BIOSPECIMENS FROM ATHN TRANSCENDS FOR FUTURE RESEARCH.ATHN TRANSCENDS IS ORGANIZED INTO SEVEN (7) COHORTS: 1. HEMOPHILIA 2. VON WILLEBRAND DISEASE 3. THROMBOSIS/THROMBOPHILIA4. NON-NEOPLASTIC HEMATOLOGIC CONDITIONS5. BLEEDING NOT OTHERWISE SPECIFIED (NOS) 6. RARE BLOOD DISORDERS7. CONGENITAL PLATELET DISORDERS 699123 NATIONAL HEMOPHILIA PROGRAM COORDINATING CENTER (NHPCC):THE NHPCC SUPPORTS A COLLABORATIVE AND INTEGRATED NATIONAL INFRASTRUCTURE OF REGIONAL HEMOPHILIA NETWORKS TO PROMOTE ACCESS AND QUALITY OF CARE FOR PEOPLE WITH BLOOD DISORDERS. THE NHPCC IS FUNDED BY A HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) COOPERATIVE AGREEMENT THROUGH ATHN, ITS SPONSORING ORGANIZATION. ATHN RECEIVED A NEW FIVE-YEAR COOPERATIVE AGREEMENT IN JUNE 2022 CARRYING THE PROJECT INTO 2027. THE NHPCC'S QUALITY IMPROVEMENT PROGRAM USES EVIDENCE-BASED PRACTICES TO IMPROVE ACCESS TO CARE, TRANSITION OF CARE, PATIENT ENGAGEMENT, AND MORE. THIS PROGRAM HAS USED RESULTS OF THE FIRST-EVER NATIONAL PATIENT NEEDS ASSESSMENT, COMPLETED BY THE NHPCC, TO PRIORITIZE AND LAUNCH QUALITY IMPROVEMENT INITIATIVES AT HTCS ACROSS THE U.S. 51657 15010 CDC COVID VTE PROGRAM:IN PARTNERSHIP WITH THE ASSOCIATION OF UNIVERSITY CENTERS ON DISABILITIES (AUCD), ATHN PARTICIPATED IN A STUDY NAMED MONITORING OF VENOUS THROMBOEMBOLISMS AMONG NON-HOSPITALIZED COVID-19 SURVIVORS. 704528 ATHN DATA QUALITY COUNTS IS HELPING ATHN AFFILIATES ENRICH THE ATHN DATASET. THE PROMISE OF USING DATA FOR RESEARCH, SURVEILLANCE, AND QUALITY IMPROVEMENT RELIES ON DATA THAT IS COMPLETE AND ACCURATE. ATHN DATA QUALITY COUNTS PROVIDES THE CRITICAL FUNDING NEEDED TO BUILD DATA MANAGEMENT CAPACITY ACROSS THE ATHN AFFILIATE NETWORK AND ENRICH THEATHNDATASET. SINCE OUR INCEPTION, ATHN HAS DISTRIBUTED OVER $8.1M IN DQC GRANTS TO OUR NETWORK OF HTCS. 1455308 15010 13435490 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 26 0 1 55 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL NY GA X MICHAEL NIEKAMP 9145883550 217 MAIN STREET CORNWALL NY 12518 CHRISTOPHER E WALSH MD PHD CHAIR 1.00 X X 0 0 0 TAMARA VOGEL MBA TREASURER 1.00 X X 0 0 0 JIM MUNN RN MS DIRECTOR 1.00 X 0 0 0 ROBERT SIDONIO MD DIRECTOR 1.00 X 6000 0 0 DUC BOBBY TRAN MD MSC DIRECTOR 1.00 X 0 0 0 JENNIFER G DAVILA MD DIRECTOR 1.00 X 0 0 0 TYLER BUCKNER MD MSC DIRECTOR 1.00 X 0 0 0 EDITH ROSATO RPH IOM DIRECTOR 1.00 X 0 0 0 MICHAEL NIEKAMP CHIEF FINANCIAL OFFICER 40.00 X 259392 0 55377 CRYSTAL WATSON PRESIDENT AND CEO 40.00 X 331982 0 60519 TAMMUELLA SINGLETON CHIEF SCIENCE OFFICER 40.00 X 354733 0 2400 MOSES MILES III CHIEF OPERATING OFFICER 40.00 X 294021 0 36376 SRIKANTH SUBRAMANYA SENIOR DIRECTOR, ENGINEERING 40.00 X 167462 0 73650 NABIL DAOUD DIRECTOR, DATA SCIENCE 40.00 X 178254 0 45672 LINDA MAGLIOCCO VP, FINANCE AND ADMINISTRATION 40.00 X 281903 0 68854 TROY VERBRUGGE LEAD SOFTWARE ENGINEER 40.00 X 190458 0 33263 CARRIE O'NEIL DIRECTOR, RESEARCH PROGRAMS 40.00 X 195435 0 29356 2259640 0 405467 30 0 1 0 NATHAN WILLIAM VENN 50 00 PRAHA 5-KOE ZAHRADNKOVA EZ 01220 SYSTEMS & SOFTWARE ENGINEERING 168300 SMITH GAMBRELL & RUSSELL LLP PO BOX 930930 ATLANTA GA 30309 LEGAL FEES 115960 2 4995579 7833450 12829029 119710 119710 2833100 2212133 620967 620967 620967 4193 4193 4193 13573899 0 0 744870 4715723 4715723 1379500 1131190 248310 5500504 3977250 1523254 278427 202777 75650 366808 268982 97826 504495 374099 130396 115960 105184 10776 45883 45883 32979 32979 333135 259224 73911 200686 133684 67002 2310917 2190317 120600 578060 77060 501000 38554 38554 31990 31990 16433621 13435490 2998131 0 681789 605909 1810411 1011954 163603 185772 4410217 4410217 0 0 5711462 3629914 8367265 5433549 642753 658004 2461874 150000 3104627 808004 X 4960916 -1164710 301722 5790255 5262638 4625545 8367265 5433549 X -2859722 -89245 2311874 X 0 1 X 1 1 1 X 11989888 12722348 13254943 13465526 12829029 64261734 11989888 12722348 13254943 13465526 12829029 64261734 13273302 50988432 88367 88549 94766 101383 119710 492775 46786 26978 14831 28311 4193 121099 64875608 0.78590 0.99030 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2019 AMOUNT: $ 46,786. 2020 AMOUNT: $ 26,978. 2021 AMOUNT: $ 14,831. 2022 AMOUNT: $ 28,311. 2023 AMOUNT: $ 4,193. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4410217 4410217 0 0 X 13451675 -89245 -89245 13540920 32979 32979 13573899 16400642 0 16400642 32979 32979 16433621 PART X, LINE 2: ATHN FOLLOWS STANDARDS THAT PROVIDE CLARIFICATIONS ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN ATHN'S FINANCIAL STATEMENTS. THE GUIDANCE PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKESN OR EXPECTED TO BE TAKEN IN A TAX RETURN, AND PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. ATHN'S POLICY IS TO RECOGNIZE INTEREST AND PENALTIES ON UNRECOGNIZED TAX BENEFITS IN INCOME TAX EXPENSE. NO INTEREST AND PENALTIES WERE RECORDED DURING THE YEAR ENDED DECEMBER 31, 2023. AT DECEMBER 31, 2023, THERE ARE NO SIGNIFICANT INCOME TAX UNCERTAINTIES. 1 BLEEDING & CLOTTING DISORDERS INSTITUTE 427 W NORTHMOOR RD PEORIA IL 61614 272050459 501(C)(3) 6600 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT BOSTON CHILDREN'S HOSPITAL 300 LONGWOOD AVE BOSTON MA 02115 042774441 501(C)(3) 251970 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT CENTER FOR INHERITED BLOOD DISORDERS 701 S PARKER SUITE 1000 ORANGE CA 92868 270179192 501(C)(3) 383451 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT CENTRAL MICHIGAN UNIVERSITY 1200 SOUTH FRANKLIN STREET MOUNT PLEASANT MI 48858 386004447 501(C)(3) 19000 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT CHILDREN'S HOSPITAL OF PHILADELPHIA RESEARCH INSTITUTE LOCKBOX1457 PO BOX 8500 PHILADELPHIA PA 191781457 231352166 501(C)(3) 21750 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT CHILDREN'S NATIONAL MEDICAL CENTER 111 MICHIGAN AVE NW STE 5400 WASHINGTON DC 20010 521640403 501(C)(3) 16800 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER 3333 BURNETT AVE ACCT OFFICE MLC 4900 CINCINNATI OH 452293039 310833936 501(C)(3) 6000 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT CONNECTICUT BLEEDING AND CLOTTING DISORDERS CENTER 282 WASHINGTON STREET HARTFORD CT 06106 060646755 501(C)(3) 6650 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT EMORY UNIVERSITY LOCKBOX - WELLS FARGO BANK P O BOX 935084 ATLANTA GA 311935084 580566256 501(C)(3) 40000 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT GREAT LAKES HEMOPHILIA FOUNDATION 638 N 18TH STREET STE108 MILWAUKEE WI 53233 237367636 501(C)(3) 319553 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT HEMOPHILIA FOUNDATION OF MICHIGAN 1921 W MICHIGAN AVE YPSILANTI MI 48197 381905673 501(C)(3) 563123 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT HEMOPHILIA OF GEORGIA 8607 ROBERTS DRIVE SUITE 150 SANDY SPRINGS GA 30350 581175625 501(C)(3) 327934 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT HEMOPHILIA OUTREACH CENTER 2060 BELLEVUE STREET GREEN BAY WI 54311 391858104 501(C)(3) 9050 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT ICAHN SCHOOL OF MEDICINE AT MT SINAI ONE GUSTAVE L LEVY PLACE SPONSORED PROJECTS FINANCE BOX 3500 NEW YORK NY 10029 136171197 501(C)(3) 193857 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT INDIANA HEMOPHILIA & THROMBOSIS CENTER 8326 NAAB ROAD INDIANAPOLIS IN 46260 352047838 501(C)(3) 12350 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT LEHIGH VALLEY HOSPITAL INC PO BOX 4000 2100 MACK BLVD ALLENTOWN PA 181054000 231689692 501(C)(3) 411118 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT MAINE MEDICAL CENTER 100 CAMPUS DRIVE SUITE 103 SCARBOROUGH ME 04074 010238552 501(C)(3) 19050 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT MAYO CLINIC PO BOX 860334 MINNEAPOLIS MN 554860334 416011702 501(C)(3) 5390 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT MICHIGAN STATE UNIVERSITY HANNAH ADM BUILDING 426 AUDITORIUM ROAD ROOM 2 EAST LANSING MI 48824 386005984 501(C)(3) 10400 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT OREGON HEALTH & SCIENCE UNIVERSITY OFFICE OF PROPOSAL AWARD MANAGEMENT P O BOX 3003 PORTLAND OR 972083003 931176109 501(C)(3) 357234 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT ORLANDO HEALTH INC VICKY S AWALT/CORP OFFICE OF RESEARCH OPS 1414 KUHL AVENUE MP131 ORLANDO FL 32806 591726273 501(C)(3) 10000 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT ORTHOPAEDIC HOSPITAL 403 W ADAMS BOULEVARD LOS ANGELES CA 90007 951644604 501(C)(3) 8300 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT PHOENIX CHILDREN'S HOSPITAL FOUNDATION 1919 E THOMAS ROAD 3RD FLOOR PHOENIX AZ 85016 860422559 501(C)(3) 5300 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT REGENTS OF THE UNIVERSITY OF CALIFORNIA 1855 FOLSOM ST SUITE 425 SAN FRANCISCO CA 94103 943067788 501(C)(3) 32400 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT REGENTS OF THE UNIVERSITY OF CALIFORNIA SD UCSD CAMPUS MAIN DEPOSITORY PO BOX 741539 LOS ANGELES CA 900741539 956006144 501(C)(3) 76821 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT REGENTS UNIVERSITY OF MICHIGAN BOX 223131 PITTSBURGH PA 152512131 386006309 501(C)(3) 40500 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT RESEARCH INSTITUTE AT NATIONWIDE CHILDRENS HOSPITAL 700 CHILDRENS DRIVE COLUMBUS OH 43205 316056230 501(C)(3) 52350 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT RHODE ISLAND HOSPITAL HEMOSTASIS AND THROMBOSIS CENTER OFFICE OF RESEARCH GRANTS CONTRACTS 593 EDDY STREET PROVIDENCE RI 02903 050258954 501(C)(3) 6650 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT RUSH UNIVERSITY MEDICAL CENTER 75 REMITTANCE DRIVE SUITE 6807 CHICAGO IL 60675 362174823 501(C)(3) 7950 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT ST JUDE CHILDREN'S RESEARCH HOSPITAL PO BOX 1000 DEPT 949 MEMPHIS TN 381480949 620646012 501(C)(3) 6850 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT THE CHILDREN'S MERCY HOSPITAL 2401 GILLHAM ROAD KANSAS CITY MT 64108 440605373 501(C)(3) 25550 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT THE FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH 350 COMMUNITY DRIVE MANHASSET NY 110303816 112673595 501(C)(3) 21200 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT THE JOHN BOUHASIN CENTER FOR CHILDREN WITH BLEEDING DISORDERS 3700 WEST PINE MALL FUSZ MEMORIAL HALL 3RD FLOOR ST LOUIS MT 63108 430654872 501(C)(3) 12000 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT TULANE UNIVERSITY 1555 POYDRAS STREET SUITE 505 NEW ORLEANS LA 70112 720423889 501(C)(3) 9500 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT UNIVERSITY HOSPITALS CLEVELAND MEDICAL CENTER UH GRANTS DEPT 781686 PO BOX 78000 DETROIT MI 482781686 341567805 501(C)(3) 6300 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT UNIVERSITY OF COLORADO DENVER OFFICE OF GRANTS AND CONTRACTS-F428 PO BOX 910238 DENVER CO 802910238 846000555 501(C)(3) 89950 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT UNIVERSITY OF FLORIDA 033 TIGERT HALL CONTRACTS AND GRANTS PO BOX 113001 GAINESVILLE FL 326113001 596002052 501(C)(3) 7300 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT UNIVERSITY OF IOWA GRANT ACCOUNTING OFFICE 2410 UCC 201 SOUTH CLINTON STREET IOWA CITY IA 522424034 426004813 501(C)(3) 21700 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT UNIVERSITY OF NORTH CAROLINA CHAPEL HILL 104 AIRPORT DRIVE SUITE 2200 CAMPUS BOX 1350 CHAPEL HILL NC 275991350 566001393 501(C)(3) 295861 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT UNIVERSITY OF PENNSYLVANIA KAREN PANCKERI 3451 WALNUT STREET ROOM P-221 PHILADELPHIA PA 191046284 231352685 501(C)(3) 6050 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT UNIVERSITY OF TEXAS HOUSTON 7000 FANNIN ST FL 9 HOUSTON TX 770303870 741761309 501(C)(3) 474956 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT VANDERBILT UNIVERSITY PO BOX 121236 DEPT 1236 DALLAS TX 753121236 352528741 501(C)(3) 15100 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT VERSITI WISCONSIN INC 29779 NETWORK PL CHICAGO IL 606731297 390807235 501(C)(3) 95868 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT WASHINGTON UNIVERSITY 7425 FORSYTH BLVD SAINT LOUIS MT 631052161 430653611 501(C)(3) 28000 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT WEILL CORNELL MEDICINE 1300 YORK AVENUE NEW YORK NY 100654805 131623978 501(C)(3) 59510 0 DATA MANAGEMENT AND RESEARCH PROJECT SUPPORT 45 0 PART I, LINE 2: ATHN HAS A FORMAL PROCESS FOR APPLYING, SELECTING, AWARDING, SUBSTANTIATING THE AMOUNTS OF GRANTS AWARDED AND TRACKING ACHIEVEMENT OF MILESTONES FUNDED BY THE GRANTS. THE ATHN DATA QUALITY COUNTS APPLICATION PROCESS IS AN ONLINE SUBMISSION PROCESS USING A STANDARD APPLICATION TEMPLATE, WITH SPECIFIC FUNDING REQUIREMENTS AND SUBMISSION DEADLINES ANNOUNCED TO ALL ATHN AFFILIATES. PROPOSALS ARE REVIEWED BY A MULTI-DISCIPLINARY GRANT REVIEW PANEL. EACH PROPOSAL IS WEIGHTED BASED ON CRITERIA ESTABLISHED FOR THAT ROUND OF FUNDING AND APPROPRIATENESS OF FINANCIAL REQUEST. UPON SELECTION OF THE SUBSET OF WINNING PROPOSALS, THE PROPOSED AWARDEES AND AMOUNTS OF EACH AWARD ARE REVIEWED BY THE DATA QUALITY COUNTS COMMITTEE FOR REASONABLENESS AND CONSISTENCY WITH BUDGET, AND APPROVED BY THE ATHN BOARD. LETTER AGREEMENTS CONFIRMING THE AWARDED AMOUNT AND REQUIREMENTS ARE PROVIDED AND EXECUTED BY EACH AWARDEE. PAYMENTS ARE ISSUED IN THREE PARTS: $2,500 UPFRONT AND THE REMAINING PAYMENTS MADE EVERY SUBSEQUENT SIX MONTHS UPON SUBMISSION OF INTERIM PROJECT REPORTS AND FINAL PROJECT REPORTS AT A RATE OF $50 OR $100 FOR UPDATING CORE DATA ELEMENTS PER PATIENT. X X X 0 0 0 0 0 0 0 1 0 CRYSTAL WATSON PRESIDENT AND CEO 287675 0 42207 0 2100 0 17515 0 43004 0 392501 0 0 0 TAMMUELLA SINGLETON CHIEF SCIENCE OFFICER 234733 0 120000 0 0 0 0 0 2400 0 357133 0 0 0 LINDA MAGLIOCCO VP, FINANCE AND ADMINISTRATION 223211 0 56592 0 2100 0 15250 0 53604 0 350757 0 0 0 MOSES MILES III CHIEF OPERATING OFFICER 254027 0 36994 0 3000 0 15422 0 20954 0 330397 0 0 0 MICHAEL NIEKAMP CHIEF FINANCIAL OFFICER 223542 0 33750 0 2100 0 14031 0 41346 0 314769 0 0 0 SRIKANTH SUBRAMANYA SENIOR DIRECTOR, ENGINEERING 165362 0 0 0 2100 0 11096 0 62554 0 241112 0 0 0 CARRIE O'NEIL DIRECTOR, RESEARCH PROGRAMS 170805 0 21630 0 3000 0 10428 0 18928 0 224791 0 0 0 NABIL DAOUD DIRECTOR, DATA SCIENCE 156354 0 19800 0 2100 0 9507 0 36165 0 223926 0 0 0 TROY VERBRUGGE LEAD SOFTWARE ENGINEER 164358 0 24000 0 2100 0 10014 0 23249 0 223721 0 0 0 PART I, LINE 7 ATHN STAFF ARE ELIGIBLE FOR ANNUAL BONUSES BASED ON THE ACHIEVMENT OF ANNUAL ORGANIZATIONAL AND INDIVIDUAL GOALS SET AT THE START OF EACH FISCAL YEAR. ANNUAL BONUS PAYMENTS ARE NOT GUARANTEED AND THE PRESIDENT & CEO DETERMINES THE ANNUAL BONUS DISTRIBUTION BASED ON THE ACHIEVEMENTS OF THE ORGANIZATION AND THE PERFORMANCE OF THE INDIVIDUAL STAFF MEMBERS FOLLOWING THE END OF EACH FISCAL YEAR. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS EVALUATES THE OVERALL PERFORMANCE OF THE ORGANIZATION TO DETERMINE THE BONUS FOR THE PRESIDENT. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS EMAILED TO ALL BOARD MEMBERS FOR THEIR REVIEW PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C ATHN REQUIRES ALL BOARD MEMBERS AND OFFICERS TO COMPLETE CONFLICT OF INTEREST STATEMENTS ON A YEARLY BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT/CEO'S COMPENSATION IS REVIEWED BY THE EXECUTIVE COMMITTEE AND APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 ALL REQUIRED PUBLIC DISCLOSURE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST DURING NORMAL BUSINESS HOURS. FORM 990, PART XI, LINE 9: ADJUSTMENT FOR GRANTS TREATED AS DEFERRED REVENUE IN THE PRIOR YEAR 2,311,874.